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Med D > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

How do alkylating agents work?
e.g topoisomerase inhibitors?

A

Prevent the uncoiling of DNA so that DNA cannot replicate.

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2
Q

MOA of vinca alkaloids:

A

Cell cycle arrest by preventing microtubule formation.

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3
Q

MOA of taxanes?

A

Spindle cell inhibition.

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4
Q

Skim how antimiotic antibiotics work:

A
  • Intercalation - inhibiting synthesis.
  • Membrane binding, increased permeability and destruction.
  • Free radical formation, disrupts the DNA chain and prevents mitosis alkylation (thus blocking DNA replication).
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5
Q

Name three common antimiotic antibiotics from the lecture?

A

Doxorubicin
Epirubicin
Bleomycin (non-anthracycline).

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6
Q

Paclitaxel, docetaxel are what class of chemotherapy agent?

A

Taxanes

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7
Q

Vincristine, vinblastine are what class of chemotherapy agent?

A

Vinca alkaloids

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8
Q

Etoposide, ifosphamide are what class of chemotherapy agent?

A

Classical alkylating drugs

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9
Q

Cisplatin, carboplatin, oxaliplatin are what class of chemotherapy agent?

A

Non-classical alkylating drugs

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10
Q

Methotrexate, 5-FU, Capecitabine are what class of chemotherapy agent?

A

Antimetabolites

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11
Q

How do antimetabolites like methotrexate work?

A

Prevents DNA synthesis

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12
Q

Vinca alkaloids are used in what type of cancer?

A

Lung cancer most commonly
also secondary metastatic breast cancer

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13
Q

Radiotherapy is commonly used in conjunction with what type of chemotherapy?

A

Platinum based chemo

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14
Q

What is meant by neoadjuvant?

A

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.

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15
Q

What is meant by adjuvant?

A

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.

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16
Q

What side effect may be seen with anthracyclines if the maximum cumulative dose is exceeded?

A

Cardiotoxicity

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17
Q

What side effect may be seen with bleomycin if the maximum cumulative dose is exceeded?

A

Pneumonitis and ILD

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18
Q

What drugs need close renal function monitoring?

A

Platinums
Capectiabine
Ifosfamide
Methotrexate

19
Q

What drugs need close liver function monitoring?

A

Etoposide
Taxanes
Anthracyclines

20
Q

Common general side effects of chemotherapy:

A
  • Neutropenic Sepsis
  • Nausea and Vomiting
  • Hair loss
  • Bone marrow suppression
  • Mucositis
  • Diarrhoea
  • Fatigue
21
Q

How is neutropenia approached with patients on chemo?

A

Safety netting. Most patients will be neutropenic but not require treatment.
- Patient education on taking their temperature everyday.

22
Q

Pulmonary fibrosis is caused by what chemotherapy drug?

A

Bleomycin

23
Q

Cardiotoxicity is caused by what chemotherapy drugs?

A

Anthracyclines e.g. Doxorubicin, Epirubicin
Alkylating agents e.g Etoposide, ifosphamide.

24
Q

Resp side effect from gemcitabine?

A

Pneumonitis
- note bleomycin also can cause a pneumonitis.

25
Q

5-FU is what type of chemo drug and what are it’s side effects?

A

5-FU - Coronary vasospasm, hand and foot syndrome aka palmar, plantar erythema.

5-FU is an antimetabolite like methotrexate.

26
Q

Peripheral neuropathy is a side effect of what chemotherapy agents?

A

Taxanes

27
Q

Give two examples of taxanes:

A

Paclitaxel, docetaxel.

28
Q

What testing is needed before starting a 5-FU chemotherapy based treatment?

A

Test for DPD deficiency - can otherwise lead to severe mucositis, diarrhoea, dehydration and a stay on ICU (can be life-threatening).

29
Q

Terms describing response to chemotherapy:

A
  • 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.
30
Q

What criteria is used to assess response to chemo treatment?

A

RESIST Criteria
(about the different responses)

31
Q

What chemo drugs cause peripheral neuropathy?

A

Vinca alkaloids
Taxanes
Cisplatin

32
Q

Side effects of cisplatin?

A

Hearing loss
Metallic taste in mouth
Peripheral neuropathy

33
Q

Platinum based chemo side effects:

A

Peripheral neuropathy and sensorineural hearing loss (due too to toxicity)

Cisplatin can cause nephrotoxicity as well as ototoxicity

34
Q

What chemo drug gives a metallic taste in the mouth?

A

Cisplatin

35
Q

Ifosphamide side effects

A

Haemorrhagic cystitis
Encephalopathy- give methylene blue

36
Q

Methotrexate give what for the OSCE!!!!!

A

Folic acid

37
Q

Cisplatin side effects:

A

Need to add full list!

38
Q

Methotrexate side effects

A

Nephrotoxic
Myelosuppression
ILD

39
Q

Cyclophosphamide side effects

A

Nephrotoxic
Bladder toxicity
SIADH

40
Q

Bleomycin needs what investigation in the OSCE

A

Baseline chest x-ray for pulmonary fibrosis.

41
Q

Haemorrhagic cystitis chemotherapy?

A

Cyclophosphamide

42
Q

5fu can cause heart attacks

A

5fu can cause heart attacks

43
Q

When to give methylene blue?

A

Encephalopathy caused by ifosphamide

44
Q

Which chemotherapy agent is associated with hypomagnesia?

A

Cisplatin is associated with hypomagnesaemia

Med D (6 decks)

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