OPB Flashcards
(38 cards)
Side effects of Tamoxifen
Menstrual disturbance: vaginal bleeding, amenorrhoea hot flushes - 3% of patients stop taking tamoxifen due to climateric side-effects Venous thromboembolism Endometrial changes- hyperplasia, polyps, cancer, uterine sarcoma Alopecia Anaemia Cataracts Cerebral ischaemia Embolism Fatigue Fluid retention Headache Nausea Retinopathy
Mechanism if action of tamoxifen
Oestrogen receptor antagonist- prevents oestrogen binding so blocking the proliferative action and inhibiting tumour growth
Indications for tamoxifen
ER+ breast cancer post-surgery
Breast cancer patients for 5 years after tumour removal
Primary prevention of breast cancer (i women >30 at moderate/ high risk)
Gynaecomastia in males
Treatment of anovulatory infertility
Contraindications for tamoxifen
Family/ personal history of idiopathic VTE
Pregnancy- must be on effective contraception prior to, during and for 2 months after treatment
Concurrent anastrozole therapy
Examples of aromatase inhibitors
Exemestane, letrozole, anastrozole
Mechanism of action of exemestane
Inhibits the aromatase enzyme to stop the conversion of androgens to oestrogen
Mechanism of action of letrozole
Inhibits the aromatase enzyme to stop the conversion of androgens to oestrogen
Mechanism of action of anastrozole
Inhibits the aromatase enzyme to stop the conversion of androgens to oestrogen
Mechanism of action of goserelin
GnRH receptor agonist- stimulates production of LH and FSH which eventually negatively feedbacks and down-regulates oestrogen and testosterone production
Mechanism of action of herceptin
Monoclonal antibodies which down-regulates HER2 receptors and decreases cell proliferation
Contraindications to aromatase inhibitors
Pre-menopausal women (high levels of circulating oestrogen)
Pregnancy/breast feeding
Side effects of aromatase inhibitors
Alopecia Hot flushes Vaginal dryness Oedema Bone pain Headache GI upset Carpal tunnel syndrome Insomnia Leukopenia Thrombocytopenia Skin reactions
Side effects of aromatase inhibitors
DECREASED BONE MINERAL DENSITY Alopecia Hot flushes Vaginal dryness Oedema Bone pain Headache GI upset Carpal tunnel syndrome Insomnia Leukopenia Thrombocytopenia Skin reactions
Method of administration of goserelin
SC injection in the anterior abdominal wall every 28 days
Indications for goserelin
Locally advanced prostate cancer (as an alternative to surgery)
Adjuvant/Neoadjuvant treatment to radiotherapy/radical prostatectomy in patients with high-risk localised or locally advanced prostate cancer
Metastatic prostate cancer
Advanced breast cancer
ER+ early breast cancer
Indications for goserelin
Locally advanced prostate cancer (as an alternative to surgery)
Adjuvant/Neoadjuvant treatment to radiotherapy/radical prostatectomy in patients with high-risk localised or locally advanced prostate cancer
Metastatic prostate cancer
Advanced breast cancer
ER+ early breast cancer
Cautions for taking goserelin
Depression Diabetes Hypertension Metabolic bone disease PCOS
Cautions for taking goserelin
Depression Diabetes Hypertension Metabolic bone disease PCOS Risk of spinal cord compression Risk of ureteric obstruction in men
Side effects of goserelin
Alopecia Pain Breast abnormalities Altered mood/ depression Impairment glucose tolerance Gynaecomastia Headache Heart failure Hot flushes Hyperhidrosis MI Neoplasm complication Paraesthesia Sexual dysfunction Skin reaction Spinal cord compression Vulvovaginal disorder Increased weight
Indications for herceptin
Early HER2+ breast cancer
Metastatic HER2+ breast cancer patients who have not received chemotherapy and where Anthracycline treatment is inappropriate (given in combination with paclitaxel or docetexal)
Monotherapy for metastatic breast cancer patients who have previously received at least 2 chemotherapy agents
Metastatic HER2+, ER/PR+ breast cancer in post-menopausal patients not previously treated with trastuzumab (given in combination with an
aromatase inhibitor)
Metastatic HER2+ gastric cancer (given in combination with cisplatin and Capecitabine or 5-fluorouracil)
Side effects of herceptin
CONGESTIVE HEART FAILURE Headache GI upset and weight loss Insomnia Cough Rash Cardiac symptoms: Arrthymias, palpitation Infection (neutropenic sepsis) Pancytopenia Fatigue Malaise Pain Tremor Dizziness Paraesthesia Altered sense of taste Hot flushes Respiratory symptoms Swollen face Alopecia Nail disorders Hand-foot syndrome Peripheral oedema
Mechanism of action of imatinab
Tyrosine kinase inhibitor- inhibits proliferation and induces apoptosis
Indications for imatinab
Philadelphia+ Chronic myeloid leukaemia (in chronic phase after failure with interferon alpha or in accelerated phase or blast crisis)
Philadelphia+ acute lymphoblastic leukaemia (30% of ALL)
C-Kit+ gastrointestinal stromal tumour (GIST)
Side effects of imatinab
HEPATOTXICITY AND CARDIOTOXICITY Pancytopenia Fluid retention GI upset Photosensitivity Alopecia Myalgia, arthralgia Blurred vision Taste alteration Skin changes
