Chemotherapy

Question 1

Myelosupression requires a stem cell transplant. They can be from…

Answer 1

Autologous donor- their own stem cells harvested back into them

Allogenic- matched donor

Question 2

Lenograstim is used to…

Answer 2

Boost stem cell production

Question 3

The cell cycle includes the following stages…

Answer 3

Mitosis 
G1 
G0 ( cells not dividing) 
S phase (DNS synthesis) 
G2

Question 4

Alkylating drugs target cells in what phase and how?

Answer 4

S phase

They form covalent bonds with DNA : cross linking , prevent uncoiling , inhibit replication

Question 5

Nitrogen mustards, nitrosoureas, platinum compounds are …

Answer 5

Alkylating agents

Question 6

Mechlorethamine

Answer 6

Nitrogen mustard

Iv

Question 7

Cyclophosphamide

Answer 7

Nitrogen mustard

Pro drug , orally, activated in liver to phosphoramide mustard and acrolein

Question 8

Acrolein can cause….

Answer 8

Haemohaggic cystitis so give with loads of fluids

Question 9

Nitrosoureas are….

Answer 9

Highly lipophilic and can cross BBB used for cns tumours

Question 10

Carmustine (iv)

Lomustine ( oral)

Answer 10

Nitrosoureas

Question 11

Cisplatin

Answer 11

Potent platinum compound

Binds to RNA / DNA/ protein

DNA polymerase is generated to repair DNA so resistance can occur

Question 12

What cancers are more sensitive to Cisplatin

Answer 12

Testicular and ovarian

Question 13

Side effects of Cisplatin

Answer 13

Very nephrotoxicity
Anaphylaxis
Severe nausea vomiting

Risk of: tinnitus, gout, peripheral neuropathy

Question 14

Carboplatin

Answer 14

Platinum compound

Derivative of Cisplatin

Less side effects can be given as outpatient

Question 15

Oxaliplatin

Answer 15

Platinum compound

Treat colorectal cancer

Question 16

Busulfan

Answer 16

Alkylation drug

Bone marrow used for leukaemia

Question 17

Procarbazine

Answer 17

Alkylation drug

Treats Hodgkin’s disease

Can cause rash

Question 18

Trabectadin

Answer 18

Alkylating agent

Soft tissue sarcoma
Advanced ovarian cancer

Hepatotoxic

Question 19

Anti metabolites (FPP)

Answer 19

Folate antagonists
Pyrimidine analogues
Purine analogues

Question 20

Methotrexate

Answer 20

Folate antagonist (anti metabolites)

Mostly excreted in urine , NSAIDs can prevent this so be watchful.

Given with folic acid to rescue normal cells

No pregnant women
Lactating mothers but with foilinic acid

Question 21

Pyramidine analogues mechanism of action

Answer 21

Compete with c+t bases which make up RNA and DNA

Inhibit DNA synthesis

Question 22

Fluorouracil

Answer 22

Pyrimidine analogue

Question 23

Capecitabine
Cytarabine
Gemcitabine

Answer 23

Pyrimidine analogues

Given parenterally

Question 24

Purine analogues mechanism of action

Answer 24

Compete with a+g and inhibit purine metabolism

Question 25

Pentostatin

Answer 25

Purine analogues

Question 26

Mercatopurine

Answer 26

Purine analogues

Question 27

Tioguarine

Answer 27

Purine analogues

Question 28

Fludarabine

Answer 28

Purine analogues

Question 29

Doxorubicin

Answer 29

Cytotoxic antibiotic Binds and inhibits DNA Inhibits topoismerase 2 Necrosis at iv site Can cause heart failure

Question 30

Bleomycin

Answer 30

Cytotoxic ABx Degrades pre formed DNA Works agains G0 10% causes pulmonary fibrosis 50% develop ulcers, hair loss, fungus

Question 31

Vincristine Vinblastine Vindesine

Answer 31

Plant derivative Madagascar periwinkle Relatively non toxic except vincristine- has neuromuscular effects Prevent tubule formation / spindle formation (m stage)

Question 32

Solid tumours occupy 1 of 3 compartments. They are ...

Answer 32

A. Dividing B. Resting cells g0 capable of dividing C. Cells no longer dividing but contributing to tumour size

Question 33

Taxane | Paclitaxel, docetaxel

Answer 33

Bark of yew tree Advanced breaths cancer

Question 34

Etoposide

Answer 34

Mandrake root Low bp on iv Testicular cancer and lymphoma No skin contact

Question 35

Hormones used to treat cancer, halt its growth by:

Answer 35

Receptor antagonists Opposing hormones Block synthesis

Question 36

Ethinyloestradiol

Answer 36

Oestrogen treatment

Question 37

Diethylstilbestrol

Answer 37

Oestrogen treatment

Question 38

Oestrogen so mechanism of action on cancer

Answer 38

Antagonist of androgen dependant prostate cancer Stimulate breast cancer proliferation

Question 39

Progesterone are used to treat

Answer 39

Endometrial cancer

Question 40

Megestrol

Answer 40

Progesterone

Question 41

Norethisterone

Answer 41

Progesterone

Question 42

GnRH mechanism of action

Answer 42

Inhibit gnrh release Lower lh/ fsh release Lower testosterone In turn can treat prostate cancer and advanced breast cancer

Question 43

Goserelin Buserelin Lueprorelin Tridtorelin

Answer 43

GnRH analogues

Question 44

Somatostatin analogues mechanism of action

Answer 44

Inhibit cell proliferation | Eg gastrin and so can be used for gi cancers

Question 45

Acreotide | Lanreotide

Answer 45

Somatostatin analogues

Question 46

Tamoxifen

Answer 46

Hormone antagonist stops oestrogen production Breast cancer Can cause blood clots and endometrial cancer along with menopausal symptoms

Question 47

Prednisone Dexamethosone In cancer treatment

Answer 47

Inhibit lymphocyte proliferation ( lymphoma, leukaemia) Counter side effects of treatment

Question 48

Monoclonal antibodies (mAbs)

Answer 48

Produced by hybridoma cells React with specific target proteins on cancer cells , activate immune system, remove cancer cells

Question 49

Rituximab Trastuzumab Ofatumumab Bevacizumab

Answer 49

Monoclonal antibodies Very expensive Few side effects as so specific

Question 50

Protein kinase inhibitors mechanism of action

Answer 50

Block tyrosine kinases in gf pathways Oral admin

Question 51

Imatinib Dosatinib Nilotinib

Answer 51

Protein kinases inhibitors