October 6, 2015 - Chemotherapy Flashcards
Three Major Cell Types
1. Proliferating
- Quiescent
- Terminally differentiated
Proliferating cells are the target for chemotherapy.
Mechanisms of Action for Chemotherapy
- Nucleoside analogues
- Interference with enzymes
- Interference with cellular machinery
- Intercalation between DNA strands
- Cross-linking stands of DNA
Neoadjuvant Chemotherapy
Chemotherapy given before surgery/radiation to debulk the tumor.
Adjuvant Chemotherapy
Chemotherapy given after surgery/radiation when no visible tumor is left, to reduce the risk of recurrence due to microscopic residual disease.
Palliative Chemotherapy
Chemotherapy given for symptomatic relief without the intent to cure.
Chemotherapy “Regimens”
Uses the principle that the whole is greater than the sum of the parts.
“2+2 = 8”
Chemotherapy and Vessel Walls
Chemotherapy can injure blood vessel walls. This is why it is important to often administer it through a central line or through a peripheral line by trained medical staff.
If the vessel breaks and it leaks out, can cause massive skin damage.
5-HT3 Antagonist
Very effective at controlling vomitting. Controls in up to 90% of cases.
Must be given before chemotherapy.
Neupogen for Neutropenia in Chemotherapy
G-CSF.
Shortens the duration of neutropenia by 1-3 days.
No proven effect on improving survival.
Alopecia
Hair loss.
Many patients will lose their hair and it may grow back different.
Secondary Malignancies
Chemotherapy damages healthy cells too.
There is up to a 0.5% chance per year of developing a secondary malignancy. Particular leukemias and lymphomas.
Organ Damage and Chemotherapy
Some chemotherapies can cause organ damage in a dose-dependant manner. You must be aware of this.
For example, anthracyclines may cause cardiomyopathy.
