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Year 2 Exam 2 > chemotherapy > Flashcards

chemotherapy Flashcards

1
Q

curative treatment

A

aggressive

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2
Q

neoadjuvant treatment

A

given before surgery to reduce tumour size

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3
Q

adjuvant treatment

A

given after surgery or with radiotherapy to clean up

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4
Q

palliative treatment

A

given to prolong life and comfortability

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5
Q

concomitant treatment

A

drugs given alongside radiotherapy

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6
Q

cytotoxic chemotherapy

A

acts on all cells, majority of cancer drugs targeting nucleic acids

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7
Q

combination therapy

A

targets multiple pathways and reduces toxicity of one class - reduced drug resistance

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8
Q

hormone therapy

A

removes or blocks hormones that the tumour requires to grow

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9
Q

monoclonal antibodies

A

trastumozab targets HER2 which is sometimes overexpressed in cancer cells

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10
Q

antibody-drug conjugates

A

antibody attached to very cytotoxic drug so it is taken straight to the tumour

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11
Q

gastrointestinal side effects of chemotherapy

A

mucositis - sore, ulcerated mouth/throat, changes in taste/appetite, constipation, diarrhoea, nausea,

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12
Q

mucositis treatment and prevention

A

analgesics, ice, anti- fungal, good oral hygiene, avoiding floss/alcohol and spicy foods

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13
Q

constipation treatment and prevention

A

fluids, high fibre diet, laxatives and dose reviews

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14
Q

diarrhoea treatment and prevention

A

small frequent meals, hydration, antibiotics if >24 hr
- delayed (24hr after chemo) loperamide & ciprofloxacin 250 bd 7/7 if >24 hr
- anticholinergic (+ sweating) = subcut atropine

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15
Q

nausea and vomiting risk factors

A

females, non-smokers, opioids, age, surgery, hypotension, hypoxaemia, migraines, obesity

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16
Q

nausea and vomiting treatment

A
  • acute - metoclopramide
  • delayed - dexamethasone
  • breakthrough - 5HT3
  • anticipatory - lorazepam
  • refractory - levomepromazine
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17
Q

scalp/skin side effects

A

alopecia, hand/foot syndrome (capecitabine) , papulopustular eruptions (EGFR inhibitors)

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18
Q

scalp/skin side effects treatments

A

scalp cooling, lanolin, clindamycin, steroids and oral antibiotics

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19
Q

blood side effects

A

myelosuppression, febrile neutropenia

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20
Q

myelosuppression risk factors

A

hypotension, COPD, leukaemia, dehydrated, inpatient

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21
Q

blood side effects treatment

A

low risk - antibiotics
high risk - admission!

22
Q

short term immunotherapy side effects

A

colitis, pneumonitis, hepatitis, rashes

23
Q

long term immunotherapy side effects

A

cardiac issues, cancers, infertility, hypersensitivity, extravasion

24
Q

grade 1 hypersensitivity

A

rash/fever

25
grade 2 hypersensitivity
flushing, fever, dyspnoea
26
grade 3 hypersensitivity
bronchospasm, angioedema, hypotension
27
grade 4 hypersensitivity
anaphylaxis
28
grade 5 hypersensitivity
death
29
DNA alkylators MOA
forms aziridinium ion and alkylates N7 of guanine. Aziridinium ion is reformed and alkylates another N7 of guanine - forms DNA crosslinks
30
DNA alkylators example
cyclophosphamide, pro-drug, activated by CYP450 hydroxylation, acrolein by product formed (Michael acceptor)
31
DNA alkylators mechanisms of resistance
- increased glutathione and glutathione-s-transferase - increased excision repair enzymes - changes in cellular drug uptake
32
DNA platinating agents MOA
form intrastrand crosslinks in DNA, chlorine ligands displaced in vivo by water, positively charged aquated platinum (II) reacts with biological nucleophiles (N7)
33
DNA platinating agents example and use
- cisplatin, used for testicular, ovarian, head, neck, lung and bladder cancers
34
DNA platinating agents mechanisms of resistance
- increased repair mechanism - increased expression of thiol proteins
35
topoisomerase inhibitors/DNA intercalators MOA
inhibits topoisomerase II by preventing the fixing of double strand breaks - intercalates into DNA
36
topoisomerase inhibitors/DNA intercalators examples
anthracyclines - daunorubicin and doxorubicin
37
topoisomerase inhibitors/DNA intercalators mechanisms of resistance
- increased efflux from a cell - increased expression of p-glycoprotein
38
anti-mitotic MOA
microtubule assembly - binds to free alpha beta tubulin dimers to disrupt balance between polymerisation and depolymerisation microtubule disassembly - stabilisation of microtubules
39
anti-mitotic examples
assembly - vinka alkaloids (vinblastine), from periwinkle plant disassembly - paclitaxel from yew bark
40
anti mitotics resistasnce
- over expression of p-glycoprotein - mutations in tubulin gene
41
anti-metabolites MOA
5-fdUMP Michael addition with thymidylate synthase and dihydrofolate (during folic acid production) and covalently binds to stop dTMP production
42
anti-metabolites examples
5-fluoro-deoxyuridine (uracil - like structure)
43
anti-folates
methotrexate, competitive inhibitor of dihydrofolate reductase
44
types of modern chemotherapy
PARP inhibitors (ribs) and tyrosine kinase inhibitors (nibs)
45
PARP inhibitors example
- Olaparib, for ovarian, fallopian and peritoneal cancers with BRCA1/2
46
discovery of PARP inhibitors
medium throughput screening, benzyl phthalazinone core moderately potent antagonist of PARP1, cyclopropylamide increased oral bioavailability
47
PARP inhibitors MOA
inhibits poly(ADP)ribose polymerase which is used to repair single stranded breaks
48
tyrosine kinase inhibitor example
imatinib - BCR-ABL kinase inhibitor sorafenib - BRAF inhibitor
49
discovery of BCR-ABL kinase inhibitors
identified 2-phenylaminopyrimidines, methyl group increased selectivity and piperidine made it water soluble
50
tyrosine kinase inhibitors mechanisms of resistance
- mutations in target protein - upregulation of other pathways

Year 2 Exam 2 (16 decks)

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