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Oncology (small) > Medical therapy (Yr4) > Flashcards

Medical therapy (Yr4) Flashcards

1
Q

what is chemotherapy?

A

genotoxic treatment of disease using cytotoxic and other drugs

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2
Q

what four ways can chemotherapy be used?

A

primary (sole therapy)
adjuvant (after surgery)
neoadjuvant (before surgery)
concurrent (simultaneously to radiation)

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3
Q

what cells are targeted by chemotherapy?

A

rapidly dividing cells (doesn’t typically effect cells in G0) only targets DNA/RNA synthesis or protein synthesis

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4
Q

what factors effect chemotherapy success?

A

growth fraction
evolution of resistance
inherent tumour sensitivity
drug dosage
tumour blood/oxygen supply
interval between treatment

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5
Q

what factors effect the response and side effects to chemotherapy?

A

administration (dose, ability to get into blood stream…)
distribution (get to target site/blood…)
metabolism (drug activation/deactivation)
excretion (liver or kidney…)

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6
Q

what patients pose dosing problems for chemotherapy?

A

obese (dose for lean weight?)
breeds with known drug sensitivities (collies)
animals with hepatic/renal compromise

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7
Q

what should the starting dose of chemotherapy drugs be?

A

maximum tolerated dose (this is a bit of a guess)

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8
Q

what is the dose of chemotherapy drugs based on?

A

body surface area (for <10kg it is dosed for mg/kg)

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9
Q

why does there have to be an interval between dosing with chemotherapy drugs?

A

allows recovery of normal tissues

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10
Q

what drugs are in a CHOP protocol?

A

vincristine, doxorubicin, cyclophosphamide, prednisolone

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11
Q

what drugs are in a CEOP protocol?

A

vincristine, epirubicin, cyclophosphamide, prednisolone

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12
Q

what would be the chemotherapy protocol of choice for a dog with lymphoma?

A

CHOP/CEOP

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13
Q

what should be done prior to each chemotherapy treatment?

A

haematology (neutrophil and platelet counts)

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14
Q

what should be done prior to cyclophosphamide therapy?

A

urinalysis

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15
Q

what chemotherapy drugs cause anaphylaxis/hypersensitivity?

A

L-asparaginase

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16
Q

what chemotherapy drugs cause cardiac arrhythmias?

A

doxorubicin

17
Q

what chemotherapy drugs cause emesis?

A

platinum compounds

18
Q

what causes acute tumour lysis syndrome?

A

rapid destruction of cancer cells in patients with a large tumour burden

19
Q

how is acute tumour lysis syndrome treated?

A

monitoring at risk patients
early IVFT
management of acute kidney injury (caused by the lysis syndrome)

20
Q

what are the main general side effects of chemotherapy?

A

bone marrow (low WBC 7-10 days)
alopecia
GI toxicity (usually only fist 5 days)
(they all relate to rapidly dividing cells)

21
Q

how can we pre-emptively manage GI toxicity from the chemotherapy drugs?

A

maropitant (prevent vomiting)
pre-treatment fasting to reduce diarrhoea
smectite for diarrhoea

22
Q

how should pyrexic neutropenic patients 7-10 days post-chemotherapy be managed?

A

might be septic (this is an emergency)
hospitalise until systemically well and stop all cytotoxic drugs (reduce dose next time)
barrier nursing and antibiotics

23
Q

what drug can cause cumulative cardio toxicity (DCM)?

A

doxorubicin

24
Q

what drug can cause sterile haemorrhagic cystitis?

A

cyclophosphamide

25
Q

what drug can cause hepatotoxicity?

A

lomustine (dogs)

26
Q

what drugs can cause nephrotoxicity?

A

cisplatin, doxorubicin, lomustine

27
Q

what drug can cause fatal non-cariogenic pulmonary oedema?

A

cisplatin

28
Q

what drugs are catastrophic perivascular irritants?

A

doxorubicin and epirubicin

29
Q

what is metronomic chemotherapy?

A

continuous low dose chemotherapy usually used as palliative therapy with the main target being angiogenesis

30
Q

what is the typical drug used for metronomic chemotherapy?

A

low dose cyclophosphamide (with an NSAID)

31
Q

how do tyrosine kinase inhibitors work?

A

inhibit activation of specific signalling pathways by specific cancer types

32
Q

what are two examples of tyrosine kinase inhibitors?

A

toceranib and mastitinib

33
Q

what are possible side effects of tyrosine kinase inhibitors?

A

diarrhoea, vomiting, anorexia
bone marrow suppression

Oncology (small) (8 decks)

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