Pharmacological Management of Cancer. Flashcards
Define the term adjuvant therapies in relation to cancer treatment.
Is additional cancer treatment given after the primary treatment to lower the risk of the cancer returning. The treatment may include chemotherapy, radiation therapy, hormone therapy, immunotherapy and/or surgery.
Discuss the term radiopharmaceuticals and provide two examples to support your answer.
A radiopharmaceutical is a drug that can be used for either diagnostic or therapeutic purposes.
Iodine- 131- used in thyroid cancer
Gallium-67 – used to obtain images of specific type of tissue or disease state of tissue.
Describe the difference between radiation therapy and chemotherapy in the treatment of cancer.
Chemotherapy – treatment of cancer with one or more cytotoxic anti-neoplastic drugs and treats more than one part of the body or sometimes targets the whole body, method is via drugs; injection, intra-arterial, IV, topical or oral.
Radiation therapy- medical use of ionising radiation to control or destroy malignant cells and mainly targets a single part of the body, method is high energy waves either external, internal, injection or oral
Describe the following: Cell-Kill Fraction and Growth fraction
Cell- Kill Fraction- is when chemotherapeutic drugs given in adequate doses tend to kill a constant proportion rather than a certain number of cancer cells.
Growth Fraction- refers to the percentage of cells engaged in proliferation (rapid increase) versus G0 phases at any given time. Tumour burden refers to number of cancer cells present in the tumour.
Discuss combination chemotherapy, including the three principles utilised to select drugs used in cancer treatment regimes.
Combination chemotherapy is the use of two or more anti-cancer drugs at the same time.
The three principles are as follows;
- Each drug when used alone should be active against the specific cancer.
- Drugs should have different mechanisms of action.
- Drugs should have different organ toxicities or if similar, at different times after drug administration.
Metoclopramide:
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
10mg TID
Mechanism of Action:
Antiemetic to treat nausea and vomiting secondary to cancer chemotherapeutic agents, radiation and opioid medications.
Indications for use as an adjunctive treatment in
cancer management:
For gastrointestinal radiological examinations as it hastens barium transit through upper GIT by its stimulation of gastric emptying and acceleration of intestinal transit.
Dexamethasone:
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
Adult: 0.75 - 9mg/day PO
Or 0.5-9mg/day IM or IV.
Mechanism of Action:
Decrease swelling/inflammation around tumours in the spine, brain, or bone and decrease the pressure of the tumour on nerve endings and relieve pain or other symptoms caused by the pressing tumour.
Indications for use as an adjunctive treatment in
cancer management:
Used for metastatic bone pain, neuropathic pain and visceral pain.
Dolasetron
(5-HT3 antagonist):
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
Adult: 100mg PO 1hr before chemotherapy.
Mechanism of Action:
Prevent nausea and vomiting caused by cancer chemotherapy. It blocks the action of serotonin, a natural substance that’s causes nausea and vomiting.
Indications for use as an adjunctive treatment in
cancer management:
Post radiation nausea and vomiting
Calcium folinate (folinic acid):
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
15mg PO
Mechanism of Action:
Used to treat or prevent blood cell disorders caused by other medications such as; thrombocytopenia, neutropenia, anemia.
Indications for use as an adjunctive treatment in
cancer management:
Is administered in chemotherapy regimens, minimize systemic toxicity; inhibiting or halt the development of a neoplasm (a tumor).
Palifermin:
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
Adult: 60mcg/kg/day
IV bolus 3 consecutive days before and 3 consecutive days after chemotherapy regimen.
Mechanism of Action:
Palifermin is used to prevent and to speed the healing of severe sores in the mouth and throat that may be caused by chemotherapy and radiation therapy (e.g. high doses of Methotrexate) used to treat cancers of the blood or bone marrow (soft fatty material in the middle of bones that makes blood cells).
Indications for use as an adjunctive treatment in
cancer management:
Palifermin is in a class of medications called human keratinocyte growth factors. It works by stimulating the growth of cells in the mouth and throat.
Oxycodone:
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
Adult: PO –5mg-15mg
Mechanism of Action:
The precise mechanism of action is unknown. However, binding to the opiate receptors in the CNS cause an inhibition of ascending pain pathways, alteration of the perception and response to pain and produces generalized CNS depression.
Indications for use as an adjunctive treatment in
cancer management:
used to help treat moderate to severe pain as a result of cancer and its treatment.
Hydromorphone:
Dose:
Mechanism of Action:
Indications for use as an adjunctive treatment in
cancer management:
Dose:
Adult: 2-4mg PO
Mechanism of Action:
Hydromorphone is a narcotic analgesic; its principal therapeutic effect is relief of pain.
Indications for use as an adjunctive treatment in
cancer management:
used to help treat moderate to severe pain as a result of cancer
Discuss four adverse effects associated with most cytotoxic drugs (agents) used in cancer treatment
Hair loss
The use of certain cytotoxic drugs causes hair growth to stop, which results in either complete or partial baldness and the loss of other bodily hair. Hair regrows once chemotherapy finishes. Not all cytotoxic drugs cause hair loss. Patients on chemotherapy can obtain wigs free of charge from the hospital subject to payment obligations.
Nausea
Nausea is the most common side effect of chemotherapy. As with other adverse effects of chemotherapy, the symptoms of nausea depend on the drug and the dosage you are given.
Damage to the mouth and pharynx mucosa
The mucous membranes of your mouth and pharynx are rapidly renewable tissues and so are vulnerable to the adverse effects of cytotoxic drugs.
Damage to bone marrow
Blood cells are formed in bone marrow, which we have in our large bones. Chemotherapy may cause a drop in white blood cell, blood platelet and haemoglobin counts.
