Chemotherapy

Question 0

Alkylating agent mechanism

Answer 0

Covalently bind two strands of DNA so they can’t unravel to replicate.

Question 1

Imatinib

Answer 1

Bcr-Abl tyrosine kinase inhibitor (CML)
KIT inhibitor (GIST)
Blocks ATP binding pocket on TK molecule

Question 2

Cisplatin

Answer 2

Platinum agent

Question 3

Oxaliplatin

Answer 3

Platinum agent used in colorectal cancer

Question 4

Platinum agent mechanism

Answer 4

Alkylating agents

Cause intra and inter strand adducts

Question 5

Mechanism of resistance to alkylating agents

Answer 5

Increased DNA repair, increased efflux/decreased influx to cells.

Question 6

Antifolate mechanism

Answer 6

Prevent pyramidine incorporation into DNA

Question 7

Methotrexate mechanism

Answer 7

Antifolate
Inhibits dihydrofolate reductase
Used in brain tumours and leukaemia

Question 8

5-fluorouracil mechanism

Answer 8

Antifolate

Prevents production of thymidine synthase, the entrance point of the folate cycle

Question 9

Vinka alkaloids

Answer 9

Spindle poisons- prevent spindle formation

Question 10

Taxoids

Answer 10

Spindle poisons
Promote assembly
Prevent disassembly

Question 11

General ADRs of chemo

Answer 11

Acute renal failure - tumour lysis causes hyperuricaemia. Treat with allopurinol 
GI perforation at site of tumour
DIC
Vomiting
Alopecia 
Skin - thrombophlebitis, extravasation, general changes 
Mucositis 
Cardiotoxicity
Lung toxicity
Pancytopenia

Question 12

Doxorubicin ADRs

Answer 12

Alopecia
Hyperpigmentation
Cardiomyopathy

Question 13

Vinca alkaloid ADRs

Answer 13

Alopecia

Question 14

Cyclophosphamide ADRs

Answer 14

Alopecia 
Hyper pigmentation 
Arrhythmia
Cardiomyopathy at high doses
Pulmonary fibrosis

Question 15

Bleomycin ADRs

Answer 15

Hyperkeratosis, hyperpigmentation, ulcerated pressure sores

Pulmonary fibrosis

Question 16

Bleomycin

Answer 16

Induces DNA strand breaks

Question 17

Doxorubicin

Answer 17

Intercalating agent

Question 18

Cyclophosphamide

Answer 18

Metabolite phosphoramide mustard causes inter and intra strand adducts

Question 19

Busulphan

Answer 19

Alkylating

Question 20

Eteposide

Answer 20

DNA strand breaks

Chemotherapy

Question 21

Mitomycin C

Answer 21

DNA cross linker

Chemotherapy

Question 22

Dactinomycin D

Answer 22

Inhibits transcription

Chemotherapy

Question 23

Melphalan

Answer 23

Alkylating agent

Nitrogen mustard family

Question 24

Capecitabine

Answer 24

Prodrug of 5 fluorouracil

Antifolate

Question 25

Vincristine

Answer 25

Vinca alkaloid

Question 26

Vincristine DDIs

Answer 26

More neuropathy if with itraconazole

Question 27

5FU DDIs

Answer 27

Warfarin

Question 28

Methotrexate DDIs

Answer 28

Penicillin

NSAIDs

Question 29

Capecitabine DDIs

Answer 29

St John’s Wort

Grapefruit juice

Question 30

Vomiting patterns in chemo

Answer 30

Acute - 4-12 hrs
Delayed -2-5 days
Chronic -up to 14 days