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Jorge FCP > Introduction to Chemotherapeutics > Flashcards

Introduction to Chemotherapeutics Flashcards

1
Q

What is a chemotherapeutic agent?

A

A drug used to treat cancers by causing cell death or stopping cells from dividing

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2
Q

What routes of administration of chemotherapeutic agents can be used?

A

Oral
Injection
IV infusion - often given slowly and can be irritant if leakage
Topical - less common in veterinary to prevent ingestion

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3
Q

How are chemotherapeutic drugs used?

A

Used alone e.g., lymphoma
Used in conjunction with radiotherapy and/or surgery e.g., mast cell tumours

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4
Q

What are cytotoxic drugs?

A

‘indiscriminate’
inhibit mitosis and/or damage DNA
kill rapidly dividing cells

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5
Q

What cells do cytotoxic drugs target?

A

Rapidly dividing cells
e.g., neoplastic cells
Also GI tract epithelium and bone marrow cells (body has to compensate, leads to adverse effects)

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6
Q

What are some examples of commonly used cytotoxic agents for lymphoma?

A

vincristine, doxorubicin, chlorambucil, cyclophosphamide

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7
Q

What are the newer chemotherapeutic agents used?

A

Targeted therapy against specific receptors, signalling pathways and antigens

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8
Q

Give examples of targeted chemotherapeutic therapies

A

Tyrosine kinase inhibitors for mast cell tumours in dogs -masitinib, toceranib
Monoclonal antibodies vs specific tumour antigens

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9
Q

What are the limitations of cytotoxic drugs?

A

Palliative not curative
Toxicity limits dosage and dosage frequency

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10
Q

What is the maximum tolerated dose?

A

highest dose with ‘acceptable’ side effects

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11
Q

What is metronomic chemotherapy?

A

Aims: delay or slow disease progression not kill cancer cells
Inhibits angiogenesis (development of new blood vessels - inhibits blood supply to cancer cells)
Modulates immune response to cancer cells

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12
Q

Which cytotoxic drugs are cell cycle non-specific?

A

doxorubicin
cyclophosphamide
lomustine
chlorambucil

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13
Q

Which cytotoxic drugs are cell cycle specific?

A

vincristine
vinblastine
cytarabine

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14
Q

What are the classes of chemotherapeutic drugs?

A

alkylating agents
plant alkaloids
anti-metabolites
anti-tumour antibiotics
platinum analogs
Tyrosine kinase inhibitors

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15
Q

What is the mode of action of alkylating agents?

A

Alkyl group binds to and cross links DNA

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16
Q

Give examples of alkylating agents and their clinical uses

A

chlorambucil
cyclophosphamide
lomustine
melphalan

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17
Q

What is the clinical use of alkylating agent - chlorambucil

A

low grade lymphoma (cats)
immune mediated diseases

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18
Q

What is the clinical use of alkylating agent - cyclophosphamide?

A

lymphoma
haemangiosarcoma
metronomic chemotherapy

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19
Q

What is the clinical use of alkylating agent - lomustine?

A

lymphoma
mast cell tumour

20
Q

What is the clinical use of alkylating agent - melphalan?

A

myeloma

21
Q

What are the adverse effects of alkylating agents?

A

Myelosuppression
GI signs
Sterile haemorrhagic cystitis (cyclophosphamide)
Hepatotoxicity (lomustine)

22
Q

What is the mode of action of plant alkaloids?

A

bind to tubulin cells and disrupt mitotic spindle

23
Q

Give examples of plant alkaloids

A

Vincristine
Vinblastine

24
Q

What is the clinical use of plant alkaloid - vincristine?

A

Lymphoma, leukaemia

25
Q

What is the clinical use of plant alkaloid - vinblastine?

A

mast cell tumour

26
Q

What are the adverse effects of plant alkaloids?

A

GI signs
Myelosuppression
Irritant if leaks from vein
Peripheral neuropathy

27
Q

What is the mode of action of anti metabolites?

A

Inhibit use of cell metabolites used in growth and cell division

28
Q

Give an example of an anti metabolite

A

Cytarabine

29
Q

What is the clinical use of the anti metabolite cytrabine?

A

Lymphoma with CNS involvement

30
Q

What are the adverse effects of anti metabolites?

A

Myelosuppression
GI signs
Alopecia
Hepatotoxicity

31
Q

What is the mode of action of anti-tumour antibiotics?

A

Inhibit topoisomerase-II causing breakage of DNA and cell death; forms free radicals

32
Q

What are examples of anti-tumour antibiotics?

A

Doxorubicin
Mitoxantrone

33
Q

What is the clinical use of anti-tumour antibiotic - doxorubicin?

A

lymphoma
haemangiosarcoma

34
Q

What is the clinical use of anti-tumour antibiotic - mitoxantrone?

A

lymphoma
haemangiosarcoma

35
Q

What are the adverse effects of anti-tumour antibiotics?

A

Myelosuppression
GI signs
Extreme irritation if leaks from vein
Alopecia
Cumulative cardiotoxicity (dogs)
Nephrotoxic (cats)<

36
Q

What is the mode of action of platinum analogs?

A

Bind platinum to DNA causing cross linkage and cell death

37
Q

What is an example of a platinum analog?

A

carboplatin

38
Q

What is the clinical use of the platinum analog carboplatin?

A

osteosarcoma
carcinomas

39
Q

What are the adverse effects of platinum analogs?

A

Myelosuppression
GI signs

40
Q

What is the mode of action of tyrosine kinase inhibitors?

A

Inhibit various TK receptors

41
Q

What are examples of tyrosine kinase inhibitors?

A

Toceranib
Masitinib

42
Q

What is the clinical use of the TK inhibitor - toceranib?

A

mast cell tumour

43
Q

What is the clinical use of the TK inhibitor - masitinib?

A

mast cell tumour
immune mediated diseases

44
Q

What are the adverse effects of TK inhibitors?

A

Weight loss
GI signs
Alopecia
Nephrotoxicity

45
Q

How can the benefit of chemotherapeutic drugs be maximised?

A

treat small tumours with a high growth fraction - plenty of rapidly dividing cells to target
Cell cycle specific drugs kill a limited number of cell each dose - repeat doses as often as possible and use combinations of drugs to target different phases in different ways

46
Q

How can the harm of chemotherapeutic drugs be minimised?

A

Be aware of adverse effects - symptomatic treatments, monitor patient, communicate with owner
Ensure quality of life is maintained

47
Q

How can chemotherapeutic drugs cause harm to humans?

A

direct exposure
metabolites excreted by pets

Jorge FCP (59 decks)

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