Chemotherapy Flashcards
How do alkylating agents work?
e.g topoisomerase inhibitors?
Prevent the uncoiling of DNA so that DNA cannot replicate.
MOA of vinca alkaloids:
Cell cycle arrest by preventing microtubule formation.
MOA of taxanes?
Spindle cell inhibition.
Skim how antimiotic antibiotics work:
- Intercalation - inhibiting synthesis.
- Membrane binding, increased permeability and destruction.
- Free radical formation, disrupts the DNA chain and prevents mitosis alkylation (thus blocking DNA replication).
Name three common antimiotic antibiotics from the lecture?
Doxorubicin
Epirubicin
Bleomycin (non-anthracycline).
Paclitaxel, docetaxel are what class of chemotherapy agent?
Taxanes
Vincristine, vinblastine are what class of chemotherapy agent?
Vinca alkaloids
Etoposide, ifosphamide are what class of chemotherapy agent?
Classical alkylating drugs
Cisplatin, carboplatin, oxaliplatin are what class of chemotherapy agent?
Non-classical alkylating drugs
Methotrexate, 5-FU, Capecitabine are what class of chemotherapy agent?
Antimetabolites
How do antimetabolites like methotrexate work?
Prevents DNA synthesis
Vinca alkaloids are used in what type of cancer?
Lung cancer most commonly
also secondary metastatic breast cancer
Radiotherapy is commonly used in conjunction with what type of chemotherapy?
Platinum based chemo
What is meant by neoadjuvant?
Neoadjuvant chemotherapy is given before the main treatment, usually surgery, in order to reduce the size of the tumour and make it easier to remove. It is often used in cases where the tumour is large or has spread to nearby tissues but has not yet metastasized to other parts of the body.
What is meant by adjuvant?
Adjuvant chemotherapy is given after the main treatment, usually surgery, in order to destroy any remaining cancer cells that may be present in the body and reduce the risk of the cancer recurring. It is often used when the cancer has a high risk of recurrence or has spread to nearby tissues or lymph nodes.
What side effect may be seen with anthracyclines if the maximum cumulative dose is exceeded?
Cardiotoxicity
What side effect may be seen with bleomycin if the maximum cumulative dose is exceeded?
Pneumonitis and ILD
What drugs need close renal function monitoring?
Platinums
Capectiabine
Ifosfamide
Methotrexate
What drugs need close liver function monitoring?
Etoposide
Taxanes
Anthracyclines
Common general side effects of chemotherapy:
- Neutropenic Sepsis
- Nausea and Vomiting
- Hair loss
- Bone marrow suppression
- Mucositis
- Diarrhoea
- Fatigue
How is neutropenia approached with patients on chemo?
Safety netting. Most patients will be neutropenic but not require treatment.
- Patient education on taking their temperature everyday.
Pulmonary fibrosis is caused by what chemotherapy drug?
Bleomycin
Cardiotoxicity is caused by what chemotherapy drugs?
Anthracyclines e.g. Doxorubicin, Epirubicin
Alkylating agents e.g Etoposide, ifosphamide.
Resp side effect from gemcitabine?
Pneumonitis
- note bleomycin also can cause a pneumonitis.
5-FU is what type of chemo drug and what are it’s side effects?
5-FU - Coronary vasospasm, hand and foot syndrome aka palmar, plantar erythema.
5-FU is an antimetabolite like methotrexate.
Peripheral neuropathy is a side effect of what chemotherapy agents?
Taxanes
Give two examples of taxanes:
Paclitaxel, docetaxel.
What testing is needed before starting a 5-FU chemotherapy based treatment?
Test for DPD deficiency - can otherwise lead to severe mucositis, diarrhoea, dehydration and a stay on ICU (can be life-threatening).
Terms describing response to chemotherapy:
- Complete response - disappearance of all measurable disease
- Partial response - 30% decrease from baseline.
- Minimal response - decrease in measurable lesions; no new lesions observed - less than 30% but still a decrease.
- Stable disease - neither partial response or progressive decease criteria have been met.
- This is the goal, along with symptomatic benefit.
- Progressive disease - 20% increase in one or more lesions.
- Confirms no response to the chemotherapy.
What criteria is used to assess response to chemo treatment?
RESIST Criteria
(about the different responses)
What chemo drugs cause peripheral neuropathy?
Vinca alkaloids
Taxanes
Cisplatin
Side effects of cisplatin?
Hearing loss
Metallic taste in mouth
Peripheral neuropathy
Platinum based chemo side effects:
Peripheral neuropathy and sensorineural hearing loss (due too to toxicity)
Cisplatin can cause nephrotoxicity as well as ototoxicity
What chemo drug gives a metallic taste in the mouth?
Cisplatin
Ifosphamide side effects
Haemorrhagic cystitis
Encephalopathy- give methylene blue
Methotrexate give what for the OSCE!!!!!
Folic acid
Cisplatin side effects:
Need to add full list!
Methotrexate side effects
Nephrotoxic
Myelosuppression
ILD
Cyclophosphamide side effects
Nephrotoxic
Bladder toxicity
SIADH
Bleomycin needs what investigation in the OSCE
Baseline chest x-ray for pulmonary fibrosis.
Haemorrhagic cystitis chemotherapy?
Cyclophosphamide
5fu can cause heart attacks
5fu can cause heart attacks
When to give methylene blue?
Encephalopathy caused by ifosphamide
Which chemotherapy agent is associated with hypomagnesia?
Cisplatin is associated with hypomagnesaemia
