Chapter 32 and 37 Flashcards
Cause of 75% of cancers
smoking, poor diet
and lack of exercise
Palliation
decrease size of tumor or control side effects to make person feel better, but the cancer continues
Cell Cycle Specific tx: M phase
Plant Alkaloids (Vincristine), Taxanes (Paclitaxel)
Cell Cycle Specific tx: G2 phase
Topoisomerase inhibitors (Irinotecan)
Cell Cycle Specific tx: S phase
Antifolates (methotrexate); Antipurine (hydroxyurea)
Cell Cycle Non-Specific tx
Alkylating agents cyclophosphamide (Cytoxan)
Anthracycline antibiotics (Doxorubicin)
Nitrosureas (Carmustine)
Miscellaenous (Cisplatin, Dacarbazine)
Agents Used in the Treatment of Cancer
Antimetabolites Alkylating agents Plant Alkaloids Antibiotic Antineoplastics Hormones Therapy Monoclonal Antibodies Radioactive Isotopes Biological Response Modifiers
Antineoplastic Agents effect
affect all cells, both healthy and sick
Antineoplastic Agents dose limiting effects
death of GI cells causing N+V
***Myelosuppression (bone marrow suppression): too low a cell count may result in death
Alkylating Agents
Cell cycle non specific
Kills cancer cells by directly attacking DNA
Alkylating Agents uses
treatment of chronic leukemias, Hodgkin’s, lymphomas
Certain lung, breast, prostate, and ovary
Alkylating Agents examples
Cyclophosphamide, nitrogen mustard
Antimetabolites
Interferes with DNA synthesis
stop development and reproduction of cell
cell cycle specific
Antimetabolites examples
mercaptopurine and 5-fluorouracil (5FU)
Antitumor Antibiotics
Bind with DNA and preventing RNA synthesis
Used in a wide variety of cancers
Antitumor Antibiotics examples
Doxorubicin, Mitomycin C and Bleomycin
Plant (Vinca) Alkaloids
Derived from plants
Block cell division during mitosis
Plant (Vinca) Alkaloids uses
ALL, Hodgkin’s and non Hodgkin’s lymphomas, neuroblastomas, cancers of the lung, breast and testes
Plant (Vinca) Alkaloids examples
Vincristine and Vinblastine
Steroid Hormones
Includes adrenocorticosteroids, estrogens, antiestrogens, progesterones and androgens
Steroid Hormones action
unclear- modify the growth of hormone-dependent cancers
Steroid Hormones example
tamoxifen
Combination chemotherapy
only partially effective used together
decreases drug resistance
attacks cancer on several fronts
kills more healthy tissue
Drugs used to treat side effects
Antiemetics (anti-nausea)
Blood-forming agents
Growth Factors
stimulate the bone marrow to produce more red, white and platelet cells
Growth Factors examples
erythropoietin (Epogen) for RBC, Filgrastim (Neupogen) and Pegfilgrastim (Neulasta) for WBC and oprelvekin (Neumega) for platelets
Growth Factors side effects
bone pain
edema, fever, headache, nausea and vomiting, rash and diarrhea, hypertension, dysrhythmias
Rescue Agents
help prevent severe side effects from Ca treatment
given at the same time or just after chemotherapy
Limitations of chemotherapy
Lack of effective drug Tumor outgrows blood supply Patient tolerance Myelosuppression Drug resistance
Antineoplastic drug adverse reactions
bone marrow suppression N+V Anorexia GI disturbances Alopecia Avoid pregnancy
Bone Marrow Suppression considerations
Assess for signs of infection
Monitor for S/S of bleeding
Bone Marrow Suppression interventions
Administer antibiotics Administer colony stimulating factors such as Epogen Private room Avoid others with infections or crowds Check labs avoid injury
Mucositis interventions
Swish and spit with anti-fungal medication for thrush
Rinse with NS and Hydrogen Peroxide
Use topical anesthetics swish and swallow before meals
Biologic Response Modifiers
Alter body defenses to kill cancer cells
Immunostimulants
Cytokines
Biotherapy Agents
broad class of protein cell regulators produced by the immune system
have multiple effects
Cytokines examples
Interferons
Interleukins
Hematopoietic growth factors
Interferons (IFNs)
have antiviral, anti-cancer and anti-inflammatory properties
Interferons (IFNs) uses
hairy cell leukemia, non-Hodgkin’s lymphoma, chronic hepatitis B & C, Kaposi sarcoma found in patients with AIDS
Interleukins (ILs)
Secreted by macrophages, lymphocytes and monocytes
Interleukins (ILs) effects
stimulates cytotoxic T cell activity against tumor cells, increase B cell and plasma cell production and promotes inflammation
Monoclonal Antibodies
any drug ending in MAB
recognize and bind to only one tumor associated antigen
Monoclonal Antibodies side effects
fevers, rigors, N/V, headache) to more severe urticaria, dyspnea, hypotension, myelosuppression bronchospasm, anaphylaxis
