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Y4 Cancer and Continuing Care > Cytotoxic Drugs > Flashcards

Cytotoxic Drugs Flashcards

1
Q

What is the mechanism of action of cyclophosphamide?

A

Alkylating agent

Causes cross-linking in DNA

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2
Q

What adverse effects are associated with cyclophosphamide?

A

Haemorrhagic cystitis

Myelosuppression

Transitional cell carcinoma

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3
Q

What is the mechanism of action of bleomycin?

A

Cytotoxic antibiotic

Degrades preformed DNA

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4
Q

What adverse effects are associated with bleomycin?

A

Lung fibrosis

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5
Q

What is the mechanism of action of anthracyclines (such as doxorubicin)?

A

Cytotoxic antibiotic

Stabilises DNA-topoisomerase II complex, inhibits DNA & RNA synthesis

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6
Q

What adverse effects are associated with anthracyclines (such as doxorubicin)?

A

Cardiomyopathy

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7
Q

What is the mechanism of action of methotrexate?

A

Antimetabolite

Inhibits dihydrofolate reductase and thymidylate synthesis

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8
Q

What adverse effects are associated with methotrexate?

A

Myelosuppression

Mucositis

Liver fibrosis

Lung fibrosis

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9
Q

What is the mechanism of action of fluorouracil (5-FU)?

A

Antimetabolite

Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (works during S phase).

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10
Q

What adverse effects are associated with antimetabolites?

A

Myelosuppression

Mucositis

Dermatitis

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11
Q

What is the mechanism of action of 6-mercaptopurine?

A

Antimetabolite.

Purine analogue that is activated by HGPRTase, decreasing purine synthesis

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12
Q

What adverse effects are associated with 6-mercaptopurine?

A

Myelosuppression

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13
Q

What is the mechanism of action of cytarabine?

A

Antimetabolite.

Pyrimidine antagonist. Interferes with DNA synthesis (specifically at S-phase) and inhibits DNA polymerase

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14
Q

What adverse effects are associated with cytarabine?

A

Myelosuppression

Ataxia

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15
Q

How do antimetabolites work?

A

Antimetabolites are drugs that interfere with one or more enzymes, or their reactions, that are necessary for DNA synthesis.

Antimetabolites are structurally similar enough to natural enzymes to replace them but different enough to interfere with their role.

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16
Q

What are examples of antimetabolites?

A

Methotrexate

Fluorouracil

6-mercaptopurine

Cytarabine

17
Q

What is the mechanism of action of vincristine?

A

Inhibits formation of microtubules

18
Q

What adverse effects are associated with vincristine?

A

Peripheral neuropathy (reversible)

Paralytic ileus

19
Q

What is the mechanism of action of vinblastine?

A

Inhibits formation of microtubules

20
Q

What adverse effects are associated with vinblastine?

A

Myelosuppression

21
Q

What is the mechanism of action of docetaxel?

A

Prevents microtubule depolymerisation and disassembly, decreasing free tubulin.

22
Q

What adverse effects are associated with docetaxel?

A

Neutropenia

23
Q

What is the mechanism of action of irinotecan?

A

Topoisomerase inhibitor

Inhibits topoisomerase I, which prevents relaxation of supercoiled DNA

24
Q

What adverse effects are associated with irinotecan?

A

Myelosuppression

25
Q

What is the normal role of topoisomerases?

A

Topoisomerases (or DNA topoisomerases) are enzymes that participate in the overwinding or underwinding of DNA.

The winding problem of DNA arises due to the intertwined nature of its double-helical structure. During DNA replication and transcription, DNA becomes overwound ahead of a replication fork.

Topoisomerase inhibitors (such as irinotecan) inhibit these enzymes and prevent DNA being unwound.

26
Q

What is the mechanism of action of cisplatin?

A

Cisplatin causes cross-linking in DNA

27
Q

What adverse effects are associated with cisplatin?

A

Ototoxicity

Peripheral neuropathy

Hypomagnesaemia

28
Q

What is the mechanism of action of hydroxyurea (hydroxycarbamide)?

A

Inhibits ribonucleotide reductase, decreasing DNA synthesis

29
Q

What adverse effects are associated with hydroxyurea (hydroxycarbamide)?

A

Myelosuppression

30
Q

Myelosuppression is a common side effect of cytotoxic drugs. Which of the main cytotoxic drugs are NOT significantly associated with myelosuppression?

A

(in brackets = target)

Cisplatin (DNA cross-linking)

Docetaxel (microtubules)

Vincristine (microtubules)

Bleomycin (degrades preformed DNA)

Anthracyclines (DNA synthesis)

31
Q

Which cytotoxic drug is associated with peripheral neuropathy?

A

Vincristine is associated with peripheral neuropathy

Cisplatin also associated

32
Q

Which cytotoxic drug is associated with haemorrhagic cystitis?

A

Cyclophosphamide is associated with haemorrhagic cystitis

33
Q

Which cytotoxic drug is associated with lung fibrosis?

A

Bleomycin is associated with lung fibrosis

34
Q

Which cytotoxic drug is associated with cardiomyopathy?

A

Doxorubicin is associated with cardiomyopathy.

Doxorubicin is an example of anthracycline.

35
Q

Which cytotoxic drug is associated with oto- and nephro- toxicity?

A

Cisplatin is associated with ototoxicity and nephrotoxicity

36
Q

Try and draw the toxicity bear! The key is on the other side of this card

A

A = Asparagine: Neurotoxic

C = Cisplatin: Ototoxic and nephrotoxic

V = Vincristine: Peripheral neuropathy
V = Vinblastine: Myelosuppression
(Christine is nervous; Blast my bones!)

B = Bleomycin: Pulmonary fibrosis

D = Doxorubicin: Cardiomyopathy

Psi = Cyclophosphamide: Haemorrhagic cystitis

M = Methotrexate: Nephrotoxic and myelosuppression

37
Q

A 62-year-old woman who is known to have metastatic breast cancer presents with increasing shortness of breath. She is currently receiving a chemotherapy regime. On examination she has a third heart sound and the apex beat is displaced to the 6th intercostal space, anterior axillary line. Which one of the following chemotherapeutic agents is most likely to be responsible?

A) Bleomycin
B) Dactinomycin
C) Docetaxel
D) Doxorubicin
E) Paclitaxel
A

D) Doxorubicin

Anthracyclines (e.g. doxorubicin) may cause cardiomyopathy.

Y4 Cancer and Continuing Care (34 decks)

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