Pharmacology of Neoplasia Flashcards
(18 cards)
Toxicity
common theme among all cancer drugs
Alkylating agents
alter the shape of DNA by covalently bonding an “alkyl” group to the double helix within a cancer cell; prevent DNA from duplicating & kill cancer cells when they divide; subclasses (nitrogen mustards, nitrosureas, platinum compounds); primary dose-limiting effect = myelosuppression
Antimetabolites
disrupt metabolic pathways of cancer cells; cell cycle specific; subclasses (folic acid analogs, purine analogs, pyrimidine analogs)
Folic acid analogs
toxic to normal cells and cancer cells; needed to make new DNA
leucovorin
used to “rescue” normal cells during folic acid analog therapy; able to enter normal cells but not cancer cells & is used to continue normal cell functioning
Antitumor antibiotics
contain substances obtained from bacteria that have the ability to kill cancer cells; bind to DNA to produce effects; must be given IV; major dose-limiting toxicity is myelosuppression
dexrazoxane (Zinecard)
used to “rescue” cardiac tissue during therapy with anti tumor antibiotics
Selective estrogen receptor blockers (SERMS)
type of hormone antagonist; activate or inhibit estrogen receptors (activate in bone; inhibit in breast); only effective in hormone-sensitive tumors; NOT cytotoxic
aromatase inhibitors
blocks synthesis of estrogen in the blood (but not estradiol formation in ovary); first-line treatment for postmenopausal women w/ER-positive breast cancer
Gonadotropin-releasing hormone analogs
initially increases production of interstitial cell stimulating hormone; eventually insesitivity develops and starves prostate of testosterone
Androgen receptor blockers
prevents testosterone and other androgens from reaching receptors in prostate
Biologic response modifiers
act directly by binding to cancer cells and killing them or indirectly by activating the immune response
Antiemetics
given to nearly all chemo pt’s to decrease/prevent n/v
cyclophosphamide (Cytoxan)
antineoplastic agent; alkylating agent; nitrogen mustard
USE: various cancers
MOA: prodrug that binds to DNA & forms cross-links which prevent DNA synthesis
AE: alopecia, myelosuppression, severe infection, sepsis, secondary malignancies, cardio toxicity, etc
Contraindicated: pregnancy, lactation, & severe myelosuppression
Pregnancy Category D
methotrexate (MTX)
antineoplastic agent; antimetabolite; folic acid analog
USE: various cancers, combination therapy to maintain remissions
MOA: blocks enzyme responsible for converting folic acid into folate; cell cycle specific
AE: myelosuppression, hepatotoxicity, ulcerative stomatitis, diarrhea, infection, pulmonary toxicity, skin reactions; crosses BBB
Pregnancy Category X
doxorubicin (Adriamycin)
antineoplastic; antitumor antibiotic
USE: solid tumors in various cancers
MOA: binds to DNA to decrease synthesis; cell-cycle nonspecific
AE: Myleosuppression and cardiotoxicty (RED DEATH); can turn tears or urine red (harmless); complete loss of hair, anaphylaxis, extravasation, secondary malignancies, n/v, mucositis, rash, excessive lacrimation, hepatotoxicity, & radiation recall phenomenon
Pregnancy: use contraception
vincristine (Oncovin)
antineoplastic; vinca alkaloid; mitotic inhibitor
USE: various cancers
MOA: binds to tubulin proteins necessary for cell division = cell death; cell cycle specific - mitosis
AE: neurotoxicity, CNS effects, myelosuppression
BLACK BOX WARNING: extravasation
Pregnancy Category D
tamoxifen (Nolvadex)
antineoplastic, hormonal agent, estrogen receptor blocker
USE: ER-positive breast cancer
MOA: binds to ERs, causing agonist effects in bone & antagonist effects in the breast
AE: increased risk of endometrial cancer
BLACK BOX WARNING: thromboembolic events
Contraindicated: anticoagulant therapy, preexisting endometrial hyperplasia, hx thromboembolic events, pregnancy, & lactation
Pregnancy Category D
