Pharmacology

Question 1

What are the 2 groups/classifications of cytotoxic therapy?

Answer 1

Cell cycle -specific

Non cell cycle -specific

Question 2

Cell cycle -specific cytotoxic therapy is relatively tumour specific. The dosage is more important than the duration of exposure. True/False?

Answer 2

False

Duration of exposure is more important than dosage

Question 3

What are the 2 main cell cycle -specific cytotoxic agents?

Answer 3

Antimetabolites (impair nucleotide synthesis)

Mitotic spindle inhibitors

Question 4

List some examples of antimetabolite cytotoxic agents

Answer 4

Methotrexate
6-Mercaptopurine
Hydroxyurea

Question 5

List some examples of mitotic spindle inhibitors

Answer 5

PLANT DERIVATIVES
Vinca alkaloids (Vincristine)
Taxotere

Question 6

Non cell cycle -specific cytotoxic therapy is not tumour specific. The dosage is more important than the duration of exposure. True/False?

Answer 6

True

Question 7

What are the 2 main non cell cycle -specific cytotoxic agents?

Answer 7

Alkylating agents
Platinum derivatives
Cytotoxic antibiotics (anthracyclines)

Question 8

Explain the mechanism of action of non cell cycle -specific cytotoxic agents

Answer 8

Bind to DNA bases
Impair RNA transcription
Break DNA strands by producing free radicals

Question 9

Give an example of alkylating cytotoxic agents

Answer 9

Chlorambucil

Question 10

List some examples of platinum derivative cytotoxic agents

Answer 10

Carboplatin

Cisplatin

Question 11

List some examples of cytotoxic antibiotics

Answer 11

Daunorubicin
Doxorubicin
Idorubicin

Question 12

List some immediate side effects of cytotoxic therapy

Answer 12

Bone marrow suppression
Gut mucosal damage
Hair loss (alopecia)

Question 13

Give a long term side effect of anthracyclines

Answer 13

Cardiomyopathy

Question 14

Give a long term side effect of vinca alkaloids

Answer 14

Neuropathy

Question 15

Give a long term side effect of cisplatin

Answer 15

Nephrotoxicity

Question 16

List some long term side effects of alkylating agents

Answer 16

Infertility

Secondary malignancy

Question 17

Combination chemotherapy is used as therapy in haematological malignancy. What is intensifying chemo limited by?

Answer 17

Myelosuppression

Question 18

How is myelosuppression overcome in patients on chemotherapy?

Answer 18

Use of growth factors
Using myelosupressive/non-myelosupressive agents
Identifying dose of active agents

Question 19

List sources of stem cells used for transplantation

Answer 19

Tissue source (blood versus bone marrow)
Patient source (autologous, allogenic from relative)

Question 20

What is involved in progenitor cell transplantation?

Answer 20

Replacement of the bone marrow

Question 21

What is the first line treatment for haematological malignancy?

Answer 21

Short course chemotherapy

Involved field radiotherapy

Question 22

What form of adjuvant therapy is good in lymphoma?

Answer 22

Radiotherapy

Question 23

What is the first line treatment for NHL?

Answer 23

Monoclonal antibody (RCHOP21)
Chemotherapy

Question 24

What is the first line treatment for chronic myeloid leukaemia?

Answer 24

Tyrosine kinase inhibitors

Imatinib

Question 25

What is the first line treatment for acute myeloid leukaemia?

Answer 25

``` Chemotherapy (cytarabine) Supportive care (hydroxycarbamide) ```

Question 26

What is the first line treatment for HL?

Answer 26

Chemotherapy (CCT for late stage) | Radiotherapy (for early stage disease)

Question 27

What is the first line treatment for CLL?

Answer 27

Observation (usually for many years) | Chemoimmunotherapy or ibrutinib

Question 28

What is the first line treatment for ALL?

Answer 28

Induction chemotherapy Dexrazoxane Rituximab