Chemotherapy drugs

Question 1

What is cancer?

Answer 1

Uncontrolled proliferation - tumour - bening OR malignant

Question 2

What causes cancer?

Answer 2

DNA mutation (inherited or acquired)

Question 3

How is cell growth usually regulated?

Answer 3

Apoptosis
Growth factors
Telomeres
Cell cycle transducers

Question 4

Define proto oncogene

Answer 4

A normal gene that when altered by mutation = oncogene

Question 5

Why are oncogenes dangerous?

Answer 5

Produce large amounts of protein to promote cell survival (anti-apoptopic)

Question 6

What are telomeres function?

Answer 6

Protect cell from deterioration or fusing with other chromosomes and with every replication they get shorter and eventually stop functioning

Question 7

In tumours, how does telomerase work?

Answer 7

Protects and repairs telomeres allowing cells to reproduce

Question 8

Why is angiogenesis needed for the growth and spread of tumours?

Answer 8

So that blood vessels can allow cells to be transported causing a secondary tumour

Question 9

Define dedifferentiation in tumour cells…

Answer 9

Specialised cells revert back to poorly differentiated

Question 10

What are the objectives of cancer therapy?

Answer 10

Curing
Prolonging
Palliative

Question 11

Name the different cancer treatments…

Answer 11

Surgery
Irradiation
Drug therapy
Combo of above

Question 12

Name the 3 compartments of a solid tumour…

Answer 12

Dividing cells
Resting cells
Cells no longer dividing

Question 13

Name the classes of alkylating agents…

Answer 13

Nitrogen mustards
Nitrosoureas
Platinum compounds
Others (Busulfan etc)

Question 14

What are alyklating agents mechanism of action?

Answer 14

Target cells in S phase

Inhibits replication by preventing uncoiling

Question 15

Cyclophosphamide, melphalan, chlorambucil, bendamustine, estramustine and mechlorethamine are what…

Answer 15

Nitrogen mustards

Question 16

What route are nitrogen mustards given?

Answer 16

IV

Question 17

Examples of nitrosureas…

Answer 17

Carmustine

Lomustine

Question 18

Cisplatin
Carboplatin (less side effects than cisplatin)
Oxaliplatin
Are examples of…

Answer 18

Platinum compounds

Question 19

Side effects of cisplatin…

Answer 19

V. nephrotoxic – requires hydration/ infusion
Causes severe nausea/ vomiting
Risk of tinnitus, peripheral neuropathy, hyperuricaemia (gout) + anaphylaxis

Question 20

Bulsofan
Procarbazine
Trabectedin
Are examples of…

Answer 20

Other alkylating agents

Question 21

Name the classes of antimetabolites…

Answer 21

Folate antagonists
Purine analogues
Pyrimidine analogues

Question 22

Name a folate antagonist…

Answer 22

Methotrexate

Question 23

Problems with methotrexate?

Answer 23

Tumour cells develop resistance

Question 24

Fluorouracil, capecitabine, cytarabine, gemcitabine

Answer 24

Pyrimidine analogues (given parenterally)

Question 25

Mercaptopurine, tioguanine, pentostatin, fludarabine

Answer 25

Purine analogues

Question 26

Name the 2 main cytotoxic antibiotics...

Answer 26

Doxorubicin | Bleomycin

Question 27

Doxorubicin cause cause...

Answer 27

Cardiac dysrhythmias/ heart failure

Question 28

Bleomycin can cause...

Answer 28

Pulmonary fibrosis Mucocutaneous reactions Hyperpyrexia

Question 29

Name the plant derivatives...

Answer 29

Vincristine Vinblastine Vindesine

Question 30

Plant derivatives only have an effect in the...

Answer 30

Mitosis phase

Question 31

Vincristine can have what effects?

Answer 31

Neuromuscular

Question 32

Hormones used in treatment of cancers in hormone-sensitive tissues such as

Answer 32

Ovaries, prostate and breast

Question 33

Hormone drugs mechanism of action...

Answer 33

Tumour growth inhibited by R antagonists, hormones with opposing actions, or drugs which block synthesis of endogenous hormones

Question 34

Name an example of oestrogen hormones...

Answer 34

Ethinyloestradiol

Question 35

Side effects of ethinyloestradiol ...

Answer 35

Nausea, fluid retention, thrombosis, impotence + gynaecomastia

Question 36

Examples of progesterones...

Answer 36

Megestrol, medroxyprogesterone, norethisterone

Question 37

Examples of GNRH analogues

Answer 37

Goserelin, buserelin, leuprorelin, triptorelin

Question 38

Name somatostatin analogues...

Answer 38

Octreotide/ lanreotide (used to treat hormone secreting tumours of GI tract)

Question 39

Name hormone antagonists...

Answer 39

Tamoxifen (breast cancer) Letrozole/ exemastine Flutamide, cyproterone, bicalutamide (prostate cancer)

Question 40

Name the glucocorticoids that inhibit lymphocyte proliferation

Answer 40

Prednisolone | Dexamethasone

Question 41

Advantages of monoclonal antibodies...

Answer 41

Targeted therapy | Fewer side effects

Question 42

Disadvantages of monoclonal antibodies...

Answer 42

Expensive | Must be given in combo with other drugs

Question 43

Which monoclonal antibody binds to CD20 protein, expressed on certain lymphoma cells → lysis of B-lymphocytes

Answer 43

Rituximab

Question 44

Side effects of rituximab...

Answer 44

Hypotension, chills, fever and hypersensitivity

Question 45

Name other examples of monoclonal antibodies...

Answer 45

Trastuzumab Ofatumumab Bevacizumab

Question 46

Which protein kinase inhibitor blocks tyrosine kinases involved in GF signaling pathways

Answer 46

Imatinib

Question 47

Ondansetron, granisetron and metoclopramide are given to control...

Answer 47

N and V

Question 48

Lorazepam is given to control...

Answer 48

Anxiety

Question 49

What are autologous and allogenic stem cells...

Answer 49

Autologous: stem cells harvested from patient + infused back after chemotherapy Allogenic: stem cells from a matched donor i.e. collected from blood (by dialysis) or bone marrow