Antineoplastic drugs Flashcards
neoplasm
cancer
malignant
can grow and spread to other parts of the body
oncology
study/treatment of tumors
how does cancer start?
single cell is genetically different –> divides and passes along abnormalities to daughter cells producing tumor/neoplasm –> then can matastasize
benign
can grow but won’t spread
chemotherapy
drug treatment that uses powerful chemicals to kill fast-growing cells
remission
clinically detectable tumor cells and all signs of malignancy are gone
pallitive
remission of secondary signs, typically without without an increase in animal’s survival time
growth fraction
percentage of cancer cells that are actively dividing
doubling time
time required for a number of cancer cells to double
nadir
lowest point of neutrophil and platelet counts after administration of a myelosuppressive drug
antineoplastic dugs
stop cancerous growth of malignant cells
can act on different phases of the cell cycle
what are the different phases of the cell cycle?
- G1 phase: enzymes produced that are needed for DNA synthesis
- S phase: DNA synthesis and replication
- G2 phase: RNA and protein synthesis
- M phase: mitosis phase involving cell division
- G0 phase: resting phase
types of cells found in neoplasms
dividing cells, temporary nondividing cells, permanent nondividing cells
cell-cycle nonspecific (CCNS) drugs
antineoplastic drugs that work during any phase of the cell cycle
cell-cycle specific (CCS) drugs
antineoplastic drugs that work during a specific phase of the cell cycle
can antineoplastic drugs interfere with normal cells too?
yes they are cytotoxic and go after all cells
alkylating agents
CCNS
causes miscoding of DNA and/or cross-linking of DNA strands to inhibit its replication
cell cycle effect: effective on all phases but mostly G1 and S
most often used for lymphoproliferative diseases, osteosarcoma, mast cell tumors, carcinomas
antitumor antibiotics
CCNS.
inhibits DNA, RNA, and protein synthesis
cell cycle effect: effective on all phases but doxorubicin more effective on S phase
mostly used for lymphoproliferative diseases, sarcomas, carcinomas
steroids
CCNS
inhibits DNA synthesis, actions may include anti-inflammatory effects, suppression of bone marrow cells, reduced edema, suppression of tumor growth
cell cycle effect: effective on all phases but mostly effective at S and M phases
most often used for lymphoproliferative diseases, reproductive cancers, mast cell tumors, CNS tumors
antimetabolities
CCS
affects S phase (involving DNA synthesis), inhibits synthesis of folic acid (needed for protein synthesis and DNA), or acts as an analog of pyrimidine or purine (bases occurring in DNA/RNA) and incorporating into DNA/RNA molecule
most often used for lymphoproliferative diseases, carcinomas
alkaloids
CCS
chemicals derived from plants
stops mitosis,
aka mitotic inhibitors
cell cycle effect: effective on M phase inhibiting mitosis and causing cell death
most often used for lymphoproliferative diseases, mast cell tumors, sarcomas, carcinomas
adverse effects of antineoplastics
B- bone marrow suppression (check CBC often)
A- alopecia (more prevalent in certain breeds)
G- GI symptoms
infertility: secondary to drug use, may be permanent
cardiotoxicity: damage to heart from certain drugs such as doxorubin, may be permanent
nephrotoxicity: kidney failure from certain drugs such as cisplatin may be seen especially in animals receiving pulse dosing of meds
what should the client do if an animal experiences alopecia as an adverse effect?
keep pet out of the cold and avoid excessive sunlight
what are some common GI signs that may be seen as an adverse effect of antineoplastics?
vomiting, diarrhea, anorexia due to drugs/nausea leaving a foul taste in mouth, nausea or vomiting can be secondary to antineoplastic use
how is administration of antineoplastics determined?
depends on type of tumor, tumor’s malignancy stage, animal’s condition, owner’s financial and emotional resources
combination therapy
administering multiple antineoplastics concurrently
pulse dosing
method of delivering some types of chemotherapeutic drugs that produce escalating levels of drug early in dosing interval followed by prolonged dose-free period
how are chemotherapy drug doses calculated?
based on body surface area because they have narrow therapeutic indexes
routes of administration for. chemotherapy drugs
oral, IV, SQ, IM, topical, intracavitary, intralesional, intravesicular, intrathecal (injected into subarachnoid space in spinal cord), intra-arterial
what type of bio-safety cabinet is used for chemotherapy drugs?
type II bio-safety cabinet (BSO)
used to prep drugs
safe handling of chemotherapy drugs
follow NIOSH guidelines
wear PPE for handling, prepping, administering drugs and when cleaning up body fluids
routes of exposure for chemotherapy drugs?
skin contact, skin absorption, inhalation of aerosols/drug particles, ingestion, needlestick injuries
chemotherapy PPE
designated prep area, latex gloves, goggles/face shields, disposable gown, clean surfaces used, designated disposal area, spill kit ready
cancer pain
treat underlying tumor causing pain: surgery, radiation, chemo
analgesia options: NSAIDs, opioids, glucocorticoids, local anesthetics, alpha-2 agonists, muscle relaxants
non-pharm therapies: acupuncture, hydrotherapy, massage, cold laser therapy
paraneoplastic syndromes
disorders that occur when immune system has a reaction to a neoplasm
often 1st sign of malignancy
tumor associated changes in animal’s body structure and/or function that occurs distant to tumor
what are the types of paraneoplastic syndromes?
similar: treat tumor and syndrome will resolve- insulinoma and hypoglycemia
not similar: syndrome needs to be treated too- hypocalcemia and a variety of tumors
immunomodulatory drugs
drugs that modify the response of the immune system
immunostimulation or immunosuppression immune response
immunostimulant drugs
aka biologic response modifiers (BRMs): given to animals to enhance their immune response
specific: react with selective specificity to 1 or more antigens
non-specific: activate innate immunity and promote release of endogenous immune mediators
interferons
immunostimulants
group of naturally occurring proteins that have antitumor and antiviral effects
regulate lymphocyte activity and interfere with viral replication
alpha interferons
type of interferon drugs
treats tumors and viral infections in cats
colony stimulating factors (CSFs)
immunostimulants
stimulate growth, maturation, and differentiation of bone marrow stem cells
filgrastim: granulocyte colony stimulating factor
interleukins
immunostimulants
group of chemicals that play various roles in the immune system
interleukin-2: promotes replication of antigen-specific T cells, treats mast cell tumors in dogs and fibrosarcomas in cats
immune polysacchride
immunostimulants
stimulator of macrophage activity
monoclonal antibodies
immunostimulants
identical immunoglobin molecules that have cytotoxic effects on tumor cells
uses antibodies made in a lab, recruits cells to tumor
biologic immunostimulant
modified bacterium with antitumor activity
melanoma vaccine
Oncept
immunostimulants
treats oral melanomas in dogs
used after surgery and/or radiation to prevent metastases
immunosuppressive drugs
interfere with 1 of the stages of the cell cycle or affect cell messengers
treats immune-mediated diseases and reduces immune response against transplanted organs
cyclosporine
immunosuppressive
inhibits proliferation of T lymphocytes
azathioprine
immunosuppressive
affects cells in S phase, inhibits T and B lymphocytes
cyclophosphamide
immunosuppressive
interferes with DNA/RNA replication
used for immune-mediated diseases (like immune-mediated hemolytic anemia)
enzymes
L-asparaginase: treats lymphomas, MCT, and thrombocytopenia
enzyme-inhibiting drugs
controls growth of tumor cells
Toceranib: tyrosine kinase inhibitor, treats grade II and III/recurrent/cutaneous MCT in dogs
