Pharmacology 7

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  • Created by: evepoag
  • Created on: 20-10-22 14:16
What can corticosteroids cause?
Hyperglycaemia
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Can long-term use of corticosteroids increase risk of infection?
Yes
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Corticosteroids can cause oral candidiasis.

What is this and how can risk of it be reduced?
Oral candidiasis is oral thrush, a fungal infection of the mouth

Reduced by rinsing out mouth with water after inhaled dose
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Abrupt withdrawal of corticosteroid treatment after a long period of time should be avoided. Why?
It can cause a life-threatening complication called adrenal insufficiency
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What are biguanides?
A class of drugs that treat hyperglycaemia in type 2 diabetes
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What 3 ways do biguanides lower blood glucose?
They prevent glucose production in the liver, improve body's sensitivity toward insulin, and reduce sugar absorbed in the intestines
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What is the difference between type 1 and type 2 diabetes?
Type 1 - absolute deficiency of insulin
Type 2 - reduced amount of insulin
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What does insulin resistance mean in type 2 diabetes?
Tissues are less responsive to insulin and so more is needed to maintain normal blood glucose
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How do biguanides work?
They decrease glucose levels by decreasing glucose production in the liver (gluconeogensis), decreasing intestinal absorption of glucose, and increasing insulin sensitivity by increasing peripheral glucose uptake
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How do sulfonylurea drugs lower blood glucose?
They increase insulin secretion
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Why should metformin (a biguanide) be taken with meals?
Decreases GI effects
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What is cancer?
Unregulated cell growth that spreads from the site of origin
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What is targeted cancer therapy?
Targets the differences that help a cancer cell to survive and grow
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Name 2 types of targeted cancer therapies
Immunotherapies

Biological therapies
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What genes are implicated in cancer?
1. Oncogenes
2. Tumour suppressor genes
3. DNA repair genes
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What are oncogenes?
They are mutated proto-oncogenes that now produces too many proteins, and these proteins have altered function
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What do oncogenes do?
Encourage cells to multiply
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Name 4 types of proto-oncogenes and what they are involved in
1. Growth factor - activates cell division
2. Receptors - receive signals from growth factors
3. Cytoplasmic signalling molecules - involved in cell proliferation
4. Nuclear transcription factors - involved in cell division
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What do tumour suppressor genes do?
Stop cells multiplying
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What do DNA repair genes do?
Repair other damaged genes
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What do normal tumour suppressor genes do?
They inhibit cell division or activate cell apoptosis
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What do mutated tumour suppressor genes do?
Loss of function in the resulting protein
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Name 2 common tumour suppressor genes
BRCA1 and BRCA2 genes
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Out of all the cancer treatments, which 2 are local treatments?
Surgery and radiotherapy
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What does chemotherapy target?
It targets ALL cells and aspects of cell division
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Why does chemotherapy target all cells?
It cannot distinguish between normal and cancerous cells
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What is cell cycle phase specific chemotherapy?
Affects cells undergoing division
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What is cell cycle phase non-specific chemotherapy?
Affects cells at any point in the cell cycle or at resting
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What do cancer hormonal therapies do?
They stop or slow down the growth of tumours that require certain hormone to grow
(hormone-sensitive tumours)
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How do hormonal therapies do this?
They prevent the body from producing the hormone, and interfere with the hormone action
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What kind of cancers are hormonal therapies usually used for?
Breast and prostate cancer
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Describe hormonal therapy in breast cancer, with specific reference to hormones
Osetrogen and progesterone are growth-factor hormones. After a biopsy, the cancer will either be oestrogen receptor positive (ER+) or progesterone receptor positive (PR+).
Hormone therapy reduces oestrogen levels to slow cancer growth or prevent from reoc
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If the tumour cells don't have oestrogen or progesterone, what are they called?
ER -
PR -
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What are SERMs?
Selective Oestrogen Receptor Modulators

They stop oestrogen from acting on breast cancer cells
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What are targeted biological therapies also called?
Immunotherapy
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How does immunotherapy or biological therapy work?
They target proteins that are more abundant in cancer cells, particularly those involved in cell growth and proliferation
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What kind of therapy KILLS target proteins and which INTERACTS with them?
Chemotherapy kills target proteins

Immunotherapy interacts with them
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Chemotherapies are cytotoxic. What does this mean?
It kills cancer cells
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Immunotherapies are cytostatic. What does this mean?
They inhibit cell proliferation
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Name 2 kinds of targeted or immunotherapies
1. Anti-angiogenics
2. Monocloncal antibody drugs (MABs)
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What are anti-angiogenics also called?
Angiogenesis inhibitors
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What do anti-angiogenics do?
They prevent or slow the growth of cancer by starving it of its needed blood supply
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What do monoclonal antibodies do?
They are man-made antibodies designed to attached to specific targets to stop them from growing
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Where do monoclonal antibodies work?
They enter the bloodstream and reach all areas of the body
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What is HER-2?
Human epidermal growth factor-2 (HER-2) are genes that make a protein found on the breast cell surface. It is normally involved in cell growth

It can also be found in the stomach and oesphagus
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In some cancers, HER-2 is over expressed. Why is this significant?
It is involved in cell growth, so the overproduction of it causes cells to grow more rapidly
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A specific MAB (monoclonal antibody therapy) targets HER-2.
What does this do?
The MAB blocks the effects of HER-2 by binding to its receptors. It encourages the immune system to attack and kill cancer cells, to stop cells from growing
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Tamoxifen is an anti-oestrogen. What is it and what will it do?
It is an antagonist - it blocks the oestrogen receptors. This inhibits oestrogen production.
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When would an anti-oestrogen be used?
In oestrogen-receptor-positive breast cancer
(ER+)
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What does this anti-oestrogen drug target?
It targets the oestrogen RECEPTORS
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What do anti-oestrogens also promote?
Apoptosis in the oestrogen-receptor-positive (ER+) tumours
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What happens if a patient is ER+ as well as HER2+?
The treatment plan will change
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What is important to note about how anti-oestrogens work in breast cells compared to other cells, like the bones or uterus?
It is an anti-oestrogen in breast cells BUT it can become an oestrogen in other tissue likes the uterus
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Anti-oestrogens thereby work on which type of breast cancers?
Oestrogen-receptor positive (ER+)
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What is aromatase inhibitors?
A type of hormonal therapy used in breast cancer that lowers oestrogen by blocking the enzyme in fat tissue called aromatase
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What is the ultimate purpose of hormonal cancer therapies?
Block the effects of hormones which act as growth factors on cells
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Monoclonal antibodies treat breast cancer through IMMUNOTHERAPY also called targeted biological therapy, not through hormones.

What types of breast cancer do they treat?
Human epidermal growth receptor 2 (HER+)
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To summarise, name examples of hormone therapies, and of biological targeted therapies
Hormone therapies:
- aromatase inhibitors
- anti-oestrogens
- SERMS (selective oestrogen receptor modulators)
Targeted biological therapies:
- monoclonal antibodies (MABs)
- anti-angiogenics
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Other cards in this set

Card 2

Front

Can long-term use of corticosteroids increase risk of infection?

Back

Yes

Card 3

Front

Corticosteroids can cause oral candidiasis.

What is this and how can risk of it be reduced?

Back

Preview of the front of card 3

Card 4

Front

Abrupt withdrawal of corticosteroid treatment after a long period of time should be avoided. Why?

Back

Preview of the front of card 4

Card 5

Front

What are biguanides?

Back

Preview of the front of card 5
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