Oncology Flashcards
What detergent is most effective for dispersing oncology drug spills?
Bleach (hypochlorite)
What stages of the cell cycle do the following chemotherapy drugs work on:
a) Antimetabolites
b) Alkylating agents
c) Cross-linking agents
d) Toipomerase inhibitors
e) Antimicrotubule agents
f) Signal transduction inhibitors
a - d = S-phase (DNA replication)
e = mitosis (M-phase)
f = generally G1 (growth 1 phase)
MoA alkylating agents
Cross-linking of DNA leading to strand breaks by covalently binding alklyl groups to macromolecules within the cell
MoA anti-tumour antibiotics
Inhibition of toipoimerases and other mechanisms which interfere with DNA synthesis
Mitotic inhibitors MoA
Inhibit assembly of the mitotic spindle
Platinum compounds MoA
DNA cross linking
Anti-metabolites MoA
Incorporation into DNA interferes with DNA synthesis
Examples of the following oncologic drugs:
a) Alkylating agents
b) Anti-tumour antibiotics
c) Mitotic inhibitors
d) Platinum compounds
a) Cyclophosphamide, chlorambucil, melphalan, lomustine, procarbazine
b) Doxorubicin, mitoxantrone
c) Vinca-alkyloids
d) Cisplatin/carboplatin
Essentially if its not an anti-tumour antibiotic, mitotic inhibitor or platinum compound it is an alkylating agent
For Taxanes (Paclitaxel and Docetaxil) outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) anti-microtubule agents (M-phase specific)
b) Prevention of tubule organisation
c) Hypersensitivity reactions, myelosupression, diarrhoea
d) Hepatic metabolism - biliary excretion
e) Anti-histamines given prior to administration
For Vinca Alkaloids outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) anti-microtubule agents (M-phase specific)
b) Binding to tubulin prevents microtubule assembly
c) Tissue vesicants - HEAT and HYALURONIDASE (also topical DMSO and flucinolone and flunixin meglumine), peripheral myelopathies, alopecia, myelosupression, diarrhoea
d) hepatic metabolism and biliary excretion
e) Care with MDR1
For Cyclophasphamide outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) Alkylating agent (nitrogen mustard)
b) Cross linking of DNA through insertion of an alklyl group
c) DLT include myeosupression (7 days), sterile haemorrhagic cytitis (prevented with frusemide), gastrointestinal signs and alopecia
d) Hepatic metabolism and renal excretion
e) Sterille haemorrhagic cystitis is a result of metabolism to acrolein which is directly toxic to the bladder mucosa. Specific treatments include pentosan sulfate, DMSO, oxybutinin and NSAIDs
For Chlorambucil outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) Alkylating agent (nitrogen mustard)
b) Cros links DNA through insertion of an alkyl group
c) DLT - myelosupression which occurs after 2 - 3 weeks. Cerebellar toxicity, alopecia and GIT signs
d) hepatic metabolism and renal excretion
For Dacarbazine and Procarbazine outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) Alkylating agent
b) Metabolised to MTIC which then methylates guanine
c) Cannot be used in cats as they don’t convert enough to the active form. DLT is GI side effects. Is also a vesicant.
For Ifosphamide outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) Alkylating agent (itrogen mustard) - similar to cyclophosphamide.
b) Insertion of alklyl group
c) DLT = myelosupression, can also cause GI and bladder mucosal changes. It should be administered with mesna and fluids.
For Lomustine outline the:
a) Drug class
b) MoA
c) DLTs/side effects +/- treatments
d) Useful PK/PD to know
e) Notes
a) Alkylating agent
b) as for all alkylating agents
c) DLT is myelosupression which may occur after 7 - 10 days. Other side effects include hepatotoxicity and pulmonary fibrosis (cats).
d) Hepatic metabolism and renal excretion
e)