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