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Barriers to successful treatment
- Toxicity to normal cells
- Low host defense
Barriers to successful tx
Solid tumors respond poorly - tumors can spread or aggravation can encourage growth
Drug resistance - random DNA mutation, P-gycoprotein can pump out drugs
Strategies for successful treatment
Intermittent therapy - taking breaks, normal cells heal faster
Cancer Treatment Toxicities
Bone marrow suppression
If a pt is experiencing CIN/V, give them what?
Other toxicites from cancer treatment
Classes of cancer drugs
- Targeted drugs
Action of Alkylating agents/Platinum compounds
Forms abnormal cross links between DNA strands
Drug resistance is common
Disrupt metabolic processes (imposter)
What are three classes of anti-metabolites?
- Folic acid analogue
- Pyrimidine analogue
- Purine analogue
Methotrexate inhibits folic acid metabolism
Leucovorin allows for normal cells to get folic acid, but not the cancer cells
Timing is important
Used only to treat cancer
Administerd IV - cause GI toxicity
Cause bone marrow suppression
Anti-tumor antibiotic effect on the heart
Cardiotoxic - can cause a delayed MI
Mitotic inhibitors side effects
Disrupt cell division in the S process
Drugs for tx of prostate cancer
- Leuprolide (Lupron) - GnRH agonist
- Flutamide (Eulixen) - Androgen Receptor Blocker
Increases release of GnRH in order to down regulate the number of testes receptors
Androgen receptor blocker
Flutamide (Eulixen) action
Blocks receptors depriving the cells of all androgen needed for growth
Block estrogen receptors, which the tumor needs to grow in breast cancer
Adverse effects of SERMs
- Tamoxifen (Nolvodex)
- Raloxifine (Evista)
Aromatase inhibitors are SERMs that will block _________ estrogen, but not ___________
Aromatase inhibitors are used for what?
post-menopausal breast cancer
Adverse effect of Aromatase inhibitors
Estrogen depletion increases the risk of osteoporosis
Epogen or Procrit are both hematopoetic growth factor drugs used for what?
Correcting anemia when H/H has fallen below 35%
Why is Fe, Folic acid and B12 given with Epogen/Procrit?
Because these are things that are needed to make blood
What hematopoetic drug is given to correct WBC count?
Thrombopoetic growth factor
- For people who are anemic from chemo
- For platelet count