Discussion on the Chemotherapy Drugs in Pharmacology. Notes on the drugs, uses, mechanism for action, indications, contraindications and side effects of the drugs.
Discussion on the Chemotherapy Drugs in Pharmacology. Notes on the drugs, uses, mechanism for action, indications, contraindications and side effects of the drugs.
Discussion on the Chemotherapy Drugs in Pharmacology. Notes on the drugs, uses, mechanism for action, indications, contraindications and side effects of the drugs.
Discussion on the Chemotherapy Drugs in Pharmacology. Notes on the drugs, uses, mechanism for action, indications, contraindications and side effects of the drugs.
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CHEMOTHERAPY
Involves the use of cytotoxic medications to cure cancer or decrease tumor size or to prevent or treat suspected metastases. It interfering with the ability of the malignant cell to synthesize vital enzymes and chemical Chemo disrupts the cell cycle in various phases by interrupting cell metabolism and replication. Based on the chemical makeup and biological activity, different drugs used for used for cancer treatment act in specific phases and sub phases of the cell cycle
THE GOALS OF CHEMOTHERAPY
To eliminate neoplastic cells in the body without permanently damaging the normal host cells To achieve remission induction in cancer patients
GOALS CURE CONTROL PALLIATION TUMORS USUALLY ARISE FROM CLONAL PROLIFERATION OF ABNORMAL CELLS
DETERMINANTS OF TUMOR GROWTH ARE:
GENERATION TIME GROWTH FRACTION
GENERATION TIME/ CELL CYCLE
GROWTH FRACTION The portion of the cells in a tumor proliferating at a particular given time The higher the growth fraction, theoretically the better response to chemotherapy
ADJUVANT AND NEOADJUVANT CHEMOTHERAPY
ADJUVANT CHEMOTHERAPY Given after surgery or radiation to destroy micro metastasis and prevent development of secondary neoplasm. NEO-ADJUVANT CHEMOTHERAPY Given before surgery or radiotherapy in order to diminish the volume or large primary neoplasm
Chemo agents can be classified either by the effects of the agent on the cell or the pharmacological properties of the agent. Chemotherapeutic agents can be divided into: CELL CYCLE-SPECIFIC CELL CYCLE-NON SPECIFIC AGENTS
CELL CYCLE SPECIFIC
These are the agents effective at a specific phase (ex: S and M phases) in the cell cycle prevent cell replication by damaging cellular DNA and blocking production of protein necessary for DNA and RNA synthesis.
CELL CYCLE-NONSPECIFIC These are the agents effective throughout all the phases of the cell cycle, including the resting phase
ALKYLATING AGENTS Are not phase specific and basically act on performed nucleic acid by creating defects in tumor DNA. They cause crosslinking of DNA strands and interfere with replication and transcription. It acts with proliferating and non proliferating cells those in G0 phase.
ANTIMETABOLITES Are phase specific, working best in the S phase and having little effect in G0. It interfere with nucleic acid synthesis by displacing metabolites at the regulatory site of a key enzyme.
ANTITUMOR ANTIBIOTICS Derived from natural sources that are generally too toxic to be used as anti-bacterial agents. They are not phase specific and act in several ways: They disrupt DNA replication and RNA transcription; create free radicals, which generate breaks in DNA and other forms of damage; and interfere with DNA repair.
MITOTIC INHIBITORS Are drugs that act to prevent cell division during the M phase. Mitotic inhibitors include the plant alkaloids and toxoids. Plant alkaloids consist of medication extracted from plant sources (periwinkle plant) : Vinca alkaloids (e.g. vincristine and vinblastine) and etoposide. The toxoids acts during the G2 phase to inhibit cell division e.g Paclitaxel, Docetaxel
HORMONES AND ANTAGONIST
The main hormones used in cancer therapy are the corticosteroids which are phase specific (G1) These act by binding to specific intracellular receptors, representing transcription of mRNA and thereby altering cellular function and growth.
HORMONES AND ANTAGONIST
Work with hormone-binding tumors. They block the hormone’s receptor site on the tumor and prevent it from receiving normal hormonal growth stimulation.
NURSING MANAGEMENT
Assessing fluid and electrolyte balance. Anorexia, nausea, vomiting, altered taste, mucositis, and diarrhea put patients at risk for nutritional and fluid electrolyte disturbances. Modifying risks for infection and bleeding. Suppression of the bone marrow and immune system is expected and frequently serves as a guide in determining appropriate chemotherapy dosage but increases the risk of anemia, infection, and bleeding disorders. Administering chemotherapy. The patient is observed closely during its administration because of the risk and consequences of extravasation, particularly of vesicant agent. Protecting caregivers. Nurses must be familiar with their institutional policies regarding personal protective equipment, handling and disposal of chemotherapeutic agents and supplies, and management of accidental spills or exposures.
