Download Chapter 14 Antineoplastic Drugs Copyright © 2015 Cengage Learning®

Chapter 14
Antineoplastic Drugs
Copyright © 2015 Cengage Learning®
Introduction
• A healthy body needs cells to reproduce
and grow in an orderly, regulated manner
– Sometimes, conditions are altered in the body
that trigger abnormal changes in the way the
cells reproduce and grow
• Can cause cell growth to become uncontrolled,
leading to overproduction or impaired cellular
development
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Introduction (cont’d.)
• Unregulated growth can lead to abnormal
cells, tissue, and tumor development
– Tumors can be classified as either benign
(non-cancerous) or malignant (cancerous)
• Antineoplastics (“against new tissue
formation”)
– Agents that counteract the development,
growth, or spread of malignant cells
– Can treat various types of cancers
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Introduction (cont’d.)
• What is chemotherapy?
– Drugs and drug combinations used for
palliative effects or for long-term or complete
remissions in early treatment of cancer
• Antineoplastic drugs are cytotoxic (destructive to
cells), and especially to cells that are proliferating
(reproducing rapidly)
• Many antineoplastic agents also possess
immunosuppressive properties
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Introduction (cont’d.)
• Antineoplastic agent groups
– Antimetabolites
– Alkylating agents
– Mitotic inhibitors
– Antitumor antibiotics
– Hormones and hormone modifiers
– Biological therapies
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Introduction (cont’d.)
– Targeted cancer therapies
– Vaccines
– Radioactive isotopes
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Introduction (cont’d.)
• The following slides discuss various
antineoplastic drugs
– Refer to the chapter for specific side effects
and contraindications
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Antimetabolites
• Work by interfering with DNA synthesis,
repair, and cellular replication
– Used in the treatment of various
malignancies, especially those involving
rapidly proliferating neoplasms
• Examples: methotrexate and fluorouracil
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Alkylating Agents
• Can treat a wide range of cancers
– Prevent growth by damaging DNA needed for
reproduction
• Examples: cisplatin and cyclophosphamide
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Mitotic Inhibitors
• Mitosis is the process of cell division and
reproduction
– Mitotic inhibitors are often plant alkaloids and
other compounds derived from natural
products that block mitosis
• Can treat many different types of cancer
• Plant alkaloid examples: vinblastine, vincristine,
and paclitaxel
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Antitumor Antibiotics
• Can treat a wide variety of malignancies
– Examples: doxorubicin, daunorubicin,
bleomycin, daunorubicin, mitomycin, and
others
• Frequently used in combination with other drugs
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Hormones and Hormone Modifiers
• Hormones
– Corticosteroids: used primarily for their
suppressant effect on lymphocytes
• Hormone modifiers
– Antiestrogen: hormonal therapy for metastatic
estrogen receptor–positive breast cancer and
palliative treatment
– Antiandrogen: hormonal therapy in the
treatment of endometriosis and metastatic
prostate cancer
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Biological Therapies
• Designed to repair, stimulate, or enhance
cancer patients' natural immune systems
– More effectively recognize and attack cancer
cells
• Active or direct and passive or indirect
• Interferon alfa
– Most widely used in cancer treatments
– Complex combination of many proteins that
boost immune system response
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Biological Therapies (cont’d.)
• Colony-stimulating factors (CSFs)
– Encourage bone marrow stem cells to divide
and develop into red and white blood cells,
and platelets
• Monoclonal antibodies (MABs)
– Exogenous (outside of body) antibodies
genetically engineered in the laboratory
– Designed to target only cancer cells, thereby
sparing normal tissues
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Targeted Therapies
• Block the growth and spread of cancer
– Interfere with specific molecules involved in
tumor growth and progression
• Signal transduction inhibitors
– Block specific enzymes and growth factor
receptors that signal cancer cell proliferation
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Vaccines
• Medicines that boost the immune system’s
natural ability to protect the body against
“foreign invaders”
– Mainly infectious agents that may cause
disease
• Broad types of cancer vaccines
– Preventive (or prophylactic)
– Treatment (or therapeutic)
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Radioactive Isotopes
• Used in the treatment of certain types of
cancer
– Sometimes the radioactive material is injected
into the affected site or implanted in the body
in the form of capsules, needles, or seeds
– Health care practitioners caring for patients
receiving radioactive isotopes must observe
special precautions to prevent unnecessary
radiation exposure
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Cautions and Responsibilities for
Antineoplastic Drugs
• Medications should be given on time and
exactly as prescribed
• Intravenous sites must be checked with
great care
• Intravenous fluids containing
antineoplastic agents should not be
allowed to get on the skin or into the eyes
of the patient or administrator
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Cautions and Responsibilities for
Antineoplastic Drugs (cont’d.)
• Antiemetics should be immediately
available and administered as prescribed
• Careful and frequent oral hygiene is
essential
• Soft foods and cool liquids should be
available to the patient as required
• Accurate intake and output is important for
adequate assessment of hydration
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Cautions and Responsibilities for
Antineoplastic Drugs (cont’d.)
• Careful observation and reporting of
symptoms and side effects is essential
• Aseptic technique is necessary to minimize
the chance of infection
• Careful assessment of vital signs is important
• The health care practitioner and family must
be informed and answer patient’s questions
honestly
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Cautions and Responsibilities for
Antineoplastic Drugs (cont’d.)
• Careful attention to detail, astute
observations, appropriate interventions,
and compassion are an integral part of
care during chemotherapy
• The health care practitioner should:
– Reassure the patient that someone will be
available to help at all times
– Identify all resources available for both the
patient and their family
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Cytotoxic Drug Dangers to Health
Care Personnel
• Most cytotoxic drugs are toxic substances
known to be carcinogenic, mutagenic, or
teratogenic
– Anyone who prepares, administers, or cares
for patients receiving cytotoxic drugs should
be aware of the dangers involved
• Refer to the chapter for specific recommendations
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