Chemotherapy Flashcards
What is chemotherapy?
Treatment of cancer with drug therapy. Agents damage cancer cells to initiate apoptosis
What is the purpose of combination chemo?
Using multiple chemotherapy agents to increase number of cells killed
How do you choose agents for combination chemo?
Different methods of action
Act at different stages of cell cycle
Different toxicities
Different methods of resistance
What patient factors must be considered before initiating chemo?
Performance status Reaction to previous cycles Bloods Co-morbidities - esp. liver & kidney Surface area/BMI of patient
How can cancers develop resistance to chemotherapy agents?
Increased efflux Decreased influx Alter drug target Enhance DNA repair Drug detoxification
What are some acute side effects of chemotherapy?
Alopecia Mucositis N&V Myelosuppresion Tumour lysis syndrome Extravasion Loss of fertility DVT/PE AKI Pneumonitis
What are some long term side effects of chemotherapy?
Chemo brain Early menopause Decreased lung capacity Osteoporosis Muscle weakness Congestive HF Hearing loss Secondary Cancer
How do alkylating agents work? Give some examples and there key side effects
Crosslink DNA to cause programmed cell death
Cyclophosphamide
- myelosupression, haemorrhagic cystitis, transitional cell carcinoma
Cisplatin
- peripheral neuropathy, ototoxic, nephrotoxic
How do anti-metabolites work?
Prevent DNA synthesis, they are S phase specific
Give some examples of anti-metabolites and their key side effects
All myelosuppressive
Methotrexate
- lung fibrosis, hepatotoxic
Fluorouracil
- dermatitis (palmar-plantar erythrodyesthesia)
6-MP
- myelosuppression when with allopurinol, increased toxicity if reduced TMPT enzyme
Give an example of an anthracycline and it’s key side effects
Doxorubicin
- dilated cardiomyopathy (can be immediate or years down line)
How do vinka-alkaloids work? Give an example and its key side effects
Prevent mitotic spindle formation
Vincristine
- peripheral neuropathy, paralytic ileus
Name some antibiotics used as chemotherapy agents. State their key side effects
Bleomycin
- pulmonary fibrosis, mucositis
