Chemotherapy Flashcards

1
Q

How does the cell cycle relate to the use of chemotherapeutic drugs?

A

Cancer therapies do not work when the cell is in the dormant stage (G0)

Drugs can be used to enhance the number of cells in the cell cycle

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2
Q

Why is chemo given in pulses?

A

Allows the cell of the bone marrow to regenerate as the cells of the tumour die

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3
Q

Discuss antimetabolites

A

Targets enzymes required for the incorporation of pyrimidines/purines into DNA

E.g. 5-FU, methotrexate

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4
Q

Discuss DNA Alkylators

A

Forms a bond between 2 strands of DNA which stops them from replicating

E.g. Platinum compounds

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5
Q

Discuss mitotic inhibitors (spindle poisons)

A

Toxoids = prevent spindle disassembly

Vinca alkaloids = prevent spindle formation

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6
Q

How can cells develop resistance chemotherapeutic drugs?

A

Efflux pumps on cell surface

Protein within the cytoplasm that bind the chemo agent

DNA repair mechanism

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7
Q

What are the clinical indicators for chemo?

A

Cancer

Malignancies

Predicted response = performance score, clinical stage, prognostic factors, molecular markers

Side effects vs best outcome

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8
Q

How can chemotherapy be administered?

A

IV – most common

Oral

Subcutaneous

Into a body cavity – bladder, pleural effusion

Intralesional – directly into the cancerous area

Intrathecal – into the CSF

Topical

IM – rarely

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9
Q

What is a PICC line?

A

Peripherally inserted central catheter

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10
Q

Outline the side effects of chemo

A

Mucositis – epithelial damage, also happens in the gut causing diarrhoea causing dehydration

Alopecia

Nausea/vomiting/diarrhoea

Skin toxicity – shouldn’t happen, when drugs gets into tissue its dies, requires plastic surgery

Lung toxicity – pulmonary fibrosis

Sterility

Myalgia

Neuropathy

Cardiotoxicity – effects muscles function, arrhythmias

Renal failure

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11
Q

How is the dose of chemo decided?

A

Surface area and/or BMI

Drug handling ability – LFT, renal function

General wellbeing – performance status, comorbidity

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12
Q

When monitoring a patient under chemotherapy what is being analysed?

A

Response of the cancer = imaging, tumour markers

Drug levels = assays

Organ damage = creatinine clearance, echo

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13
Q

Define neoadjuvant

A

Given before surgery or radiotherapy for the primary cancer

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14
Q

Define adjuvant

A

Given after surgery to excise the primary cancer, aiming to reduce relapse risk

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15
Q

Define palliative

A

To treat current or anticipated symptoms without curative intent

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