Pharmacology: Drugs Used to Treat Cancer – Flashcards
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A disease characterized by uncontrolled cell division
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Cancer
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What are three characteristics of cancer cells?
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1. lose normal function 2. divide rapidly 3. invade surrounding cells
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What happens to the cell once it is damaged?
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It is no longer responsive to normal chemical signals checking its growth
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What is cancer thought to result from?
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damage to the suppressor genes that control cell growth
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Abnormal cells often travel to distant sites where they populate new tumors
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Metastasis
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a defined swirling of abnormal enlargement, or mass
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Tumor
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What term is used interchangeably with tumor?
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Neoplasm
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Tumors that are considered solid masses are usually classified as?
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Breast or lung cancer
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Tumors that are considered widely disseminated in the blood are usually classified as?
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Leukemia
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factors that increase the risk for developing cancers
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Carcinogens
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What are three chemical carcinogens?
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1. Chemicals in tobacco smoke 2. Asbestos 3. Benzene
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What are two psychical carcinogens?
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1. exposure to radiation (leukemia) 2. Ultraviolet light (skin cancer)
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What are three viruses that cause cancer?
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1. Herpes simplex 2. HPV 3. HIV
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What is a unclassified factor that will increase the risk for cancer?
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Immunosuppressant drugs
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What are two primary actions of chemotherapy drugs?
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1. Attack DNA and proteins (kill cancer cells) 2. Poison metabolic pathways of rapidly growing cells (stop the growth of cancer cells)
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What are the 3 general goals of chemotherapy?
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1. Cure 2. Control 3. Palliation
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What goal is set as the primary goal and is usually attainable if the cancer is identified and treated early
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CURE
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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
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CONTROL
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What goal is attained when cancer is in advanced stages and cure and control are not attainable?
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PALLIATION
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What are the three things that are attainable when setting the palliation goal?
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1. reduce tumor size 2. reduce severity of pain and symptoms 3. improve quality of life
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What three cancers are most likely treated with palliation?
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1. pancreatic cancer 2. osteosarcoma 3. Karposi's sarcoma
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When is chemotherapy used?
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alone or in combo with surgery or radiation
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administration of anti-neoplastic drugs after surgery or radiation therapy
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Adjuvant chemotherapy
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What is the purpose of chemotherapy?
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To kill any remaining caner cells that may be present after radiation or surgery
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What is an adverse effect of cancer drugs?
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severe toxicity (damage to normal tissue)
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What type of doses are chemo administered in?
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Some are single doses and some are several doses over several days
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Why would you wait a few weeks before giving another dose of chemo?
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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
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What could delay chemotherapy treatment?
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Immunosuppressants
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What cells are most susceptible to adverse effects of cancer drugs?
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Normal cells
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when stem cells in the bone marrow are destroyed
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Blood toxicity
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What are three things that can limit dosages and delay or discontinue chemotherapy?
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Anemia, leukopenia, thrombocytopenia
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low RBC count, normal HCT
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Anemia
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What is the normal HCT range for men?
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42-54
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What is the normal HCT range for women?
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38-46
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low white blood cell count
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leukopenia
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Normal WBC count
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6,000-10,000
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Normal platelet count
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150,000-350,000
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low platelet count
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Thrombocytopenia
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value for a low platelet count
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< 20,000
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Normal Platelet count:
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150,000 - 350,000
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To combat bone marrow depression, patients may be given:
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1. bone marrow transplants 2. ESA's 3. Granulocyte stimulating agents 4. blood transfusions 5. platelet transfusions
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epithelial lining of the digestive tract commonly becomes inflamed
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Mucositis
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What are s/s of mucositis?
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1. painful ulcerations 2. difficulty eating or swallowing 3. GI bleeding 4. intestinal infections 5. severe diarrhea
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What can a patient take before chemotherapy to prevent GI toxicity?
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Antiemetic (anti-vomiting) - Ativan, Zofran, Reglan, Compazine
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What s/s are present when chemotherapy triggers the vomiting center in the medulla?
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Nausea and vomiting
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Hair follicles are damaged
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Alopecia
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What are 7 s/e of chemotherapy?
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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
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The lowest point a person's RBC's, WBC's, and platelet count can reach
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Nadir
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What is the time it takes Nadir to occur with WBC's and platelets?
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7-14 days
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What is the time is takes Nadir to occur with RBC's?
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3-4 weeks
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agents that cause serious tissue damage as they escape from an artery or a vein during an infusion or injection
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Vesicant
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What route is preferred when administering a vesicant?
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Central lines
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What is it called when a vesicant escapes from an injection site and produces severe tissue and nerve damage?
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Extravasation
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What are the classifications of Cancer drugs?
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1. alkylating 2. antimetabolites 3. antitumor antibodies 4. hormones and hormone antagonists 5. natural products 6. biologic response modifiers 7. monoclonal antibodies
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forming bonds or linkages with DNA
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Alkylation
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Change the shape of DNA double helix and prevents nucleic acid from completing normal cell division
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Alkylating agents
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What is an adverse/side effect of alkylating agents?
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bone marrow suppression
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Name an alkylating agent
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cyclophosphamide (Cytoxan)
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What should you do to Cytoxan prior to IV administration?
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Dilute
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What should you monitor before administering cytoxan IM?
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Platelet count; hold if low count
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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
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Antimetabolites
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these drugs have a similar structure to the nutrients needed to construct proteins and nucleic acids (DNA and RNA)
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Antimetabolites
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Name an antimetabolite
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methotrexate (Rheumatrex, Trexall)
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What drugs are similar to alkylating agents?
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Antitumor antibiotics
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What is the difference between alkylating and Anti-tumor antibiotics?
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Antitumor antibiotics are administered IV or thru a direct catheter into body
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What are two major adverse effect of anti tumor antibiotics?
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Bone marrow suppression and cardiotoxicity
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Name an Anti-tumor antibiotic
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doxorubicin (Adriamycin)
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What can Adriamycin cause?
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Extravasation
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How should extravasation be treated?
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With ice packs or reduced dosage of the drug
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drugs that affect cell division - mitotic inhibitors
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Natural products (Plants)
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Derived from periwinkle plants
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Vin- drugs
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Adverse effect of Oncovin?
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nervous system toxicity
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Derived from bark of Pacific Yew
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-taxel drugs
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What are the 4 hormone drugs?
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1. glucocorticoids 2. progestins 3. estrogens 4. androgens
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Name a hormone antagonist
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anti estrogen
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Are doses of Hormones small or large?
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Large doses
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drugs that block substances essential for tumor growth
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Hormones
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natural ability to suppress cell division in lymphocytes
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Glucocorticoids
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What does glucocorticoids treat?
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Lymphoma (Hodgkins and leukemia)
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What are two glucocorticoid?
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Prednisone and dexamethasone (Deltasone)
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What can the prolonged use of glucocorticoids result in?
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Cushing's Disease
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hormones used to treat tumors that contain specific hormone receptors
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Gonadal
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palliative therapy for breast cancer in post-menopausal women
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Androgens
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used to treat metastasis breast cancer and prostate cancer
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Estrogens
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used to treat advanced endometrial cancer
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Progestins
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What hormone antagonist is used to treat advanced prostate cancer?
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Androgen antagonist
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Name an androgen antagonist
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bicultamide (Casodex)
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What hormone antagonist treats tumors that are the cause of breast cancer?
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Anti-estrogens
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Name an anti-estrogen
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tamoxifen (Soltamox)
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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?
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Biologic response modifiers (BRM's)
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What are two BRM drugs?
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Interferon and Interleukin-2
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What are the two actions of Interleukin-2?
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1. activate cytotoxic T-cells 2. promote other actions of the immune system response
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What are three actions of Interferon?
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1. suppress cancer cell division 2. enhance phagocytic activity of macrophages 3. promote cytotoxic activity of T-lymphocytes
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Once this drug binds to the target cell, the cancer cell dies or is marked for destruction by other cells of the immune system
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Monoclonal anti-biodies
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Monocolonia antibodies are engineered to attack many tumor cells? T/F
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False, they are engineered to attack ONE SPECIFIC type of tumor cell
