10.2 Chemotherapy Flashcards
(30 cards)
What are the classes of Chemotherapy drugs?
Alkylating Agents Anti-metabolites Spindle Poisons Intercalating Agents DNA Scissors
What routes can we take?
Peritoneal Oral IV Intrathecal Directly into the tumour
What are the general ADRs?
Nausea and Vomiting Fatigue Bone Marrow Suppression (Infections, Anaemia) Alopecia Weight Loss
What are some Alkylating Agents?
Cisplatin
What are some anti-metabolites?
Methotrexate (6-MP)
5-FU (FDUMP)
How do we give doses of chemotherapy?
Why?
Fractionated Doses
Fractional Kill Hypothesis
Let Bone Marrow Recover
When do we use chemotherapy?
Neo/Adjuvant
Palliative
With Radiotherapy/Hormonal/Immune Therapy
Can Chemo ever cure?
Yes, Blood borne tumours, Soft tissue
Not on it’s own for solid tumours
What are some Spindle Poisons?
Vinca Alkyloids
Taxanes
What are some DNA Scissors?
Bleomycin
What are some Intercalating Agents?
Anthracyclins
What are the three types of cancer cell?
Which are succeptable to chemotherapy
A -Cells which are dividing and contribute to tumour growth. Succeptable to Chemo
Cells which are dormant in G0 but can become A if conditions change. Not succeptable
C- Cannot divide, add to the tumour bulk
How do alkylating agents work?
They form bulky adducts by binding to DNA strands (inter/intrastrand)
Prevent DNA unwinding so no DNA replication
How do intercalating agents work?
They get between base pairs and prevent replication
Prevent Topoisomerase II
How do anti-metabolites work?
They work best in S1 (rapidly diving cells)
They prevent base synthesis
so DNA/RNA/Protein synthesis cannot occur
Causes apoptosis
How do spindle poisons work?
Prevent successful Mitosis
VA prevent spindle formation from tubules
Taxanes prevent spindles from breaking down into microfilaments
They cause DNA to be in one cell, or cells don’t seperate therefore causes apoptosis
How do DNA Scissors work?
Bind to DNA/Chelates/Fe2+
Form Free Radicals
They cut strands of DNA
When do DNA Scissors work best?
G2
Which types of cancers do anti-metabolites not work as well in
Slow Growing Tumours
Dormant/Latent Tumours
When do Spindle Poisons act? (In the Cell Cycle)
M Phase
How do you work out dosage?
Work out the Body Surface Area
Renal and Plasma levels are taken into account as well
When do Alkylating Agents have the most effect?
In the Cell Cycle…
S Phase
How is the PK of Chemotherapy agents effected?
Distribution: Age, Weight, Sex, Vomiting, GI problems (Oedema)
Elimination: Renal/Liver Failure
Other medication
Why are oral agents not as good?
Side Effects - Vomiting
Toxic
Very Variable Bioavailability
