Lec 19 & 20 (Chemotherapy & Cancer) Flashcards
Chemotherapy
use of chemical agents against an invading organism or cancer cells
Chemical Agents (4)
- antibiotics: made by one organism, lethal to another
- plant alkaloids
- analogous of endogenous molecules essential for cell replication/vitality
- monoclonal Ab: specific for target
Beta-lactam Antibiotics
mechanism, resistance, gram -/+, impact
i. e. penicillins, cephalosporins
1. covalently bind an inhibit bacterial trasnspeptidase enzyme
- cross-links polymers of cell wall
- selective, no human homologue of enz.
2. resistance: bacterial expression of beta lactamase
- enzyme that cleaves beta lactam ring of antibiotic, increasing IC/ED50
3. typically on gram negative bacteria, have membrane pore that allows for drug influx
4. impaired cell wall synthesis: bacteriocidal (cell death)
Folate Synthesis
equation, antibacterial action
- PABA (DHF synthetase) DHF (DHF reductase) THF
- dUMP/THF (thymidylate synthetase) dTMP/DHF
- dTMP required for nucleic acid synthesis
- sulfonamide antibiotics: inhibit DHF synthetase
- trimethoprim (+other): inhibit DHF reductase
Protein Synthesis Antibiotics
- inhibit 50S and 30S ribosomal machinery for mRNA translation into protein
- block formation of initiation complex, peptide chain elongation, cause miscoding
ex: tetracyclines, azithromycin
Treatment Types (3)
- Definitive: based on test of bacterial culture/drug sensitive. documented.
- Empiric: based on clinical assessment of likely cause + effective drug.
- Prophylactic: pretreatment with empirically chosen agent to reduce infection risk.
HIV: fusion/entry inhibitor
prevent entry of HIV material into Th cell
HIV: reverse transcriptase inhibitor
inhibit enzyme that catalyzes formation of DNA from viral DNA
HIV: integrase inhibitor
inhibits incorporation of proviral DNA into human host genome
HIV: protease inhibitor
inhibition of viral protein that catalyzes breakdown of large viral protein to release viral structural proteins
HCV drug target: interferons
- interferons (i.e. INFa-2a) activate macrophages and lymphocytes to enhance antiviral efficacy
- drug target/activate INFs. pegylated to extend t1/2 and combined with ribavirin to increase antiviral effect
HCV drug target: proteases
- inhibit NS3/4a protease that catalyzes breakdown of large viral proteins and release them for replication
- protease inhibitors restore innate immune response in the liver to viral infection (eg telapravir)
HCV drug target: nonstructural proteins
-inhibit NS5A protein replication complex, thus blocking its role in replication and assembly of viral proteins (eg ledipasir)
HCV drug target: (non) nucleoside polymerases
- inhibit NS5B polymerase by binding one of several sites on the enzyme (RNA-dependent RNA polymerase) inhibiting its ability to generate viral DNA
- can be chain terminators or allosteric inhibitors
Malarial Life Cycle
mosquito injects sporozoites into host, replicate in liver and released. target RBCs where schizont pathology can be seen
- infect RBCs and propagate, then cause RBCs to lyse
- leads to aggregation and adhesion of infected RBCs, tissue damage
- gametes taken back up into mosquito, continue cycle