Chemotherapy Flashcards
Myelosupression requires a stem cell transplant. They can be from…
Autologous donor- their own stem cells harvested back into them
Allogenic- matched donor
Lenograstim is used to…
Boost stem cell production
The cell cycle includes the following stages…
Mitosis G1 G0 ( cells not dividing) S phase (DNS synthesis) G2
Alkylating drugs target cells in what phase and how?
S phase
They form covalent bonds with DNA : cross linking , prevent uncoiling , inhibit replication
Nitrogen mustards, nitrosoureas, platinum compounds are …
Alkylating agents
Mechlorethamine
Nitrogen mustard
Iv
Cyclophosphamide
Nitrogen mustard
Pro drug , orally, activated in liver to phosphoramide mustard and acrolein
Acrolein can cause….
Haemohaggic cystitis so give with loads of fluids
Nitrosoureas are….
Highly lipophilic and can cross BBB used for cns tumours
Carmustine (iv)
Lomustine ( oral)
Nitrosoureas
Cisplatin
Potent platinum compound
Binds to RNA / DNA/ protein
DNA polymerase is generated to repair DNA so resistance can occur
What cancers are more sensitive to Cisplatin
Testicular and ovarian
Side effects of Cisplatin
Very nephrotoxicity
Anaphylaxis
Severe nausea vomiting
Risk of: tinnitus, gout, peripheral neuropathy
Carboplatin
Platinum compound
Derivative of Cisplatin
Less side effects can be given as outpatient
Oxaliplatin
Platinum compound
Treat colorectal cancer
Busulfan
Alkylation drug
Bone marrow used for leukaemia
Procarbazine
Alkylation drug
Treats Hodgkin’s disease
Can cause rash
Trabectadin
Alkylating agent
Soft tissue sarcoma
Advanced ovarian cancer
Hepatotoxic
Anti metabolites (FPP)
Folate antagonists
Pyrimidine analogues
Purine analogues
Methotrexate
Folate antagonist (anti metabolites)
Mostly excreted in urine , NSAIDs can prevent this so be watchful.
Given with folic acid to rescue normal cells
No pregnant women
Lactating mothers but with foilinic acid
Pyramidine analogues mechanism of action
Compete with c+t bases which make up RNA and DNA
Inhibit DNA synthesis
Fluorouracil
Pyrimidine analogue
Capecitabine
Cytarabine
Gemcitabine
Pyrimidine analogues
Given parenterally
Purine analogues mechanism of action
Compete with a+g and inhibit purine metabolism
Pentostatin
Purine analogues
Mercatopurine
Purine analogues
Tioguarine
Purine analogues
Fludarabine
Purine analogues
Doxorubicin
Cytotoxic antibiotic
Binds and inhibits DNA
Inhibits topoismerase 2
Necrosis at iv site
Can cause heart failure
Bleomycin
Cytotoxic ABx
Degrades pre formed DNA
Works agains G0
10% causes pulmonary fibrosis
50% develop ulcers, hair loss, fungus
Vincristine
Vinblastine
Vindesine
Plant derivative
Madagascar periwinkle
Relatively non toxic except vincristine- has neuromuscular effects
Prevent tubule formation / spindle formation (m stage)
Solid tumours occupy 1 of 3 compartments. They are …
A. Dividing
B. Resting cells g0 capable of dividing
C. Cells no longer dividing but contributing to tumour size
Taxane
Paclitaxel, docetaxel
Bark of yew tree
Advanced breaths cancer
Etoposide
Mandrake root
Low bp on iv
Testicular cancer and lymphoma
No skin contact
Hormones used to treat cancer, halt its growth by:
Receptor antagonists
Opposing hormones
Block synthesis
Ethinyloestradiol
Oestrogen treatment
Diethylstilbestrol
Oestrogen treatment
Oestrogen so mechanism of action on cancer
Antagonist of androgen dependant prostate cancer
Stimulate breast cancer proliferation
Progesterone are used to treat
Endometrial cancer
Megestrol
Progesterone
Norethisterone
Progesterone
GnRH mechanism of action
Inhibit gnrh release
Lower lh/ fsh release
Lower testosterone
In turn can treat prostate cancer and advanced breast cancer
Goserelin
Buserelin
Lueprorelin
Tridtorelin
GnRH analogues
Somatostatin analogues mechanism of action
Inhibit cell proliferation
Eg gastrin and so can be used for gi cancers
Acreotide
Lanreotide
Somatostatin analogues
Tamoxifen
Hormone antagonist stops oestrogen production
Breast cancer
Can cause blood clots and endometrial cancer along with menopausal symptoms
Prednisone
Dexamethosone
In cancer treatment
Inhibit lymphocyte proliferation ( lymphoma, leukaemia)
Counter side effects of treatment
Monoclonal antibodies (mAbs)
Produced by hybridoma cells
React with specific target proteins on cancer cells , activate immune system, remove cancer cells
Rituximab
Trastuzumab
Ofatumumab
Bevacizumab
Monoclonal antibodies
Very expensive
Few side effects as so specific
Protein kinase inhibitors mechanism of action
Block tyrosine kinases in gf pathways
Oral admin
Imatinib
Dosatinib
Nilotinib
Protein kinases inhibitors
