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
