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CHEMOTHERAPY, proto-oncogene - Coggle Diagram

- - - - cisplastin
        
        AE
        
        nephrotoxicity :blue_heart:
        
        neurotoxicity :thinking_face:
        
        peripheral nerves
        
        sensory loss
        
        paresthesias
        
        feet :feet:
        
        hand :hand::skin-tone-4:
        
        ototoxicity :ear::skin-tone-3:
        
        inner ear damage
        
        tinnitus
        
        hearing loss
        
        bind to DNA base = adduct = DNA damage = apoptosis with P53 :skull_and_crossbones:
    - - topol I = camptothecins
        topotecan
        
        block religation of topol I --> ssDNA break --> dsDNA break --> cell death :skull:
        
        usual function - cut one strand of DNA
        
        severe diarrhea :toilet:
      - topo II = epipodophyllotoxins
        etoposide
        
        note: usual function - cut double strand DNA
        
        block religation of topol II --> dsDNA break --> cell death :skull:
        
        chromosomal translocation = 2nd leukemia :fire:
    - - cyclophosphamide
        
        AE
        
        hemorrhagic cystitis 🩹
        
        drug metabolite accumulation
        
        irritate bladder mucosa
        
        treatment
        
        hydration :baby_bottle: = flush out metabolite
        
        mensa = neutralize metabolite
        
        2nd leukemia :fire: #
        
        gonadotoxic :twisted_rightwards_arrows:
        
        alopecia :woman-getting-haircut::skin-tone-2:
        
        transfer alkyl group to DNA bases = DNA damage = apoptosis with p53 :skull_and_crossbones:
  - - - vinca alkaloids = vincristine
        
        block tubulin polymerization
        
        AE
        
        neurotoxicity / peripheral nerve damage
        
        sensory loss
        
        motor loss
        
        hand :hand::skin-tone-3:
        
        feet :feet:
        
        due to long axon distance from cell body
        
        constipation :toilet::toilet:
      - taxanes = paclitaxel
        
        block microtubule assembly
        
        AE
    - - pyrimidine analog
        
        5-fluorouracil
        
        AE
        
        palmar-plantar erythrodysesthesia
        
        diarrhea
        
        converted to F-dUMP --| thymidylate synthase
        --> :arrow_down: dTMP -
        -> :arrow_down: dTTP
        --> :arrow_down: DNA base
      - inhibit purine biosynthesis
        
        folate analog = MTX
        
        MTX --| DHFR = no conversion of dihydrofolate to tetrahydrofolate = no coactivator for thymidylate synthase
        
        AE
        
        nephrotoxicity :blue_heart:
        
        hepatotoxicity :yellow_heart:
        
        pulmonary toxicity :pig_nose::
        
        embryo development :baby_symbol::
        
        also used to treat psoriasis
        
        purine analog = 6-thioguanine
        
        hepatotoxicity :yellow_heart:
        
        jaundice
        
        dark urine
        
        6TG -----> 6-thioguanylic acid --| purine synthesis --> :arrow_down: DNA/RNA synthesis
- - - - cetuximab #
        
        monoclonal antibody
        
        bind to EGFR = block EGF binding = downregulation #
        
        colorectal cancer / WT Ras and Braf only
        
        AE
        
        pulmonary toxicity :pig_nose:
        
        rash
    - - erlotinib
        
        block EGF Receptor #
        
        AE
        
        rash
        
        pulmonary toxicity :pig_nose:
        
        lung cancer w/ EGF mutated receptor
      - sunitinib
        
        block VEGF receptor + other RTKs
        
        AE
        
        HTN :hearts:
        
        thromboembolism
        
        bleeding
        
        renal cancer
      - imatinib
        
        AE: dec renal function = fluid retention = edema
        
        CML :fire:
        
        block BCR-ABL RTK + other RTKs #
        
        (contraindicated against HF)
    - - block BRAF #
      - AE: skin squamous cell carcinoma
      - for: malignant melanoma with BRAF mutation
  - - - tamoxifen
        
        SERM = selective estrogen receptor modulator
        
        :no_entry: estrogen receptor
        
        ER+ breast cancer
        
        breast tissue
        
        :check: stimulate estrogen receptor
        
        bone: protective against osteoporosis
        
        uterus #
        
        liver #
        
        AE
        
        hot flashes (dec estrogen in brain)
        
        thromboembolism risk (inc estrogen in liver -> inc clotting factor)
        
        uterine cancer risk
      - flutamide
        
        prostate cancer
        
        block androgen receptor of prostate gland
        
        AE
        
        decrease libido
        
        ER
        
        gynecomastia
    - - anastrozole
        
        :no_entry: aromatase in estrogen synthesis
        
        AE
        
        hot flashes (decrease estrogen in brain) #
        
        osteoporosis risk (dec estrogen in bone)
        
        ER+ breast cancer