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34 Cards in this Set
- Front
- Back
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What does the therapeutic index tell us about antineoplastic drugs?
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the index is narrow, so toxicity to the host is likely
dose is very important, because small increases can cause damage to host cells |
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How are doses calculated for antineoplastics?
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by surface area or BW
-use BW in cats and in dogs less than 10kg |
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What are the major ADEs of antineoplastics?
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bone marrow suppression
GI (vomiting, diarrhea etc) hair loss, thinning nephrotoxicity cardiotoxicity CNS toxicity |
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What are the contraindications of antineoplastics?
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do not use in breeding animals (teratogenic), extravasation can cause massive tissue damage
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Which toxicities are acute?
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GI, allergy, anaphylaxis
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Which toxicities are chronic?
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myelosuppression, tissue damage, alopecia
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What are the major causes of therapeutic failure?
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wrong drug, wrong dose, slow growing tumor, inability to target all tumor cells, patient toxicity, resistance
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How can tumors become drug resistant?
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alterations in absorption, distribution, metabolism or excretion of the drug
alterations in tumor blood flow drug inactivation repair of damage by the tumor cells target receptor alterations in tumor cells |
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What cautions should be used in handling antineoplastics?
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use hood to prevent inhalation
wear gloves to prevent absorption through skin keep food and drink out of prep area don't recap needles *advise owners on proper handling as well! |
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How do nitrogen mustard antineoplastics work?
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alkylating agents
non-specific |
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What are the nitrogen mustard antineoplastics?
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Cyclophosphamide, Chlorambucil
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What is the primary toxicity associated with nitrogen mustards?
What other toxicities can occur? |
bone marrow suppression
Cyclophosphamide can cause sterile hemorrhagic cystitis |
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How do nitrosoureas work?
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alkylating agents
non-specific *lipid soluble (can penetrate CNS) |
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What are the nitrosoureas?
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Lomustine
Carmustine |
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What platinum compounds are used as antineoplastics?
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cisplatin
carboplatin *DO NOT USE cisplatin in cats |
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How do platinum compounds work?
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alkylating agents
non-specific |
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What is the primary toxicity of platinum compounds?
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nephrotoxicity
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How do folic acid analogs work?
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inhibit dihydrofolate reductase
-mimic folic acid -S phase specific -must be actively transported (can develop resistance) |
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What are the folic acid analogs?
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methotrexate
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How do the pyrimidine analogs work?
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inhibit DNA synthesis
S phase specific |
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What are the pyrimidine analogs?
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cytarabine, 5-fluorouracil
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What special toxicity is associated with pyrimidine analogs?
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5-fluorouracil can cause CNS toxicity
*DO NOT use it in cats |
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What are the vinca alkaloids?
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vincristine
vinblastine |
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How do vinca alkaloids work?
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block microtubule formation
-M phase specific |
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What special toxicity is associated with vinca alkaloids?
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vincristine can cause peripheral neuropathy
both are damaging if extravasation occurs |
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How do antineoplastic antibiotics work?
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inhibit topoisomerase
-DNA cannot be re-ligated -non-specific |
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What is the primary toxicity of antineoplastic antibiotics?
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dose related cardiotoxicity
*may also be damaging if extravasated |
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What are the antineoplastic antibiotics?
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Doxyrubicin
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What enzymes can act as antineoplastics?
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L-asparaginase
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How does L-asparaginase act as an antineoplastic agent?
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cleaves asparagine, which is essential for cell growth
-G1 phase specific |
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What is the primary toxicity associated with L-asparaginase?
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anaphylaxis
*foreign proteins can trigger immunologic response |
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How do cyclooxygenase inhibitors act as antineoplastics?
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may induce apoptosis of tumor cells that use COX pathways in their function
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What cyclooxygenase inhibitors are antineoplastics?
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piroxicam
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What toxicities are associated with cyclooxygenase inhibitors?
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GI and renal (lose protective PGs)
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