Chemotherapy

Question 1

What are the different type of treatment?

Steroids are also used but the mechanism used is not understood.

Answer 1

Single or combination agents

Monoclonal antibodies

Targeted treatments - imatinib, venetoclax

Question 2

What are the different type of chemo and think of one drug name for each? - JUST READ

Answer 2

Alkylating agents - cyclophosphamide
Antimetabolites - methotrexate, fludarabine
Anti-tumour antibodies - daunorubicin
Mitotic inhibitors/plant alkaloids - vincristine

Question 3

General short term side effects:

What is the main side effect?

Chemo is also toxic to the gut:

• What does it do in the mouth?
• What about their bowels?

What are some other physiological side effects? - 5

How does it affect the person day to day?

Answer 3

Myelosuppression - pancytopenia

Sore mouth
Change in taste

Diarrhoea

N&V
Hair loss 
Effects on fertility 
Liver toxicity 
Teratogenicity 

Fatigue and general malaise

Question 4

What long term side effects could chemo have?

Answer 4

Cardiotoxicity
Interstitial lung disease
Bone problems - steroids
Secondary malignancies

Question 5

Monoclonal antibodies:

Give one example of this drug - R

What are the normal infusion related reactions (IRRs)?

Answer 5

Rituximab

Fever
Hypotension
Rash
Anaphylaxis

Question 6

Targeted therapies:

Give one example - I

Answer 6

Ibrutinib

Question 7

Antineoplastic exam questions will most often revolve around the mechanism of action, cell cycle specificity, or adverse effects.

General adverse effects associated with this group of drugs are bone marrow suppression, nausea, vomiting, ulcers and alopecia.

Certain drugs also have other adverse effects that you should know about.

What is Cyclophosphamide (and its sister Ifosfamide) infamous for causing?
The other drugs listed are associated with different adverse effects as follows:

What is Bleomycin infamous for causing?

What 2 parts of the body is Cisplatin (just like vancomycin and aminoglycosides) known for being toxic to?

Main side effect for Doxorubicin aka Adriamycin?

Vincristine is notable for its dose-limiting neurotoxicity!

Answer 7

Haemorrhagic cystitis, causing haematuria.

Always remember to give mesna with these drugs to reduce the likelihood of hemorrhagic cystitis.
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Pulmonary fibrosis 
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Ototoxic and nephprtoxic 
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Cardiotoxicity - dilated cardiomyopathy