Chemotherapy Flashcards
Which tumours have high sensitivity to chemo?
Lymphomas Germ cell tumours SCLC Neuroblastoma Wilm's tumour
Which tumours have a modest sensitivity to chemo?
Breast Colorectal Bladder Ovary Cervix
Which tumours have a low sensitivity to chemo?
Prostate
Renal cell
Brain
Endometrial
What are the main classes of chemotherapy agents?
Antimetabolites
Alkylating agents
Intercalating agents
Spindle poisons
Which part of the cell cycle do antimetabolites act at?
Act on DNA synthesis
What part of the the cell cycle to alkylating agents act on?
DNA replication
What part of the cell cycle do intercalating agents act on?
DNA transcription
DNA duplication
What part of the cell cycle do spindle poisons act on?
Miosis
What is an example of an alkylating agent?
Cisplatin
What is cisplatin derived from?
Platinum
What is the route of administration of cisplatin?
IV
What is the mechanism of cisplatin?
Forms a ligand between DNA strands
Causes a single strand break so replication is impaired
What are the side effects of cisplatin?
Anaemia Bone marrow failure Fever Leucopenia Nephrotoxicity
What are examples of antibmetabolites?
Methotrexate
5-fluorouracil
What are indications for methotrexate?
RA
Cancer
Psoriasis
IBD
What are the routes of administration of methotrexate?
PO
IM
IV
What is the mechanism of methotrexate?
Inhibits dihydrofolate reductase
Reduces the synthesis of purines/pyrimidines
Prevent DNA synthesis
What are the side effects of methotrexate?
Fever Headache Nausea Vomiting Mucositis Bone marrow suppression
What are the indications for 5-fluorouracil?
Solid GI tumour
(pre)malignant skin lesions
What are the routes of administration for 5-fluorouracil?
IV
IM
Skin cream
What is the mechanism of 5-fluorouracil?
Inhibit thymidylate synthase
Reduce synthesis of purines/pyrimidines
Prevents DNA synthesis
What are the main types of spindle poison?
Vinca alkaloids
Taxanes
What is an example of a vinca alkaloid?
Vincristine
What is the mechanism of vinca alkaloids?
Inhibit assemble of microtubules - prevent spinle formation
Cells cannot divide
What are side effects of vinca alkaloids?
Nausea
Abdominal cramps
V+D
What is an example of a taxane?
Paclitaxel
What is the mechanism of taxanes?
Microtubule depolymerisation inhibitor - cells are too rigid so cannot divide
What are the side effects of taxanes?
Alopecia Depression Bone marrow disorder Insomnia Weight changes