Chemotherapy Flashcards
What are the different types of chemotherapy
=Neo-adjuvant
=Adjuvant
=Palliative
What type of drugs would you use for chemotherapy
Cytotoxic drugs which kill rapidly dividing cells
Why do we give multiple drug regimens
Different classes work in different ways and attack different sites of cell division
-Also reduces toxicity
Why do we give cycles of chemotherapy
- Achieve total cell kill
- Limit toxicity
- Typically 3 week cycles
What do the antimetabolites do
Interfere with the metabolic pathways In DNA synthesis
What are folate antagonists do
- Inhibit purine and pyrimidine synthesis
- Interfere with the folic acid system
What is Neo-adjuvant chemotherapy
Anti-caner drugs at the start of treatment to shrink the tumour and it facilitates surgery
What is adjuvant chemotherapy
Mop up any cells left behind after surgery or any metastasised cells
What is palliative chemotherapy
Use of drugs to alleviate symptoms of patients with non-curable cancer
What would you do after you give someone a folate antagonist and why
Give patient folic acid to stop formation of megaloblastic anaemia
What do false substrates do
They are chemically similar to pyrimidine and so is incorporated into DNA as false metabolites and lead to the damage of DNA
-ALso inhibits thymidylate synthase
What do alkylating agents do
Cause chemical cross-linking of DNA leading to defective DNA replication
What do platinum compounds do
Inhibition of DNA synthesis by cross linking guanine residues and so DNA can’t also be repaired
What are side effects of platinum compounds
Cause a lot of nausea
What do anthracycline antibiotics do
Interfere with nucleotide synthesis by intercalating between DNA strands so DNA replication can’t take place, inhibiting topoisomerase and generating free radicals
what do topoisomerase inhibitors do
Inhibit topoisomerase 2 which means DNA can’t stick together and so DNA starts to break up
What are the two types of microtubule inhibitors
Vinca alkaloids and taxanes
What is the role of vinca alkaloids (type of microtubule inhibitors)
Block the formation of mitotic spindle
What is the role of taxanes (type of microtubule inhibitors)
Make spindle fibres rigid so they can’t be involved in mitosis
What is a side effect of anticancer drugs
Myelosuppression (inhibition of production of cells in bone marrow)
Inhibit all fast growing cells
What does myelosupression cause
- Anaemia
- Decreased resistance to infection so increased chance of getting neutropenic sepsis
- Increased bleeding
What should you do to make sure that myelosuppression isn’t uncontrolled
Monitor blood cell counts and Hb before and during treatment
how do you know when the patient should have the next treatment
See when the blood count becomes near to normal
Why is neutropenic sepsis likely during chemotherapy
Because of a reduction of neutrophils
How do you overcome reduced white counts
Colony-Stimulating Factors
What drug causes cardio toxicity when used with anticancer drugs
Anthracycline antibiotics
What drugs are used to overcome nausea caused by platinum compounds
anti-emetics
What is used for palliative care
- Pain relief
- Strong opioids
- laxatives for the constipation
What opioids are used for pain relief in palliative care
Morphine and diamorphine
When are morphine and diamorphine used
Morphine-Twice a day to provide baseline cover for pain relief
Diamorphine-More water soluble so used intravenously
When is oramorph used
For breakthrough pain when the opioids aren’t working
when are fentanyl patches used for
Pain relied and to use for helping patient to swallow
