masterclass 4 Flashcards
(26 cards)
what to use for receptor positive post menopausal breast cancer
anastrazole
Anastrozole class
aromatase inhibitor
moa of anastrazole
converts androgens into oestrogen so there is less oestrogen to bind and promote estrogen dependant genes
why dosent anastrozole work in pre menopausal syndrome
oestrogen released from the ovaries in pre and conversion from androgens in the peripheral tissues but this is a small amount
in postmenopausal women where does all the oestrogen come from
conversion in peripheral tissues
Adverse effects of anastrozole
hot flushes, hair thinning, vaginal dryness, steven johnson syndrome, toxic epidermal necrolysis
class of tamoxifen
SERM
what is steven johnson syndrome
blistering of the skin, detachment of the epithelial layer, type four allergic response
progression of steven johnson syndrome
starts on the face then the chest and then spread onto the peripheral limbs, it can also affect the mucous membranes
Toxic epidermal necrolysis is????
continuation of steven johnson syndrome, more severe
what can inhibit the metabolism of tamoxifen
SSRIs
warfarin and tamoxifen
can increase anticoagulation through CYP3A4 inhibition
who does acute lymphoblastic leukemia affect
children
why does acute myeloid leukemia affect
adults
ALL first line therapy
chemo
chemo therapy for ALL
Induction, consolidation and maintenance
what is induction
destroy as many leukemia cells as possible
what is consolidation
intraspinal injections and tablets
what to do after induction
bone marrow biopsy
what are patients FBCs when on induction
pancytopenic
chemo drugs for ALL
Cyclophosphamide
vincristine
doxorubicin
dexamethasone
cyclophosphamide class
alkylating agent
cyclophosphamide moa
causes linkage between parts of the DNA molecule so it can no longer uncoil. Can also bind to protein which blocks DNA repair
where can cyclophosphamide accumulate
bladder
