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CPT - Other Drugs > Immune System and Malignant Disease > Flashcards

Immune System and Malignant Disease Flashcards

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1
Q

Give two examples of antimetabolites used in chemotherapy.

A
  • 5-fluorouracil

* Methotrexate

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2
Q

What is the mechanism of action of 5-fluorouracil?

A

Inhibits thymidylate synthase (can’t produce thymine for DNA synthesis)

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3
Q

What is the mechanism of action of methotrexate?

A

Dihydrofolate reductase inhibitor (can’t produce thymine for DNA synthesis)

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4
Q

What is an example of a vinca alkaloid?

A

Vincristine

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5
Q

What is the mechanism of action of vincristine?

A

Inhibits microtubule assembly, prevent cell replication

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6
Q

What is an example of a taxane?

A

Paclitaxel

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7
Q

What is the mechanism of action of paclitaxel?

A

Inhibits microtubule depolymerisation - so attach to chromatids but can’t pull then pull them to opposite poles

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8
Q

What is an example of a platinum compound?

A

Cisplatin

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9
Q

What is the mechanism of action of cisplatin?

A

Inhibits DNA replication by forming covalent bonds between intra- and inter-strands of DNA (adducts)

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10
Q

What are some of the ADRs of chemotherapy?

A
  • Lungs - Pulmonary fibrosis
  • Heart - Cardiotoxicity, phlebitis
  • GI - nausea, vomiting, diarrhoea and mucositis
  • Urinary - cystitis, renal failure
  • Muscles - Myalgia
  • Bones - Myelosuppression
  • Nerves - Neuropathy
  • Skin/hair - local reaction, alopecia
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11
Q

What are the specific chemotoxicities of cisplatin?

A

Ototoxicity and nephrotoxicity

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12
Q

What are the specific chemotoxicities of vincristine?

A

Peripheral neuropathy

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13
Q

What are the specific chemotoxicities of methotrexate and 5-fluorouracil?

A

Myelosuppression

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14
Q

What are the specific chemotoxicities of cyclophosphamide?

A

Heamorrhagic cystitis

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15
Q

What are 3 examples of anti-proliferative immunosuppressants?

A
  • Azathioprine
  • Cyclophosphamide
  • Mycophenolate mofetil
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16
Q

What are 2 examples of calcineurin inhibitors?

A
  • Ciclosporin

* Tacrolimus

17
Q

What are calcineurin inhibitors used for?

A
  • Transplantation
  • Atopic dermatitis
  • Psoriasis
18
Q

What is the mechanism of action of calcineurin inhibitors?

A

Active against T helper cells - prevent production of IL-2 via calcineurin inhibition

19
Q

When is mycophenolate mofetil used?

A
  • Transplantation

* Induction and maintenance for lupus nephritis/vasculitis maintenance

20
Q

What is the mechanism of action of mycophenolate mofetil?

A

Prodrug

Inhibits IMD, needed for guanosine synthesis - impairs B and T cell proliferation but spares other rapidly dividing cells (due to guanosine salvage pathways in other cells)

21
Q

What are the ADRs of mycophenolate mofetil?

A
  • Nausea and vomiting
  • Diarrhoea
  • Myelosuppression
22
Q

What is the mechanism of action of cyclophosphamide?

A

An alkylating agent - crosslinks DNA so it can’t replicate

23
Q

When is cyclophosphamide used?

A
  • Lymphoma, leukaemia and solid cancers

* Lupus nephritis

24
Q

How is cyclophosphamide excreted?

A

Kidneys

25
Q

What are the toxicities associated with cyclophosphamide?

A
  • Increased risk of bladder cancer, lymphoma and leukaemia

* Infertility (related to accumulative dose and age)

CPT - Other Drugs (11 decks)

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