Chemotherapy

Question 1

what are the 9 cytotoxic SE?

Answer 1

1. extravastation of IV drugs
2. throboembolism
3. hypoeruricaemia
4. alopecia
5. N&V
6. bone marrow suppression
7. urotherlial toxicity
8. oral mucositis
9. pregnancy and reproduciton function (teratogenic)

Question 2

what drugs have the most significant effects on pregnancy and reproductive function?

Answer 2

alkylating drugs and procarbazine

Question 3

what is tumour lysis syndrome and what cancers is this risk higher?

Answer 3

rapid destruction of malignant cells - influx of electrolytes, causing renal failure and arrhythmias

high risk in lymphomas or leukamias

Question 4

what are the clinical feautures of tumour lysis syndrome?

Answer 4

hyper K+
hyper urea
hyper PO4
hypo Ca2+

Question 5

what drug is associated with urothelial toxicty and how is this treated?

Answer 5

cyclophosphamide
treatment = mesna

Question 6

what drugs are assocaiated with bone marrow suppression?

Answer 6

all cytotoxics except vincristine and bleomycin

Question 7

what chemotherapy agent has side effects of pulmonary fibrosis, respiratroy failure, and deramtological toxicity?

Answer 7

belomycin - antineoplastic antibiotic

Question 8

what route can vinca alkaloids be given?
what is their main side effect?

Answer 8

IV only
main side effect = CNS toxicity (peripheral/autonomic neuropathy)

Question 9

what class do methotrexate, flourouracil, and capecitabine belong to?

Answer 9

antimetabolites

Question 10

what are the main side effects of paclitaxel (taxane)

Answer 10

cardiac disease, pneumonitis, sepsis

Question 11

can aromatase inhibitors be given to all women?

Answer 11

not for pre-menopausal women as they are anti-oestrogens

Question 12

what class of drug is most likely to cause permanent male sterility?

Answer 12

alkylating agents

Question 13

what class of antiemetics are most commonly used in chemotheraoy and why?

Answer 13

5HT3 antagonists - ondansetron
dopamine antagonists - metoclopramide, domperidone

this is becuase cytotoxic drugs usually affect the chemotherapy trigger zone, which is where these classes of drug have activity

Question 14

why aren’t antihistamines used often in chemotherapy?

Answer 14

because they act on the vestibular apparatus which is linked to motin sickness

Question 15

what cytotoxic have high emetogenic potnetial?

Answer 15

cisplatin, doxorubicin, cyclophosphamide