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10 Cards in this Set
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Categories of Antineoplastic Agents Alkylating agents react with RNA and DNA and other proteins ----->Chlorambucil Antimetabolites have similar structures to those of natural metabolites (folic acid) ---->Methotrexate Antineoplastic Antibiotics Non selective, toxic to human cells. ---> Doxorubicin
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Mitotic Inhibitors Kill cells as mitosis begins--->vincristine Hormones and hormone modulator for cancers susceptible to estrogen stimulation ---> Tamoxiflen Cancer Cell specific Agents tx chronic myeloid leukemia(CML) and CD117-positive. Unresectable or metastatic malignant GI stromal tumors (GIST)---> Imatinib |
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Alkylating Agents CHLORAMBUCIL Warning- Can severely suppress BM function carcinogen/mutagenic/teratogenic Produc. infertility |
Actions: Kills cells in resting phase CI: Pregnancy, myelosuppression, Liver Dysfunction AE: Myelosuppression, Hemorrhagic Cystitis, Ototoxicity, Sterility D2D: Oral anticoagulants NC: Hydration, BMsuppression(risk bleed & infect), Birth Control Red. invasive procedures. pt must report fever (>_100.4). Patterned rash. Bruising, mouth sores, any sign of infection. Drink (~12cup)water. Report oliguria. |
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Cytoprotective Drugs Amifostine -- Protects from cisplatin toxic effects Mesna -- Reduces incidence of hemorrhagic cystitis caused by Ifosfomide/cyclophosphamide Rasburicase & Allopurinol - protect from tumor lysis syndrome by controlling uric acid levels Dexrazoxane -- Cardiac protective and Approved for tx of extravassation d/t antineoplastic antibiotic chemo. |
Tumor Lysis Syndrome Oncological emergency caused by massive tumor cell lysis with release of large amount of potassium, phosphate and nucleic acids into the systemic circulation nucleic acids-->Uric acid-->hyperurecemia hyperphosphatemia (both can cause Acute kidney Injury ) |
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Antimetabolite Agents METHOTREXATE compete for folic acid with cancer cells |
Actions: Inhibits DNA synthesis CI: Pregnancy, Liver disease AR: Myelosuppression, GI toxicity - ulcerative stomatitis, photosensitivity D2D: Oral anticoagulants NC: Monitor for GI toxicity (1st signs glossitis/gingivitis). Monitor I&O ratio and pattern. Hydration. Thrombocytopenia signs. Leukovorin is normally started 24 hrs after methotraxate is given to prevent/decrease effects. |
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LEUKOVORIN (Reduced folic acid) Chemoprotectant w/ Methotrexate --> prevents fatal toxicity children bone cancer (osteogenic sarcoma- Ewin's tumor) Chemo-enhancer w/ flourouracil potentiates the effects of the drug |
Leukovorin Tx of megaloblastic anemia when folic acid is present |
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Antineoplastic Antibiotic DOXORUBICIN others: Bleomycin - Pulm toxic - PFT |
Action: Inhibits DNA & RNA synthesis --> cell death CI: Pregnancy & Lac, cardiac, pulmonary, liver and renal disease AE: Cardiac and pulmonary toxicity, myelosuppression, alopecia D2D: none specifically. Use caution w/drugs that cause toxicity to heart and lungs NC: Baseline cardiac Function --> Affects heart muscle (monitor ejection fraction) . Monitor for extravasation, alopecia, BM suppression Report signs of liver dysfunction-jaundice, dark urine, pruritus |
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Mitotic Inhibitors VINCRISTINE inhibits cell division |
Actions: Inhibits mitosis/cell division CI: Obstructive jaundice, pregnancy, lactation, man and women of childbearing potential AR: CNS - peripheral neuropathies. GI - stomatitis/pharyngitis, severe constipation (impaction), paralytic ileus (children). GU: urinary retention, dysuria, high excretion of sodium/dehydration, (monitor I&O) Skin: extravassations D2D: may decrease digoxin & phenytoin levels NC: Neuro-toxic-peripheral neuropaties, extravassation and fatal if admin intrathecally. |
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Hormones and hormone modulator TAMOXIFLEN Goserelin- prostatecancer Leuprorelin - advanced prostate cancer |
Action: Block/interfere w/estrogen receptor sites to prevent growth or cause cancer cell death. I: Breast cancer AE: Hypercalcemia, CVD, stroke, DVT, hot flashes , hepatic dysfunction D2D: any drug that inc serum lipids anticougulants - inc risk for bleeding NC: Women- Menopausal symptoms males: gynecomastia, decreased libido, hot flashes |
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Personalized therapies - Cancer cell specific agents Protein Tyrosine Kinese Inhibitors - act on enzymes need for protein building by certain tumors -> inhibiting tumor growth --- Imatinib Epidermal Growth Factors - inhibits EGFRs and prevents cells from multiplying out of control and die---- Erlotinib (non small cell lung cancer). Limited use toxicity. AE: serious skin conditions - blistering and skin peeling. Lung disease that may cause death. Liver/kidney failure. GI perforation |
Proteasome Inhibitors - w/o this protein complex, cell loses homeostasis and dies. Bortezomib - Tx of multiple myeloma Monoclonal Antibodies - Attack protein antigens on surface cells . May react with specific types of cancer that may enhance immune response. Programmed to interfere w/growth of cancer cells -- Herceptin Linked to anticancer drugs so that antibodies latch onto cancer cells delivering the poison directly to the tumor |
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Colony Stimulating Factors Counter BM suppression effects of chemo WBC - Neutropenia (neutrophils and monocytes) * Filgrastim * Pegfilgrastim * Sargramostim |
RBC- Anemia (Erythrocytes) * Epoetin alpha * Darbepoetin alfa Platelets (Thrombocytopenia) * Oprelvekin |
