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Cancer > Cancer part 2 - Cytotoxic CT > Flashcards

Cancer part 2 - Cytotoxic CT Flashcards

(57 cards)

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1
Q

Describe the Log Kill hypothesis

A

It is when the chemotherapy kills off 99% of the cancer cell every round

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2
Q

What are the physical barriers of cytotoxic chemotherapy

A

No blood supply to supply drug to the middle of a solid mass tumour due to necrosis

Pressure impacts the movement of drugs into tumour (High tumour interstitial pressure )

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3
Q

Adverse effects of Cytotoxic chemotherapy

A

Nausea
Damage to the GIT
>Causes mouth ulcers
Damage to the the Haemopoietic system
>Myelosuppression (Bone marrow damage)

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4
Q

How can the Mucositis be treated

A

Local anaesthetics in the from of sweets

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5
Q

What can myelosuppression cause

A

Increased viral and fungal infections

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6
Q

How can myelosuppression be avoided

A

Chaning the treatment

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7
Q

How can myelosuppression be avoided

A

Treatment
>Change the timing of the dose
>Through Transfusion of Platelets,
>CSF
Prevention
>Avoid exposure to infection
>Patients do better at home
>Avoid infected people/crowds
>Watch kitchen hygiene

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8
Q

How long does it take for hair loss to occur

A

within 1-2 weeks

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9
Q

What side effect of CT agents normally affect men

A

Gonadal damage: Pt’s become sterile

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10
Q

List some drug specific side effect and the drugs that cause the S/E

A

Cisplatin: Renal toxicity

Ifosfamide and cyclophosphate: Haemorrhagic cystitis

Doxorubicin: Cardiotoxicity

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11
Q

How does drug resistance occur with Anti-cancer drugs

A

> Improved proficiency in DNA repair

> Decreased drug activity

> Increased drug inactivity

> Increased efflux of drug

> Alternative biochemical pathway

> Alteration in target enzymes

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12
Q

What factors need to be considered before starting chemotherapy

A

Patient age- older
Health status
Geographical variation
If it is write for the patient

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13
Q

What percentage of people die within a month of starting chemo and what does that indicate`

A

8.4% lung cancer, 2.4% breast cancer

Indicates that Chemo was the likely cause of their death

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14
Q

What scales are used to assess pt’s performace status

A

Zubrod scale (0-4)

Karnofsky scale (100-10)

Who score (0-1)

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15
Q

What are the two types of cell cycle drugs

A

Cell cycle specific
Cell cycle non-specific

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16
Q

Properties of cell cycle specific drugs

A

Kills cells most effective at a stage in the cycle

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17
Q

Properties of cell cycle non-specific drugs

A

Can kill cell at any stage
It is dose dependant

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18
Q

Which class of drugs affect the specific cell cyle stages (Cell specific drugs)

A

G1:
>Hormonal drugs
>Antineoplastic enzymes
S:
>Topoisomerase-1 inhibitors
>Antimetabolites
G2:
>Epipodophyllotoxin derivatives
>Bleomycin
M:
>Taxanes
>Vinca Alkaloids

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19
Q

List some Antineoplastic enzymes (G1)

A

Asparaginase
Pegaspargase

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20
Q

List some Topisomerase-1 inhibitors (S)

A

Topotecan
Irinotecan

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21
Q

List some Subclasses of Antimetabolites (s)

A

Folate analogues

Purine Analogues

Pyrimidine Analogues

Miscellaneous class: Hydroxyurea

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22
Q

Name some folate analogues

A

Methotrexate

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23
Q

Name some purine analogues

Study These Flashcards
A

Cladribine

Fludarabine

Gemcitabine

Mercaptopurine

Pentostatin

Thioguanine

24
Q

Name some Pyrimidine Analogues

Study These Flashcards
A

Capecitabine

Cytarabine

Gemcitabine

Floxuridine

Fluorouracil

25
Name some Epipodophyllotoxin derivatives (S)
Etoposide Teniposide
26
Name some Taxanes (M/G2)
Docetaxel Paclitaxel
27
Name some Vinca Alkaloids (M)
Vinblastine Vincristine Vinorelbine
28
Name some Cell cycle Non-specific classes
Alkylating agents Antitumour antibiotics Miscellaneous
29
List some Alkylating agents
Busulfan Chlorambucil Cyclophosphamide Ifosfamide Mechlorethamine Melphalan
30
Name some Anti-tumour Antibiotics
Dactinomycin Daunorubicin Doxorubicin Idarubicin Mitomycin Mitoxantrone
31
Name some Miscellaneous non-cell cycle specific drugs
Carboplatin Carmustine Cisplatin Dacarbazine Hexamethyl-melamine Hydroxyurea Lomustine procarbazine
32
How are chemotherapy usually administered
They are given as a combination that do not have over lapping mechanisms or toxicities.
33
Properties of Alkylating agent
>Most effective during the proliferating stages (G1 and S) >Toxic to any rapidly diving cells >Used in combo >Used for solid and lymphatic tumour >They are Mutagenic and carcinogenic leading to secondary malignancy
34
what is the general mechanism of Alkylating agents
Binds covalently to nucleophilic groups on the nucleotides and prevents DNA replication
35
Which specific locations do alkylating groups bind
N7 and O6 of guanine N1 and N3 of adenine N3 of cytosine
36
Which binding location is most critical for cytotxic action
Guanine N7
37
What are some ways that Alkylating agents can cause DNA damage?
>Inter-strand cross-linking of DNA strands - stops strand separation >Intra-strand cross-linking >Base ring cleavage - strand cleavage >De-purination - strand cleavage >Tautomeric mutation - G pairs with T, GC to AT in daughter cells >Ineffective repair - frameshift mutation
38
What is nitrogen Mustard and how does it cause cancers
Bischloroethylamines (SCH2CH2Cl) developed from nitrogen or sulphurs used in chemical warfare Lead to tumours (due to damaged DNA from remaining SCH2CH2- group)
39
What are the mechanism of Alkylating agents (Nitrogen mustards)
Chlorine disaggregates Undergo intramolecular cyclisation forming an unstable ethylene immonium cation Tertiary amine is transformed into quaternary ammonium cmpd Ring opens out to form reactive carbonium ion which performs the alkylation Carbonium ion is unstable reacts with an electron donor (The DNA)
40
What does changing the R group on the nitrogen mustards do
Changes the activity and specificity
41
What are some general side effects of Alkylating agents
>Extravasation damage >N&V >Mucositis >Myelosuppression >Alopecia >Depressed Gametogenic >Increased risk of non-lymphocytic leukaemia >Drug handling/Waste handling
42
What is the name of the most potent Nitrogen mustard
Mechlorethamine
43
Why is mechlorethamine not used as often anymore
Very instable Little drug excreted lots of Extravasation accident at the injection site
44
What are the most commonly used Alkylating Drugs
Cyclophosphamide ifosfamide
45
How is Cyclophosphamide aministered
Orally
46
How is ifosfamide Administered
47
How are both Cyclophosphamide and ifosfamide activated
By the enzyme in the liver- hepatic p450
48
What causes the resistance of Cyclophosphamide and ifosfamide
Increased DNA repair Increased production of thiols
49
What conditions are Cyclophosphamide and ifosfamide used for
Burkitt’s lymphoma and other lymphomas ALL (acute lymphoblastic leukaemia) Breast cancer
50
what are the standard side effects for cytotoxic chemotherapy
>N/V/D >Alopecia >Myelosuppression >Haemorrhagic cystitis - fibrosis of bladder - due to acrolein >Amenoohoea/sterility >Secondary malignancies
51
Name some other Alkylating drugs
Chlorambucil Melphalan
52
What are the properties of Chlorambucil
Carrier molecule delays activation of the drugs for better distribution Oral admin for lymphocytic leukemias
53
Properties of mephalan
Has Phenlyalanine as a carrier >Targets melanomas Administered orally for myelomas and ovarian cancer
54
Name tow other nitrogen mustards
Uramutine Oestramustine
55
What is a pharmacological sanctuary
When metastasis occurs where a drug can not get to. >The Brain due to BBB
56
What is a nitrosourea
A drug made from the slight alteration of nitrogen mustards
57
what is the function of nitrosourea
To have more access to the pharmacological sanctuary

Cancer (18 decks)

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