Copyright © 2015 Cengage Learning® Chapter 14 Antineoplastic Drugs.

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Chapter 14Antineoplastic Drugs

Introduction• A healthy body needs cells to reproduce

and grow in an orderly, regulated manner– Sometimes, conditions are altered in the body

that trigger abnormal changes in the way the cells reproduce and grow• Can cause cell growth to become uncontrolled,

leading to overproduction or impaired cellular development

Introduction (cont’d.)• Unregulated growth can lead to abnormal

cells, tissue, and tumor development– Tumors can be classified as either benign

(non-cancerous) or malignant (cancerous)• Antineoplastics (“against new tissue

formation”)– Agents that counteract the development,

growth, or spread of malignant cells– Can treat various types of cancers

Introduction (cont’d.)• What is chemotherapy?

– Drugs and drug combinations used for palliative effects or for long-term or complete remissions in early treatment of cancer• Antineoplastic drugs are cytotoxic (destructive to

cells), and especially to cells that are proliferating (reproducing rapidly)

• Many antineoplastic agents also possess immunosuppressive properties

Introduction (cont’d.)• Antineoplastic agent groups

– Antimetabolites– Alkylating agents– Mitotic inhibitors – Antitumor antibiotics– Hormones and hormone modifiers– Biological therapies

Introduction (cont’d.)– Targeted cancer therapies – Vaccines – Radioactive isotopes

Introduction (cont’d.)• The following slides discuss various

antineoplastic drugs– Refer to the chapter for specific side effects

and contraindications

Antimetabolites• Work by interfering with DNA synthesis,

repair, and cellular replication – Used in the treatment of various

malignancies, especially those involving rapidly proliferating neoplasms• Examples: methotrexate and fluorouracil

Alkylating Agents• Can treat a wide range of cancers

– Prevent growth by damaging DNA needed for reproduction• Examples: cisplatin and cyclophosphamide

Mitotic Inhibitors• Mitosis is the process of cell division and

reproduction– Mitotic inhibitors are often plant alkaloids and

other compounds derived from natural products that block mitosis• Can treat many different types of cancer• Plant alkaloid examples: vinblastine, vincristine,

and paclitaxel

Antitumor Antibiotics• Can treat a wide variety of malignancies

– Examples: doxorubicin, daunorubicin, bleomycin, daunorubicin, mitomycin, and others• Frequently used in combination with other drugs

Hormones and Hormone Modifiers • Hormones

– Corticosteroids: used primarily for their suppressant effect on lymphocytes

• Hormone modifiers – Antiestrogen: hormonal therapy for metastatic

estrogen receptor–positive breast cancer and palliative treatment

– Antiandrogen: hormonal therapy in the treatment of endometriosis and metastatic prostate cancer

Biological Therapies • Designed to repair, stimulate, or enhance

cancer patients' natural immune systems– More effectively recognize and attack cancer

cells• Active or direct and passive or indirect

• Interferon alfa – Most widely used in cancer treatments – Complex combination of many proteins that

boost immune system response

Biological Therapies (cont’d.)• Colony-stimulating factors (CSFs)

– Encourage bone marrow stem cells to divide and develop into red and white blood cells, and platelets

• Monoclonal antibodies (MABs) – Exogenous (outside of body) antibodies

genetically engineered in the laboratory– Designed to target only cancer cells, thereby

sparing normal tissues

Targeted Therapies• Block the growth and spread of cancer

– Interfere with specific molecules involved in tumor growth and progression

• Signal transduction inhibitors– Block specific enzymes and growth factor

receptors that signal cancer cell proliferation

Vaccines• Medicines that boost the immune system’s

natural ability to protect the body against “foreign invaders”– Mainly infectious agents that may cause

disease• Broad types of cancer vaccines

– Preventive (or prophylactic)– Treatment (or therapeutic)

Radioactive Isotopes• Used in the treatment of certain types of

cancer– Sometimes the radioactive material is injected

into the affected site or implanted in the body in the form of capsules, needles, or seeds

– Health care practitioners caring for patients receiving radioactive isotopes must observe special precautions to prevent unnecessary radiation exposure

Cautions and Responsibilities for Antineoplastic Drugs

• Medications should be given on time and exactly as prescribed

• Intravenous sites must be checked with great care

• Intravenous fluids containing antineoplastic agents should not be allowed to get on the skin or into the eyes of the patient or administrator

Cautions and Responsibilities for Antineoplastic Drugs (cont’d.)

• Antiemetics should be immediately available and administered as prescribed

• Careful and frequent oral hygiene is essential

• Soft foods and cool liquids should be available to the patient as required

• Accurate intake and output is important for adequate assessment of hydration

• Careful observation and reporting of symptoms and side effects is essential

• Aseptic technique is necessary to minimize the chance of infection

• Careful assessment of vital signs is important • The health care practitioner and family must

be informed and answer patient’s questions honestly

• Careful attention to detail, astute observations, appropriate interventions, and compassion are an integral part of care during chemotherapy

• The health care practitioner should:– Reassure the patient that someone will be

available to help at all times– Identify all resources available for both the

patient and their family21

Cytotoxic Drug Dangers to Health Care Personnel

• Most cytotoxic drugs are toxic substances known to be carcinogenic, mutagenic, or teratogenic– Anyone who prepares, administers, or cares

for patients receiving cytotoxic drugs should be aware of the dangers involved• Refer to the chapter for specific recommendations

Copyright © 2015 Cengage Learning® Chapter 14 Antineoplastic Drugs.

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