Antineoplastic Drugs Flashcards
The most common cancer in both men and women is
lung cancer
most common cancer for women?men?
breast. prostate
the second leading cancer in both men and women
colorectal
cancer is chacterized by
- uncontrolled cellular growth
- local tissue invasion
normal cell functions
to replace worn out cells, heal wounds and maintain healthy organs
metastasis pathways
lymphatic (most common), blood, body spaces (eg. abdominal cavity), through implantation
remission is
the elimination or reduction in the disease (may be transient or permanent)
what are the phases of carcinogenesis
- initiation - exposure to carcinogens = ce;; damage and cell mutation
- promotion - altered environment promotion of cell growth
- transformation - cells become cancerous and detectable
- progression - genetic changes, further cell growth and metastases
cancer cell cycles
cell cycle specific - most effective when in a specific phase of the cycle (cycling)
cell cycle non-specific - effective during both division and resting states of the cell cycle
treatment method: surgery used for
diagnosis for most early stages of solid tumors
treatment method: radiation
to shrink tumors that are localized
tx method. to treat the primary tumor as well as areas of metastases
chemotherapy
last tx method
biologic therapu
chemotherapies:
alkylating agents, antimetabolites, plant alkaloids, antitumor antibiotics, hormones
chemotherapies are organized by
MoA and origin
biologic therapy targets
specific areas affecting cell growth
biological therapy design
improves outcomes with less adverse effects
biological therapies not just for cancer
psoriasis, rheumatoid arthritis, crohns disease
cell cycle specific vs cell cycle non specific
Cell cycle specific: NOT G0, greatest effects on actively dividing cells, at certain phases of cell growth
non cycle specific - INCLUDING G0 against slow growing tumours, at any stage
cell cycle specific tx
antimetabolites, bliomycin, vinca alkaloids, podophyllin
cell cycle non-specific tx
alkylating agents, abs, cisplatin, nitrosoureas
Gap 0 phase
resting phase, cells not dividin
Gap 1 phase
post mitotic phase- enzymes necessary for DNA synthesis, protein and RNA synthesis
synthesis phase
cellular DNA duplicated
gap 2 phase
premitotic phase - precursors of mitotic spindle procedure
mitosis phase
cell division: P,M,A,T and cytokinesis
alkylating agents and specificity
non specific
inhibit DNA replication
how do alkylating agents inhibit DNA replication
covalently binds to DNA strands (DNA strand breakage or uncoiling)
inhibits DNA synthesis and fxn
what are major toxicities of alkylating agents
Myelosuppression is a major dose-limiting toxicity
Sterility, Nausea/vomiting, alopecia (hair loss)
Second malignancies
what are the different types of alkylating agents
- nitrogen mustards, platinum analogs, nitrosoureas, alkyl sulfonates, non classic
which type of alkylating is classic?heavy metals?
nitrogen mustards. platinum analogs
what are anti-metabolites? cell specificiy
structural analogs of natural metabolites involve in DNA and RNA synthesis
disrupt cell replication and cell division in DNA, RNA strands and cellular proteins
= S phase
examples of anti metabolites
pyrimidine analogs, purine analogs, anti-folate
what are plant alkaloids? cell specificity?
halts cell division leading to cell death (inhibits mitosis) and inhibit tumor proliferation
example of plant alkaloids
vinca alkaloids (vincristine, vinblastine) taxoids (paclitaxil, docetaxel - stabilize microtubule)
Where are these drugs derived from
Vincristine? Vinblatine? docetaxel
Periwinkle plant, periwinkle plant, yew plant
Antitumor antiobiotics? specificity
blocks DNA/RNA sysnthesis and interferes with cell replication.
non specific
examples of antitumor antibiotics
bleomycin, doxorubicin, mitomycin
hormones: estrogen receptor modulator
use? cancer type? ex?
binds to estrogen receptors on the tumor, decreasing DNA synthesis. breast cancer. tamoxifen
hormones: aromatose inhibitors
use? cancer type? ex?
blocks estrogen from being produced in post-menoposal women. breast cancer. anastrozole, letrozole.
hormones: antiandrogens
use? cancer type? ex?
blocks testosterone from binding at the androgen receptor on tumor cells. prostate cancer. cyproterone, bicalutamide. flutamide.
when are estrogen receptor modulator used
3-5 yrs after surgical removal. primarily pre and post menopausal women with hormonal receptive cancer and for breast cancer in men
when are aromatase inhibitors used
added to tx after 3-5 yerds of estrogen receptor modulator (tamoxifen) duration 2-3 yrs
what are biologic response modifier
inhibits replication, suppresses proliferation, enhances cell breakdown
examples of biologic response modifiers
interferon, monoclonal antibodies,
what are bone metabolism regulators
inhibits bone resorption by binding to crystals in the bone matrix where there is an increased turnover rate of bone, inhibition of osteoclast function and decrease bone destruction,
bone metabolism regulators treat these type of cancers
that have moved to the bone
ex of bone metabolism regulators
pamidronate, clodronate
diff between pamidronate and clodronate? similarities
p: for tumor induced hypercalemia
c: for malignancy related hypercalcemia
both: osteolytic bone metastases and osteonecrosis of the jaw (rare
mucositis is a dental implication of chemotherapy.when does is occur and what causes it? prevention?
5-7 days or weeks of starting chemo. 5-fluorocacil (antimetabolite). ice chips, basic OH, alcohol free mouthwast/ soda/ salt rinse
tx of mucositis
benzydamine - numbness and relieve pain. remove dentures, oral rinses, asses brushing and diet, severe= analgesics
gingival bleeding can be cause by? tx?
low platelet counts. CHX rinse
