Oncology Flashcards
What are indications of tamoxifen?
to treat ER+ breast cancer - adjuvant or slow disease progression
What is the mechanism of action of tamoxifen?
2/3 cancer expresses oestrogen receptors - oestrogen binds to these to stimulate cell proliferation. Tamoxifen blocks this effect.
anti-estrogen
What are the important adverse reactions of tamoxifen/letrozole?
anti-oestrogen - vaginal dryness, hot flushes, loss of bone density
venothromboembolism
endometrial cancer
liver failure
What are the warnings for tamoxifen/letrozole?
Fertility related - miscarriage, secreted in breast milk, do not give in pre-menopausal women with ovaries
What are the important interactions of tamoxifen/letrozole?
inhibits P450 - interacts with warfarin
fluoxetine and paroxetine inhibit activation
What is an example of an aromatase inhibitor and how do they work?
Letrozole
inhibit aromatase which converts androgen to oestrogen
What are the common indications of NSAIDs and some examples?
ibuprofen, naproxen
as need analgesia (esp. inflammatory)
What is the mechanism of action of NSAIDs?
COX inhibitor
What are some adverse reactions of NSAIDs?
GI toxicity
renal impairment
increased risk of CVS events
What are some warnings of NSAIDs?
heart, liver, renal failure
GI bleed or peptic ulcer disease
What are some interactions with NSAIDs?
anything that increases GI toxicity - SSRIs, corticosteroids, aspirin, anticoagulants, ACE-i, diuretics
