Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

What is meant by the fractional cell kill hypothesis?

A

Chemotherapy is given in fractioned doses to target rapidly dividing cells. The following dose should be given so that only bone marrow cells have had chance to recover, resulting in the tumour cell burden decreasing with each bolus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which tumours are highly sensitive to chemotherapy?

A 
Lymphoma
Germ cell tumour 
Small cell 
Neuroblastoma 
Wilms tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which tumours have a modest sensitivity?

A 
Breast 
Colorectal 
Bladder
Ovary 
Cervix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which tumours have low sensitivity?

A

Prostate
Renal cell
Brain tumour
Endometrial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where can cytotoxic agents exert their effects?

A

Antimetabolites
Alkylating agents
Intercalating agents
Spindle poisons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do platinum agents exert there effects?

A

Form inter and intrastrand adducts, leading to inhibition of DNA synthesis.
DACH platinum adducts are bulky and thought to be more effective in inhibiting DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does 5-fluorouracil act as an antimetabolite?

A

It inhibits TS (thymidylate synthase) and prevents production of dTMP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does methotrexate work as a antimetabolite?

A

It inhibits dihydrofolate reductase and therefore prevents purine synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the spindle poisons and how do they exert their mechanism of action?

A

Taxoids- promote assembly and prevent disassembly of microtubules.

Vinca alkaloids prevent spindle formation of microtubules.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What mechanisms of resistance can cancer produce towards alkylating agents?

A

Decreased entry/increased exit of agent - active pump
In activation of agent within cell
Enhanced repair of DNA lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The predicted response of cancer is different between individuals due to?

A

Performance score
Clinical stage
Prognostic factors/score
Molecular or cytogenetic markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name some of the common side effects of chemotherapy

A 
Alopecia 
Pulmonary fibrosis 
Cardiotoxicity
Renal failure 
Myelosuppression 
Phlebitis 
Neuropathy 
Myalgia 
Sterility 
Cystitis 
Diarrhoea 
N and V 
Mucostitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the patterns of vomiting and how is it thought to be triggered?

A

Multifactorial but direct action of chemotherapy drugs on the central chemoreceptor trigger zone.

Acute phase: 4-12 hours
Delayed onset: 2-5 days
Chronic phase: >14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

With bleomycin, what skin ADRs can occur?

A

Hyperkeratosis
Hyperpigmentation
Ulcerated pressure sores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

With busulphan, doxorubicin, cyclophosphasmide and actinomycin D what skin toxicity can occur?

A

Hyperpigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is mucositis and how may it present?

A

GIT epithelial damage and can affect part or whole tract.
Presents as sore mouth/throat, diarrhoea, GI bleed.
Commonly worst in oropharynx and may present with oral candidiasis.

17
Q

Which drugs cause cardiomyopathy ?

A

Doxorubibicin
High dose cyclophosphamide
mortality 50%

18
Q

Which drugs cause arrhythmias?

A

Cyclophosphamide

Etoposide

19
Q

Which drugs can give lung toxicity (pulmonary fibrosis)?

A 
Bleomycin 
Mitomycin C 
Cyclophosphamide 
Melphalan
Chlorambucil
20
Q

Why does chemotherapy need to be prescribed by specialists?

A

Narrow therapeutic index

Significant side effects

Dose needs to be altered based on surface area,BMI, drug handling ability, general wellbeing (performance status and comorbidities)

Treatment phasing needs to account for growth fraction, cell kill of each cycle, marrow and GI recovery, tolerability (organ damage and physical side effects in short and long term)

21
Q

How are chemotherapeutics monitored?

A

Imaging
Response to treatment:
Tumour markers
Bone marrow/cytogenetics

Drug assays

Organ damage - creatinine damage and echocardiogram

22
Q

What are some of the most adverse effects?

A

Acute renal failure - hyperuricaemia leads to urate crystals in tubules

GI perforation at site of tumour - reported in lymphoma

DIC - onset within few hours for AML

23
Q

What is the local effects of skin toxicity with chemotherapy?

A

Irritation and thrombophlebitis

Extravasation

24
Q

What is haematological toxicity important ?

A

Most frequent dose limiting
Most frequent cause of death

Different agents with variable effects on degree and lineage

25
Q

What causes variability in pharmacokinetics?

A

Abnormalities in absorption, distribution, elimination and protein binding

26
Q

Name some other drug classes used to treat cancer

A

Hormones
Monoclonal antibody
Cytokines
Immunotherapy

Pharmacology (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions