Chemotherapy Flashcards
Name the purines
Adenine and Guanine
Name the Pyridimines
Cytosine and Thymine
What is a nucleotide ?
sugar phosphate base
why is the prognosis of cancers so bad ?
short window between detection and death due to exponential growth - need early detection
what must cells do in order for chemo to work ?
be in the cell cycle not in G0
What are the steps in the cell cycle ?
M-Mitosis
G1- Metabolic changes prepare the cell for division. At a certain point - the restriction point - the cell is committed to division and moves into the S phase.
S- DNA Synthesis
G2- Metabolic changes assemble the cytoplasmic materials necessary for mitosis and cytokinesis.
what is the fractional cell kill hypothesis ?
Every time chemo is administered the cells of bone marrow is allowed to regrow to stop side effects but quick enough to reduce tumour cell growth
what is Imantinib ?
Tyrosine kinase inhibitor competitively for CML
how do alkylating agents work ?
what compounds are good at this ?
creates Bond within the Double strand so it cannot unzip and replicate = apoptosis
platinium compouns - cisplatin
how is DACH platinum adducts even more effective ?
Bulky side groups attached
how does 5-Fluorouracil work ?
Antimetabolite
Inhibit thymidylate synthase used to synthesise pyrimidines into DNA
how does methotrexate work ?
Antimetoblite
Dihydrofolate reductase inhibitor , used in folate cycle . Folate cycle makes purines.
how do 2 types of spindle poisons work?
vinca alkoloids - stops assembly of spindle formations
Taxoids - promotes assembly , cell too ridge to divide
how to cells develop resistance to alkylating agents ?
Tumour cells can pump out the alkylating agent
Inactivation of agent via GSH
how do we predict response to chemo?
performance score
clinical stage
molecular changes
what are IV procedures for chemo?
PICC line - can go home hickman line (Central line)
what are side effects of chemo ?
alopecia nausea and vomting sterility renal failure myelosurpression
what is seen in complications of high sensitive tumour of chemo ?
acute renal failure - Urea increase due to rapid breakdown of tumour= Urate crystals in renal tubules
GI perforation at site of tumour = Lymphomas
DIC within hours of acute myeloid leukaemia
why does vomiting occur ? what is the pattern ?
action on central CTZ
Acute pahse = 4-12 hours
Delayed onset = 2-5 days
Chronic phase = persist up to 14 days
what skin problems do you see in Chemo?
Local - irritation and thrombophlebitis
General -
hyperpigmentation
where is mucosits seen worse in chemo ? presents as ?
Oropharynx sore mouth diarrhoea GI bleed can lead to infections
what kind of cadrio toxicity is seen in chemo ?
cardio myopathy
arrhythmias
what drug is lung toxic ?
what can you not give ?
Bleomycin
Fibrosis
oxygen
what haematological toxicity is the worse ? why ?
neutrophil - White cell
neutropenic sepsis
