Pharmacology: Drugs Used to Treat Cancer

How should extravasation be treated?

With ice packs or reduced dosage of the drug

Name an androgen antagonist

bicultamide (Casodex)

What is an adverse/side effect of alkylating agents?

bone marrow suppression

Name an alkylating agent

cyclophosphamide (Cytoxan)

What is cancer thought to result from?

damage to the suppressor genes that control cell growth

Name an Anti-tumor antibiotic

doxorubicin (Adriamycin)

low white blood cell count

leukopenia

Name an antimetabolite

methotrexate (Rheumatrex, Trexall)

Adverse effect of Oncovin?

nervous system toxicity

What is an adverse effect of cancer drugs?

severe toxicity (damage to normal tissue)

Name an anti-estrogen

tamoxifen (Soltamox)

Derived from bark of Pacific Yew

-taxel drugs

What are two primary actions of chemotherapy drugs?

1. Attack DNA and proteins (kill cancer cells) 2. Poison metabolic pathways of rapidly growing cells (stop the growth of cancer cells)

What are 7 s/e of chemotherapy?

1. Blood toxicity 2. Gi toxicity 3. alopecia 4. fatigue 5. fetal death/ birth defects 6. opportunistic infections 7. ulcerations and bleeding of the lips and gums

What are three chemical carcinogens?

1. Chemicals in tobacco smoke 2. Asbestos 3. Benzene

What are the 3 general goals of chemotherapy?

1. Cure 2. Control 3. Palliation

What are three viruses that cause cancer?

1. Herpes simplex 2. HPV 3. HIV

What are the two actions of Interleukin-2?

1. activate cytotoxic T-cells 2. promote other actions of the immune system response

What are the classifications of Cancer drugs?

1. alkylating 2. antimetabolites 3. antitumor antibodies 4. hormones and hormone antagonists 5. natural products 6. biologic response modifiers 7. monoclonal antibodies

To combat bone marrow depression, patients may be given:

1. bone marrow transplants 2. ESA's 3. Granulocyte stimulating agents 4. blood transfusions 5. platelet transfusions

What are two psychical carcinogens?

1. exposure to radiation (leukemia) 2. Ultraviolet light (skin cancer)

What are the 4 hormone drugs?

1. glucocorticoids 2. progestins 3. estrogens 4. androgens

What are three characteristics of cancer cells?

1. lose normal function 2. divide rapidly 3. invade surrounding cells

What are s/s of mucositis?

1. painful ulcerations 2. difficulty eating or swallowing 3. GI bleeding 4. intestinal infections 5. severe diarrhea

What three cancers are most likely treated with palliation?

1. pancreatic cancer 2. osteosarcoma 3. Karposi's sarcoma

What are the three things that are attainable when setting the palliation goal?

1. reduce tumor size 2. reduce severity of pain and symptoms 3. improve quality of life

What are three actions of Interferon?

1. suppress cancer cell division 2. enhance phagocytic activity of macrophages 3. promote cytotoxic activity of T-lymphocytes

Normal Platelet count:

150,000 - 350,000

Normal platelet count

150,000-350,000

What is the time is takes Nadir to occur with RBC's?

3-4 weeks

What is the normal HCT range for women?

38-46

What is the normal HCT range for men?

42-54

Normal WBC count

6,000-10,000

What is the time it takes Nadir to occur with WBC's and platelets?

7-14 days

value for a low platelet count

< 20,000

What is the difference between alkylating and Anti-tumor antibiotics?

Antitumor antibiotics are administered IV or thru a direct catheter into body

administration of anti-neoplastic drugs after surgery or radiation therapy

Adjuvant chemotherapy

Change the shape of DNA double helix and prevents nucleic acid from completing normal cell division

Alkylating agents

forming bonds or linkages with DNA

Alkylation

Hair follicles are damaged

Alopecia

What hormone antagonist is used to treat advanced prostate cancer?

Androgen antagonist

palliative therapy for breast cancer in post-menopausal women

Androgens

low RBC count, normal HCT

Anemia

What are three things that can limit dosages and delay or discontinue chemotherapy?

Anemia, leukopenia, thrombocytopenia

What hormone antagonist treats tumors that are the cause of breast cancer?

Anti-estrogens

What can a patient take before chemotherapy to prevent GI toxicity?

Antiemetic (anti-vomiting) - Ativan, Zofran, Reglan, Compazine

these drugs chemically resemble the essential building blocks of cells and interfere with the aspects of nutrients or nucleic acid metabolism of rapidly growing tumor cells

Antimetabolites

these drugs have a similar structure to the nutrients needed to construct proteins and nucleic acids (DNA and RNA)

Antimetabolites

What drugs are similar to alkylating agents?

Antitumor antibiotics

What cancer drug alters body defenses to enhance the destruction of cancer cells by stimulating the immune system to rid the body of cancer cells?

Biologic response modifiers (BRM's)

when stem cells in the bone marrow are destroyed

Blood toxicity

What are two major adverse effect of anti tumor antibiotics?

Bone marrow suppression and cardiotoxicity

Tumors that are considered solid masses are usually classified as?

Breast or lung cancer

What goal is set when cancer has progressed and a cure is not possible, preventing the growth and spread of the tumor is the goal

CONTROL

What goal is set as the primary goal and is usually attainable if the cancer is identified and treated early

CURE

A disease characterized by uncontrolled cell division

Cancer

factors that increase the risk for developing cancers

Carcinogens

What route is preferred when administering a vesicant?

Central lines

drugs that block substances essential for tumor growth

Hormones

What can the prolonged use of glucocorticoids result in?

Cushing's Disease

What should you do to Cytoxan prior to IV administration?

Dilute

used to treat metastasis breast cancer and prostate cancer

Estrogens

What can Adriamycin cause?

Extravasation

What is it called when a vesicant escapes from an injection site and produces severe tissue and nerve damage?

Extravasation

Monocolonia antibodies are engineered to attack many tumor cells? T/F

False, they are engineered to attack ONE SPECIFIC type of tumor cell

natural ability to suppress cell division in lymphocytes

Glucocorticoids

hormones used to treat tumors that contain specific hormone receptors

Gonadal

What is a unclassified factor that will increase the risk for cancer?

Immunosuppressant drugs

What could delay chemotherapy treatment?

Immunosuppressants

What are two BRM drugs?

Interferon and Interleukin-2

What happens to the cell once it is damaged?

It is no longer responsive to normal chemical signals checking its growth

Why would you wait a few weeks before giving another dose of chemo?

It will give normal cells time to recover from the adverse effects of the drug; also gives tumor cells that have not been replicating more time to divide and become more sensitive to the next chemo round

Are doses of Hormones small or large?

Large doses

Tumors that are considered widely disseminated in the blood are usually classified as?

Leukemia

What does glucocorticoids treat?

Lymphoma (Hodgkins and leukemia)

Abnormal cells often travel to distant sites where they populate new tumors

Metastasis

Once this drug binds to the target cell, the cancer cell dies or is marked for destruction by other cells of the immune system

Monoclonal anti-biodies

epithelial lining of the digestive tract commonly becomes inflamed

Mucositis

The lowest point a person's RBC's, WBC's, and platelet count can reach

Nadir

drugs that affect cell division - mitotic inhibitors

Natural products (Plants)

What s/s are present when chemotherapy triggers the vomiting center in the medulla?

Nausea and vomiting

What term is used interchangeably with tumor?

Neoplasm

What cells are most susceptible to adverse effects of cancer drugs?

Normal cells

What goal is attained when cancer is in advanced stages and cure and control are not attainable?

PALLIATION

What should you monitor before administering cytoxan IM?

Platelet count; hold if low count

What are two glucocorticoid?

Prednisone and dexamethasone (Deltasone)

used to treat advanced endometrial cancer

Progestins

What type of doses are chemo administered in?

Some are single doses and some are several doses over several days

low platelet count

Thrombocytopenia

What is the purpose of chemotherapy?

To kill any remaining caner cells that may be present after radiation or surgery

a defined swirling of abnormal enlargement, or mass

Tumor

agents that cause serious tissue damage as they escape from an artery or a vein during an infusion or injection

Vesicant

Derived from periwinkle plants

Vin- drugs

When is chemotherapy used?

alone or in combo with surgery or radiation

Name a hormone antagonist

anti estrogen