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Principles of Disease > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

What are treatment options for cancer?

A

Surgery

Radiotherapy

Chemotherapy

Targeted therapies

Immunotherapy

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2
Q

What are the steps of the cell cycle?

A

G1 (gap 1, preparation for DNA replication)

R (restriction point, point in G1 where the cell becomes committed)

S (DNA replication)

G2 (preparation for mitosis)

M (mitosis, cell divsion)

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3
Q

What happens during G1 (gap 1)?

A

Preparation for DNA replication

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4
Q

What is R during the cell cycle?

A

Restriction point, where the cell become committed

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5
Q

What happens during S?

A

DNA replication

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6
Q

What happens during G2?

A

Preparation for mitosis

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7
Q

What happens during M?

A

Mitosis, cell division

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8
Q

What are things that make the cell cycle go around?

A

Growth factors

Oncogenes

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9
Q

What makes the cell cycle stop?

A

Tumour suppresor genes

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10
Q

What does chemo delivery do?

A

Reduces the amount of cells

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11
Q

What happens if the interval between chemo delivery is to long?

A

The cells grow back

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12
Q

How is systematic therapy delivered?

A

Oral or intravenous route

Regular cycles with timing dependent on the findings from pharmacokinetics (half life, excretion)

May need to delay treatment if toxicites develop

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13
Q

What needs to happen to chemotherapy if toxicities develop?

A

It needs to be delayed

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14
Q

What are methods of assessing drug therapy?

A

CT scan

PET scan

Clinical examination

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15
Q

What may assessing drug activity help?

A

Overall survival (OS)

Progression-free survival (PFS)

Improved quality of life (QoL)

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16
Q

What is progression free survival?

A

Length of time during and after treatment of a disease that a patient lives with the disease but it does not get any worse

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17
Q

What is overall survival?

A

The length of time from either the diagnosis or the start of treatment for a disease that the patient is still alive

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18
Q

What does an adjuvant do?

A

Improve survival

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19
Q

What does a neoadjuvant do?

A

May improve survival through increasing operability

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20
Q

What is adjuvant treatment?

A

Treatment given in addition to a primary treatment

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21
Q

What is neoadjuvant chemotherapy?

A

Medicines administered before surgery for the treatment of cancer

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22
Q

What are some different classes of cytotoxic agents?

A

Alkylating agents

Anti-metabolites

Mitotic inhibitors

Antibiotics

Other

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23
Q

What are some sites of action for cytotoxic agents?

A

Anti-metabolites prevent RNA synthesis by binding to DNA

Alkylating agents cross link guanine nucleobases, directly attacking DNA

Intercalating agents wedge between bases along DNA to stop polymerase and other proteins from binding (preventing DNA transcription and DNA duplication)

Spindle poisons act on tubulin, which forms the microtubules that attach to chromosomes during mitosis

24
Q

What do alkylating agents do?

A

Attach to free guanines on seperated DNA strands, impairing DNA replication

25
What does the alkyl group of an alkylating agent allow?
Covalent bonds with other molecules
26
What is an example of an alkylating agent?
Cisplatin
27
What are some mechanisms of resistance against alkylating agents?
Decreases entry or increases exit of agent in cell Inactivation of agent in cell Enhanced repair of DNA lesions produced by alkylation
28
How do antimetabolites work?
Similar structure to essential metabolites required by cell prior to cell division Can be incorporated into new nuclear material or bind with vital enzymes
29
What are examples of antimetabolites?
Antagonise folic acid Antagonis purine
30
What are examples of spindle poisons?
Vinca alkaloids Taxanes
31
What do vinca alkaloids do?
Metaphase arrest agents, blocking microtubule formation and spindle formation
32
What do taxanes do?
Promote spindles and freeze cells at that stage
33
What are the 2 classes of antimiotic antibiotics?
Anthracyclines Non-anathracyclines
34
What do antimiotic antibiotics do?
Intercalate and inhibit DNA and RNA synthesis Bind to membranes and increase permeability of ions Free radicals disrupt DNA chain and prevent mitosis
35
Where during the cell cycle do alkylating agents act?
All of the stages
36
Where during the cell cycle do antibiotics act?
End of G1 through to the start of G2
37
Where during the cell cycle do antimetabolites?
S
38
Where during the cell cycle do metabolic inhibitors act?
During M
39
What is the aim of combination therapy?
Increase efficacy
40
What are the principles underlying combination therapy?
Different mechanisms of action Dissimilar toxicity profile (such as both do not act with neurotoxicity)
41
What does having different mechanisms of action during combination therapy allow?
Synergistic or at least additive Reduce risk of developing resistance
42
What are some possible side effects of chemotherapy?
Vomiting Nausea Alopecia (loss of hair) Tiredness
43
What does moderately emetogenic chemotherapy refer to?
Moderate incidences of nausea and vomiting
44
What does highly emetogenic chemotherapy refer to?
High incidents of nausea and vomiting
45
What is CINV?
Chemotherapy induced nausea and vomiting
46
What is peripheral CINV?
Where drugs act on enterochromaffin cells in the gastric glands which release serotonin which acts on vagal afferent 5-HT3 receptors
47
Where do the gastric glands release during peripheral CINV?
Serotonin
48
What does serotonin act on during peripheral CINV?
5-HT3 receptors
49
What is central CINV?
Drugs act on brainstem NK3 receptors and cause CINV
50
What are examples of hormonal drugs?
Anti-oestrogen for breast cancer Gonadorelin analogue Anti-adrogen for prostate cancer
51
What is anti-oestrogen used for?
Breast cancer
52
What is anti-adrogen used for?
Prostate cancer
53
What are some things targeted drugs act against?
Epidermal growth factor receptor (EGFR) Vascular endothelial growth receptor (VEGR)
54
What receptors do T lymphocytes have?
Activation and inhibitory receptors
55
How does immunotherapy work?
Cancer cells hide from the immune system by binding to the self receptor PD1, but drugs can inhibit this

Principles of Disease (45 decks)

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