Antineoplastic Drugs Part 1: Cell Cycle-Specific Drugs

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jcrespo8
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51813
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Antineoplastic Drugs Part 1: Cell Cycle-Specific Drugs
Updated:
2010-11-27 00:26:45
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Pharmacology chapter
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  1. Antimetabolites-mechanism of action
    • -cell-cycle specific analogues
    • -they either falsely substitute for purines, pyrimidines, or folic acid
    • -or they inhibit critical enzymes involved in the synthesis or function of these compounds
    • -ultimately inhibit the synthesis of DNA, RNA, and proteins
  2. Folate Antagonists medications
    -Methotrexate: used in treatment of solid tumors (breast, neck, and head); used in treatment of rheumatoid arthritis b/c it has immunosuppressive activity which inhibits lymphocyte multiplication; antidote is Leucovorin
  3. Antimetabolites (Adverse Effects)
    • -hair loss, nausea, vomiting, diarrhea, and myeolosuppression
    • -common general symptoms are fever and malaise
    • -tumor lysis syndrome; may include hyperphosphatemia, hyperkalemia, and hypocalcemia; electrolyte abnormalities treated with diuretics such as mannitol, IV calcium supplementation,
    • -severe: palmar-plantar dysesthesia; mild symptoms are painless swelling and erythema to painful blistering of the pt's palms and soles
  4. Antineoplastic Enzymes
    • -indications: treatment of acute lymphocytic leukemia
    • -adverse effects: impaired pancreatic function, can lead to hyperflycemia and severe or fatal pancreatitis
    • -drug exmaple: asparaginase and pegaspargase
  5. Effects on Antineoplastic Drugs on Normal Cells
    • -killing of normal cells of the GI mucous membrane may result in altered nutritional status, stomatitis, altered bowel function, poor appetitel, nausea, vomiting, and diarrhea
    • -...or hair follicles leads to alopecia (loss of hair)
    • -...in bone marrow results in dangerously low (life threatening) blood cell counts
    • -...germinal epithelial cells leads to sterility (irreversible) in males, damages to the ovaries with amenirrhea in females, and teratogenic effects with possible fetal death
  6. interventions for stomatitis
    • -oral hygiene before and after eating
    • -avoid lemon, glycering, undiluted peroxide, and alcohol containing products b/c of drying/irritating effects
    • -use soft bristle tootbrush and solutions of warm saline
    • -pt's with dentures, remove and clean frequently, wear at mealtimes only if severe stomatitis
    • -helpful to use otc saliva substitutes or sugarless candy/gum to stimulate saliva flow
    • -avoid spicy, acidic, hot foods, alcohol, and tobacco
    • -if white patches noted oral antifungal suspensions may be ordered
  7. Mitotic Inhibitors: Adverse Effects
    • -hair loss, nausea and vomiting, myelosuppression
    • -liver, kidney, lung toxicities
    • -convulsions
    • -extravasation
  8. Topoisomerase 1 Inhibitors (mechanism of action)
    • -derived from camptothecin, a substance taken from a chinese shrub
    • -inhibit proper DNA function in the S phase by binding to the DNA-topoisomerase 1 complex
  9. Topoisomerase 1 Inhibitors (indications)
    • -primarily treat ovarian cancer and colorectal cancer, small cell lung cancer
    • -shown to be effective in cases of metastatic ovarian cancer
  10. Topoisomerase 1 Inhibitors
    • -bone marrow suppresion (predictable, reversible, manageable)
    • -GI effects; nausea, vomiting, diarrhea
    • -Irinotecan causes cholinergic diarrhea (delayed can occur 2 to 10 days after dosage)

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