Chemotherapy

Question 1

What are the 5 main classes of chemo agents?

Answer 1

DNA synthesis inhibs
Antimetabolites
Microtubule function inhibs
Protein assembly inhibs
Monoclonal antibodies

Question 2

Name 6 chemo drugs that act on DNA synthesis

Answer 2

Cyclophosphamide
Cisplatin
Doxorubicin
Topotecan
Irinotecan
Etoposide

Question 3

Action, uses and SE of cyclophophamide

Answer 3

Alkylating agent, damages DNA-> misreading
Used in lymphoma, leukaemia, soft tissue and solid tumours
SE= bone marrow suppression, alopecia, GI toxicity, sterility, teratogen, cardiac and bladder toxicity

Question 4

Action, uses and SE of cisplatin

Answer 4

Platinum compound, cross links DNA-> misreading
Many uses
SE= severe kidney damage, n+v

Question 5

Action, uses and SE of doxorubicin (adriamycin)

Answer 5

Cytotoxic antibiotic, blocks DNA polymerase
Widely used for acute leukaemia and lymphoma
SE= GI ulcers, n+v, bone marrow suppression, cardiomyopathy, heart failure

Question 6

What is particularly dangerous about doxorubicin?

Answer 6

If you miss the blood vessel when injecting it, causes massive tissue necrosis

Question 7

Name 2 topoisomerase inhibitor 1s

Answer 7

Topotecan, irinotecan

Question 8

Action, uses and SE of topotecan

Answer 8

Inhibits topoisomerase, blocks regulation of DNA-> apopotosis
Used in ovarian and lung cancer
SE= GI upset, n+v, alopecia, myelosuppression

Question 9

Action, uses and SE of etoposide

Answer 9

Topoisomerase inhibitor 2
Prevents recoiling of DNA so can’t fit into 2 new cells
Used in lung, leukaemia and testicular cancer

Question 10

Name a topoisomerase inhibitor 2

Answer 10

Etoposide

Question 11

Name 5 antimetabolites

Answer 11

Methotrexate
Leucovorin
6-mercaptopurine
5-flurouracil
Hydroxyurea

Question 12

Action, uses and SE of methotrexate

Answer 12

Folic acid analogue
Inhibits dihydrofolate reductase-> no thymidine
Used in breast cancer, lung, lymphoma
SE= bone marrow suppression, GI upset

Question 13

Action& uses of leucovorin

Answer 13

Folic acid agonist to help normal cells recover 24hrs after giving methotrexate (bypasses dihydrofolate reductase phase)
Give large dose 24hrs after methotrexate

Question 14

Action and SE of 6-MP

Answer 14

6-mercaptopurine
incorporated into DNA then misread-> apoptosis
SE= bone marrow suppression

Question 15

Action and SE of 5-flurouracil

Answer 15

Blocks thymidylate synthetase

SE= bone marrow suppression

Question 16

Action and SE of hydroxyurea

Answer 16

Blocks deoxyribo conversion, eliminated in urine

SE= bone marrow suppression, rapid recovery

Question 17

Name 4 drugs that disrupt microtubule function

Answer 17

Vincristine, vinblastine, docetaxel, paclitaxel

Question 18

Name 2 vinca alkaloids, action& uses.

Answer 18

Vincristine, vinblastine
Blocks division at metaphase, stimulates depolymerisation
Used in lymphomas and leukaemia

Question 19

Name a topoisomerase inhibitor 2

Answer 19

Etoposide

Question 20

Name 5 antimetabolites

Answer 20

Methotrexate
Leucovorin
6-mercaptopurine
5-flurouracil
Hydroxyurea

Question 21

Action, uses and SE of methotrexate

Answer 21

Folic acid analogue
Inhibits dihydrofolate reductase-> no thymidine
Used in breast cancer, lung, lymphoma
SE= bone marrow suppression, GI upset

Question 22

Action& uses of leucovorin

Answer 22

Folic acid agonist to help normal cells recover 24hrs after giving methotrexate (bypasses dihydrofolate reductase phase)
Give large dose 24hrs after methotrexate

Question 23

Action and SE of 6-MP

Answer 23

6-mercaptopurine
incorporated into DNA then misread-> apoptosis
SE= bone marrow suppression

Question 24

Action and SE of 5-flurouracil

Answer 24

Blocks thymidylate synthetase

SE= bone marrow suppression

Question 25

Name 3 monoclonal antibodies and the cancer they are used to treat

Answer 25

Trastuzumab- breast cancer Rituximab- B cell leukaemia Imatinib- chronic myeloid leukaemia

Question 26

Name 4 drugs that disrupt microtubule function

Answer 26

Vincristine, vinblastine, docetaxel, paclitaxel

Question 27

Name 2 vinca alkaloids, action& uses.

Answer 27

Vincristine, vinblastine Blocks division at metaphase, stimulates depolymerisation Used in lymphomas and leukaemia

Question 28

Name 2 taxanes, action, uses and SE

Answer 28

Docetaxel, paclitaxel Promote and blocks polymerisation of tubulin Used in ovarian and breast cancer as radiosensitisers SE= general cytotoxicity, hypersensitivity, motor neuropathy, leg oedema

Question 29

What is docetaxel?

Answer 29

A taxane that disrupts microtubule function via polymerisation of tubulin. Used in ovarian and breast cancer.

Question 30

Name a chemo agent that disrupts protein assembly

Answer 30

Asparaginase

Question 31

Action, uses and SE of asparaginase

Answer 31

Decreases amino acid thats not essential in normal cells but is essential in cancer cells that lack asparagine synthase Used in acute lymphatic lymphoma SE= hepatic and pancreatic dysfunction (albumin, insulin and clotting factor synthesis inhibited)

Question 32

What is asparaginase?

Answer 32

Chemo agent that blocks protein assembly

Question 33

Name 3 monoclonal antibodies used to treat cancer, specifying target

Answer 33

Trastuzumab- HER2 receptor Rituximab- CD20 receptor Imatinab- DNA

Question 34

Name 3 monoclonal antibodies and the cancer they are used to treat

Answer 34

Trastuzumab- breast cancer Rituximab- B cell leukaemia Imatinib- chronic myeloid leukaemia

Question 35

What is rituximab?

Answer 35

Monoclonal antibody used to treat B cell leukaemia, binds to CD20 receptor

Question 36

What is imatinib?

Answer 36

Monoclonal antibody used to treat chronic myeloid leukaemia, binds to DNA

Question 37

What are the options for cancer therapy?

Answer 37

Radio therapy, surgery, drug therapy, immunotherapy

Question 38

What types of cancer is chemotherapy most effective for?

Answer 38

Burkitt's lymphoma (constantly in a growth spurt) Myeloid leukaemia Choriocarcinoma Metastasis

Question 39

What is chemo least effective for?

Answer 39

Lung and colon cancer (caught late)

Question 40

What are the drug resistance mechanisms?

Answer 40

``` Decreased uptake Increased efflux Increased repair activity Emergency response genes Altered drug targets ```

Question 41

What increases efflux of chemo agents?

Answer 41

P-glycoprotein

Question 42

How is chemo administered?

Answer 42

IV, 4-6 cycles each lasting 4 weeks | Usually drug combinations

Question 43

What drug combinations are used for solid organs and colorectal cancer?

Answer 43

FOLFOX Leucovorin Flurouracil Oxaliplatin

Question 44

What drug combinations are given for breast cancer?

Answer 44

``` CMF Cyclophosphamide Methotrexate Flurouracil Then tamoxifen ```

Question 45

What drug combinations are given for Hodgkin's lymphoma?

Answer 45

``` DBDV Doxorubicin Bleomycin Dacarbazine Vinblastine ```