principles of chemotherapy. objectives at the completion of this session the participant will be...

Principles of Principles of ChemotherapyChemotherapy

ObjectivesObjectivesAt the completion of this session the participant will be able to:◦Define combination chemotherapy

◦Recognize classifications for chemotherapeutic agents

◦Identify common side effects for selected agents

◦Describe nursing interventions for selected agents

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Factors Affecting Factors Affecting Response to Response to MedicationMedication

Pharmacogenetics

Diet

Kidney Function

Liver Function

Infections3

Classes of Classes of Chemotherapeutic Chemotherapeutic

AgentsAgents

ClassificationsClassificationsCell-cycle-specific

◦Cell-cycle specific drugs kill cells that are actively dividing during specific phases of the cell life cycle

Cell-cycle-nonspecific◦Affects cells equally regardless of the cell phase

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Alkylating AgentsAlkylating AgentsEither inaccurately replicate or inhibit the replication of DNA causing cell mutation or death

They are most active in the resting (Go) phase

Examples:◦cyclophosphamide◦ifosfamide◦platinum complexes◦topoisomerase I inhibitors

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Antitumor Antitumor AntibioticsAntibiotics

Bind to DNA and interfere with further replication of DNA, and transcription of RNA

They are active in all phasesExamples:

◦doxorubicin◦daunorubicin◦idarubicin◦dactinomycin

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AntimetabolitesAntimetabolitesResemble essential metabolic elements needed for cell growth and are altered so that synthesis of RNA and DNA is inhibited

Examples:◦cytarabine◦methotrexate◦6-mercaptopurine

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Plant AlkaloidsPlant AlkaloidsArrest cells in metaphase and prevent spindle formation by binding to the microtubules

Examples:◦vincristine◦vinblastine◦etoposide

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HormonesHormonesAct in a variety of ways and their

mechanism of action is not fully understood

Have a “direct lytic action” on cells in certain diseases such as leukemia and lymphoma

They inhibit tumor proliferation by blocking naturally occurring substances that stimulate tumor growth

Examples:◦dexamethasone◦prednisone

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ImmunosuppressantImmunosuppressantssClass of drugs capable of inhibiting

the body’s immune systemDecrease the body’s own natural

defense to foreign bodies and is useful in treating non-cancer diseases and organ rejection

Examples:◦Cellcept◦Rapamycin◦Tacrolimus◦Imuran◦Cyclosporin

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MiscellaneousMiscellaneousWide variety of agents which do not fit into any other category or whose mechanism of action is not fully understood

Example:◦asparaginase◦hydroxyurea

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Combination Combination ChemotherapyChemotherapy

The use of two or more drugs given simultaneously or in sequence, in an effort to achieve the best therapeutic response within a range of toxicity

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Chemotherapy Used Chemotherapy Used For Non-Cancer For Non-Cancer DiseasesDiseasesCyclophosphamide (Cytoxan)Methotrexate (Mexate)Mercaptopurine (6-MP)Vincristine (Oncovin®)Daunorubicin Doxorubicin (Adriamycin PFS®)Mitoxantrone(Novantrone®)Pentostatin (Nipent®)Hydroxurea(Hydrea®)

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Immunosupressant Immunosupressant Agents Used For Non-Agents Used For Non-Cancer DiseasesCancer Diseases

Sirolimus (Rapamycin)Tacrolimus (Prograf®)Mycophenolate Mofetil

(CellCept®)Imuran (Azathioprine)Cyclosporin (Neoral,

Sandimmune)15

QUESTIONS?QUESTIONS?