Chapter 14 - Antineoplastic Drugs

Question 1

Antineoplastic

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Answer 1

(Against new tissue formation) refers to an agent that counteracts the development, growth, or spread of malignant cells and therefore treats various types of cancer.

Question 2

Benign

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Answer 2

Tumors that are Noncancerous

Question 3

Malignant

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Answer 3

Tumors that are cancerous.

Question 4

Antineoplastic agents can be generally classified into 9 major groups:

(P. 225)

Answer 4

1. Antimetabolites
2. Alkylating agents
3. Mitotic Inhibitors
4. Antitumor antibiotics
5. Hormones and Hormone Modifiers
6. Biological Therapies (CSFs and MABs)
7. Targeted cancer Therapies (STIs)
8. Vaccines
9. Radioactive Isotopes

Question 5

Chemotherapy

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Answer 5

Is a constantly growing field in which many old and new drugs and Drug combinations are used.

Question 6

Palliative effects

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Answer 6

Alleviation of symptoms or for long-term or complete remissions in early treatment of cancer.

Question 7

Cytotoxic

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Answer 7

Antineoplastic drugs are cytotoxic “destructive to cells”.

Question 8

Proliferating

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Answer 8

Reproducing rapidly.

Question 9

Signal transduction Inhibitors (STIs)

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Answer 9

New drugs in the targeted therapy category and are given by the oral route.

Question 10

Immunosuppressive

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Answer 10

Decreasing the production of WBC’s, antibodies and phagocytes and depressing the inflammatory reaction.

Question 11

Antimetabolites

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Answer 11

Work by interfering with DNA synthesis, repair, and cellular replication and are used in the treatment of various malignancies, especially those involving rapidly proliferating neoplasms (new growth).

• Some injectable Antimetabolites include methotrexate and fluorouracil.

Question 12

Alkylating Agents

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Answer 12

Are used in the treatment of a wide range of cancers. These agents prevent cell growth by damaging DNA needed for reproduction. Can cause long-term damage to the bone marrow.

• Some Alkylating agents include cisplatin and cyclophosphamide.

Question 13

Mitosis

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Answer 13

Refers to the process of cell division and reproduction. Mitotic Inhibitors are often plant alkaloids and other compounds derived from natural products that block mitosis.

Question 14

Plant Alkaloids

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Answer 14

Intrathecal Administration (into the spinal canal) of these agents is fatal.

• This route must not be used. Syringes containing these agents should be labeled, “Warning– For IV use only, fatal is given intrathecally”.

Question 15

Extravasation

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Answer 15

Occurs when a drug or liquid intended for IV Administration leaks into the surrounding tissue.

• in particular, chemotherapy can cause painful irritation, and is left untreated can lead to necrosis of that tissue.

Question 16

Plant Alkaloid - Paclitaxel (Abraxane)

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Answer 16

Is the first approved albumin nanoparticle drug. Was originally extracted from the bark of the Western (Pacific) Yew.

Question 17

Anti-tumor antibiotics

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Answer 17

are used to treat a wide variety of malignancies.

• Doxorubicin (Adriamycin) is considered the most active chemotherapy agent and is a critical component in the treatment Protocols of breast, lung, gastric, and ovarian cancers and Lymphoma, but it can permanently damage the heart is a maximum lifetime dose is reached.

Question 18

Corticosteroids

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Answer 18

Such as prednisone, are used primarily for their suppressant effect on lymphocytes in Leukemia and Lymphoma.

Question 19

Hormones and hormone modifiers

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Answer 19

Used in the treatment of cancer include the corticosteroids. Hormone modifiers include the antiestrogen and antiandrogen agents.

Question 20

Dexamethasone

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Answer 20

Large doses have been found to be effective in the prevention and treatment of nausea and vomiting associated with many antineoplastic agents, when administered before or during chemotherapy. It is also used to treat cerebral edema associated with brain tumors.

Question 21

Antiestrogens

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Answer 21

A nonsteroidal agent belonging to a class of drugs called selective estrogen-receptor modifiers (SERMs), tamoxifen, binds to estrogen receptors in various tissues. It can be used as a primary hormonal therapy both for metastatic estrogen receptor-positive breast cancer in both men and postmenopausal women and also for palliative treatment. Tamoxifen also stimulates estrogen receptors in bones and may help prevent osteoporosis.

Question 22

Antidrogens

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Answer 22

These drugs include leuprolide acetate, which suppresses testosterone production in the testes and is usually administered intramuscular (IM) (Lupron Depot) or subcutaneously (SC) (Eligard) on monthly regimen every one, three, four, or six depending on the dosage for prostate cancer they are also used as hormonal therapy in the treatment of endometriosis.

Question 23

Six hormones

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Answer 23

Including the estrogens, progestins, and androgens, are also used as antineoplastic agents in the treatment of malignancies involving the reproductive system.

Question 24

Biological Therapies

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Answer 24

Is designed to repair, stimulate, or enhance cancer patients’ natural immune systems to more effectively recognize and cancer cells.

Question 25

Interferons

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Answer 25

Is a complex combination of many proteins that boost immune system response. They are used in the treatment of certain leukemia, melanoma, Kaposi’s sarcoma, and Non-Hodgkin’s lymphoma.

• also used to treat Hepatitis B and C, multiple sclerosis and other conditions.

Question 26

Colony stimulating factors (CSFs)

P. 231

Answer 26

Such as erythropoietin (Epogen, Procrit) usually do not directly affect tumor cells. They encourage bone marrow stem cells to divide and develop into red blood cells (RBCs) and white blood cells (WBCs) and platelets.

Question 27

Monoclonal antibodies (MABs)

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Answer 27

Are exogenous (outside the body) antibodies genetically engineered in the Laboratory. MABs are designed to Target only cancer cells, thereby sparing normal tissues.

Question 28

Angiogenesis Inhibitors (AIs)

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Answer 28

Prevent the formation of new blood vessels that tumors need to grow and invade nearby tissue. AIs may stop or slow the growth of a cancer, not completely eradicate it.

Question 29

Bevacizumab (Avastin), in combination with other agents,

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Answer 29

Is indicated for the first-line treatment of patients with metastatic carcinoma of the highly vascularized colon, kidney, or long.

Question 30

trastuzumb (Herceptin), combined with paclitaxel,

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Answer 30

Another MAB, is indicated for first-line treatment of metastatic breast cancer in patients with tumors that produce excess amount of protein called HER2.

• All MABs are administered intravenously.
• severe reactions can be minimized by premedicating with Tylenol, Benadryl or Demerol.
• signs of severe reaction is bronchospasms (may be necessary to stop infusion).

Question 31

Vaccines

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Answer 31

Are medicines that boost the immune system natural ability to protect the body against “foreign invaders,” mainly infectious agents that may cause disease.

There are two broad types of cancer vaccines:

• Preventive (or prophylactic), which are intended to prevent cancer from developing in healthy people.
• Treatment (or therapeutic), which are intended to treat an existing cancer by strengthening the body’s natural defenses against cancer.

Question 32

Radioactive Isotopes

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Answer 32

Are also used in the treatment of certain types of cancer.

• Sometimes the radioactive material is injected into the affected site.
• radioactive sodium iodine is administered po to treat thyroid cancer thyroid cells naturally take up the radioactive iodine.
• Radioactive material is sometimes implanted in the body in the form of capsules, needles, or seeds.

Question 33

Radioimmunotherapy

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Answer 33

Consists of MABs that have radioisotopes attached to them so that whatever the targeted antibody binds to can also be irradiated.

• the primary side effect is a decreased blood count occurring 4 to 6 weeks after treatment.
• the distinct Advantage is that it is usually given one time.
• gowns and gloves should be worn when handling patients excreta such as feces, urine, and body secretions.