Cytotoxic Drugs Flashcards
classification of drugs
- cell cycle specific
2. non-cell cycle specific
features of cell cycle specific agents
tumour specific
duration of exposure more important than dose
examples of cell cycle specific drugs
methotrexate
hydroxyurea
what does methotrexate inhibit
dihydrofolate reductase
what does hydroxyurea impair
deoxynucleotide synthesis
features of non-cell cycle specific drugs
non tumour specific – damage normal stem cells, can lead to secondary malignancy
cumulative dose more important than duration
examples of non-cell cycle specific drugs
alkylating agents
- chlorambucil
platinum derivates
- cis-platinum
what group of antibiotics are cytotoxic
anthracyclines
general side effects of cytotoxic drugs
bone marrow suppression
gut mucosal damage
alopecia
side effect of cis-platinum
nephrotoxicity
side effect of anthracyclines
cardiotoxicity
side effect of neuropathy
vinca alkaloids
side effect of alkylating agents
infertility
secondary malignancy
why does chemo fail
slow tumour doubling time
tumour sanctuaries
what limits chemo intensity
myelosuppression
why is chronic lymphoid leukaemia difficult to treat
p53 mutations
what drug is given in Hodgkin lymphoma
bleomycin
what can but given in high grade B cell NHL
rituximab
prophylactic drugs given to chemo patients
anti-fungals
- itraconazole/ posaconazole
how does chronic myeloid leukaemia progress
chronic phase – accelerated phase – blast crisis
which cancers respond well to chemo and why
lymphoma, CLL and acute leukaemia
cells are more easily triggered to undergo apoptosis
what is neutropenic sepsis
sepsis + neutrophil count <0.5
0r <1 if chemo in past 21 days
what type of drug is useful in chronic myeloid leukaemia
tyrosine kinase inhibitor
what does rituximab ‘kill off’
anti CD20- B cells
