Oncology Flashcards
1
Q
Name the side effects of cytotoxic drugs
A
- Cyclophosphamide: haemorrhagic cystitis, myelosuppression, transitional cell carcinoma.
- Bleomycin: lung fibrosis.
- Doxorubicin: cardiomyopathy.
- Methotrexate: myelosuppression, mucositis, liver fibrosis, lung fibrosis, nephrotoxicity.
- Fluorouracil: myelosuppression, mucositis, dermatitis.
- Vincristine: peripheral neuropathy.
- Vinblastine: myelosuppression.
- Docetaxel: neutropenia.
- Cisplatin: ototoxicity, peripheral neuropathy, hypomagnesaemia.
- Asparagine: neurotoxicity.
2
Q
Describe the MOA of common cytotoxic agents
A
- Cyclophosphamide: Alkylating agent - causes cross-linking in DNA.
- Bleomycin: Degrades preformed DNA.
- Doxorubicin: Anthracycline - Stabilizes DNA-topoisomerase II complex inhibits DNA & RNA synthesis.
- Methotrexate: Inhibits dihydrofolate reductase and thymidylate synthesis.
- Fluorouracil: Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase.
- 6-mercaptopurine: Purine analogue that is activated by HGPRTase, decreasing purine synthesis.
- Cytarabine: Pyrimidine antagonist. Interferes with DNA synthesis specifically at the S-phase of the cell cycle and inhibits DNA polymerase.
- Vincristine/vinblastine: Inhibits formation of microtubules.
- Docetaxel: Prevents microtubule depolymerisation & disassembly, decreasing free tubulin.
- Cisplatin: Causes cross-linking in DNA.
- Hydroxyurea (hydroxycarbamide): Inhibits ribonucleotide reductase, decreasing DNA synthesis.
3
Q
Suppression of N+V in intracranial tumours
A
Dexamethasone
4
Q
Outline the features of neoplastic spinal cord compression
A
- Back pain.
- Lower limb weakness.
- Sensory loss and numbness.
- Lesions above L1 result in UMN signs in the legs and a sensory level.
- Lesions below L1 cause LMN signs in legs and perianal numbness.
5
Q
What is the management of neoplastic spinal cord compression?
A
High dose dexamethasone
6
Q
What is the investigation of choice for suspected neoplastic spinal cord compression?
A
Whole MRI spine
