Antineoplastic Drugs Flashcards
What cell phase are Alkylators?
Non-cell-cycle-phase specific and most active in resting phase (G0)
How do Alkylating agents work?
- Replacement of hydrogen by an alkyl group
- Produce abnormalities and cross-links in DNA, RNA and proteins, preventing normal cell function
How do Anti-metabolites work?
- Cell cycle specific (S phase)
- Interfere with DNA/RNA and protein synthesis during S cycle, and therefore are best for rapidly dividing cancers
- By blocking some types of synthesis, apoptosis can occur
- Resembles metabolic material, so it incorporates into DNA strands and breaks it
If a drug belongs to an anti-tumor antibodies group, what suffixes are they likely to end in?
- rubicin
- mycin
What are anti-tumor antibiotics?
- Work as both antimicrobial and cytotoxic, cell-cycle nonspecific, to produce toxic effects
- Most act as a way to regulate the twisting/winding of DNA
What is targeted therapy?
- The ability to deliver drugs directly to tumors
- Interferes with growth factor signaling (which is involved in the initiating and progression of certain cancers)
What are monoclonal antibodies?
- Immunoglobulin molecules from cloned cells, as a targeted therapy
- Works by blocking ligand when binding with an antigen
What is hormone therapy?
- Tx of cancers of hormone-derived or hormone-sensitive tumors
- Blocks the stimulation of steroid-specific receptors on the surfaces of cells, thereby blocking the cell from receiving normal hormone growth stimulation
- Decreases the tumor growth factor
What are antineoplastic drug toxicities often the result of?
Dose dependent and cumulative dose
What causes the toxicities of antimetabolite therapy?
- Suppression of cell growth in mitotically active tissues (eg. bone marrow, GI, skin)
What is the suffix for anti-androgens?
- lutamide
What is the suffix for topoisomerase I inhibitors?
- otecan
What class is topotecan?
- Plant alkaloids
- Topoisomerase I inhibitors
What class is irinotecan?
- Plant alkaloids
- Topoisomerase I inhibitors
Are nitrosureas CCPNS or CCPS?
CCPNS
How do nitrosurea’s work?
Damage DNA or interfere with DNA replication
Are vinca plant alkaloids CCPS or CCPNS?
CCPS (M-phase)
How do vinca plant alkaloids work?
Cell cycle phase arrest
How do corticosteroids work?
- Inhibits the stimulation of steroid-specific receptors located on the surface of cells
- Blocks the receptors to prevent cells from receiving normal hormonal growth stimulation = decreases growth fraction of tumor
How do miscellanous agents work?
- CCPNS
- Inhibit DNA, RNA or protein synthesis
What are the different classes of hormone therapies?
- Corticosteroids
- Androgens
- Estrogens
- Anti-estrogen’s, progestins
- Estrogen-receptor antagonists
- Aromatase inhibitors (aromatase = needed for estrogen synthesis)
- Luteinizing hormone-releasing hormone analogues
- Gonadotropin-releasing hormone antagonist
- Antiandrogens
What is tamoxifen?
- Most common hormone modulator for estrogen positive breast Ca
- Selective estrogen receptor modular (SERM)
- Blocks estrogen in the breast tissue by sitting in place of the estrogen receptor - without estrogen attaching, there is no signal to grow and multiply
What are the side effects of tamoxifen?
- Think of common birth control side effects, similar *
- Hot flashes may occur once you start taking it and usually improves with use
- Vaginal discharge or dryness
- Nausea
- Headache
- Muscle or joint pain
- Skin rashes
- Fatigue
- Swelling
- HTN
- Blood clots **
- Weight changes
- Hair thinning
- Changes in cholesterol or triglycerides
- Endometrial cancer (rarely occurs with prolonged use)
What are management options for hot flashes?
- Take tamoxifen at bedtime
- If night sweats are interrupting sleep, take tamoxifen in the morning
- Avoid alcohol, spicy foods, and caffeine
- Regular exercises
- Cool environment
- Wear layers
What is goserelin?
- Gonadotropin-releasing hormone agonist
- GRH stimulates the pituitary to produce more sex hormones (follice and lutenizing) by blocking the GRH receptor site
- Treats prostate and breast cancer
- In men, decreases testosterone
- In women decreases estrogen and progesterone
What are the side effects of goserelin?
- Effects are from lowered estrogen and testosterone
- Increased bone pain (if mets to the bones)
- Hot flashes
- Fatigue
- Impotence
- Decreased libido
- HA
- Weight changes
- Sugar fluctuations
- Increase in cholesterol or triglycerides
- Bone loss happens gradually, increased risk of #’s
How are chemo agents classified?
- Cell cycle or non cycle specific
- further classified into subgroups based on chemical structure, biological source and the effects on the cell cycle
What are the different classifications of chemo agents?
- Alkylating agents
- Antitumor antibiotics
- Antimetabolites
- Nitrosureas
- Plant alkaloids
- Hormonal agents
What chemo drug classes are cycle specific?
Plant alkaloids in M phase (stops cell cycle)
Antimetabolites in S phase (stops DNA synthesis, resembles metabolic elements for cell growth)
What chemo classes are cycle non-specific?
- AA (break DNA helix, hinders replication)
- Antitumor antibiotics (bind to DNA and interferes with replication)
- Hormones (interfere with protein synthesis and direct lytic action)
