GI MC4 Flashcards
Anastrozole
aromatase inhibitor
vagina adverse effects of Anastrozole
vaginal dryness, vaginal bleeding,
hair thinning,
GI adverse effects of Anastrozole
anorexia, nausea, vomiting, diarrhoea,
bone adverse effects of Anastrozole
arthralgia, arthritis, bone fractures, bone pain,
skin adverse effects of Anastrozole
rash (including stevens-johnson syndrome), cutaneous vasculitis,
head adverse effects of Anastrozole
Hot flushes, asthenia and drowsiness -may affect driving or operate machinery,
other adverse effects of Anastrozole
Slight increase in total cholesterol
Very rarely allergic reactions including angioedema and anaphylaxis
Tamoxifen
oestrogen receptor antagonist
SSRIs affect on breast cancer treatment
can inhibit metabolism of tamoxifen
warfarin affect on breast cancer treatment
Tamoxifen inhibits CYP3A4 therefore increasing risk of bleeding
chemo regime
Induction
Consolidation
Maintenance
induction
intensive treatment aimed at destroying as many leukaemia cells as possible and achieving remission
induction duration
4-6 weeks
Consolidation
aimed at remission and preventing spread. Often involves intra-spinal injections and then tablets.
Maintenance
Involves regular tablets and possible injections.
Maintenance duration
lasts 2 years (girls) or 3 years (boys)
Hyper-CVAD chemo combination
Cyclophosphamide, vincristine, doxorubicin, dexamethasone
why do we use combo chemo
exploits dif stages of cell cycle
Cyclophosphamide
bifunctional alkylating drug
Cyclophosphamide side effecs
Impaired fertility in future
Bone marrow suppression and neutropenia
Can develop other malignancies → e.g acute myeloid leukaemia, bladder cancer
how to reduce rick of chemo bladder cancer
mesna
mesna
mercaptoethane sulphonic acid prior to treatment
Vincristine
Vinca alkaloids- mitotic inhibitors
how does vincristine work
block mitosis in metaphase- tubulin molecules fail to polymerize in the presence of vinca alkaloids
in anaphase dissolution of the mitotic spindle leads to cell death
Doxorubicin
Anthracycline - cytotoxic antibiotic
Doxorubicin side effect
dilated cardiomyopathy .
Methotrexate starts when
6 week chemotherapy induction
Methotrexate
folic acid antagonist
hwo is Methotrexate excreted
renally
Methotrexate main side effect
hepatotoxicity
why monitor FBC with methotrexate
monitor platelet count as can cause toxicity to bone marrow
Chemotherapy GI side effects
diarrhoea, sore mouth, nausea and vomiting
Chemotherapy Bone marrow side effects
myelosuppression can lead to anaemia, neutropenia and thrombocytopenia
Chemotherapy hair side effects
partial/ total alopecia
Chemotherapy fertiloity side effects
Reproduction: can affect both men and women
Chemotherapy tumour lysis syndrome
rapid breakdown of malignant cells can cause hyperuricemia, hyperkalaemia, hypophosphatemia, hypocalcemia with consequent renal damage/ arrhythmias
Capecitabine
base analogue anti-metabolite
Capecitabine MOA
Interferes with DNA synthesis- stops cells making and repairing DNA
It is a pyrimidine antagonist and is a prodrug of flurouracil
Oxaliplatin
platinum compound
Cisplatin and carboplatin are used for
solid malignancy
side effects of platinum compounds
Severe nausea and vomiting Nephrotoxicity with renal impairment (hydration important) Ototoxicity Peripheral neuropathy Myelosuppression
