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Pharmacology basics and detailed descriptions of medicines and their interactions.
Typology: Study notes
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Antineoplastic drugs are classified into nine major groups:
Antimetabolites are drugs that kill cells and are therefore called cytotoxic. These medications affect cells that are dividing. They mimic the molecules cells use to grow and cause cells to be unable to divide to make new cells. Because cancer cells divide faster than normal cells, they are more affected by the drugs than normal cells. These medications target all dividing cells, though, so they profoundly affect other parts of the body. Methotrexate and fluorouracil, two commonly used antimetabolites, are used for many cancers. Methotrexate can be used orally or as an injection, whereas fluorouracil comes in an injectable form and a topical form for skin cancers. These antimetabolites can cause stomach ulcers and other stomach issues. Alkylating Agents A few examples of alkylating agents include cisplatin and cyclophosphamide, which are used to treat several cancers. As with many antineoplastic agents, their purpose is to prevent cell growth. However, the concern with alkylating agents is the long-term damage associated with these medications, specifically to bone marrow. Other major concerns include damage to the nervous system, ulcers, and pulmonary fibrosis. Mitotic Inhibitors Mitotic inhibitors work to inhibit the process of mitosis, a cellular process necessary for a cell to divide, which is required for all cells in the body. Impacting this process inhibits the division of cancer cells as well as normal cells. The major concerns with mitotic inhibitors, such as vinblastine and vincristine, are their likelihood of causing peripheral nerve damage and myelosuppression , which can lead to anemia and decreased immune function. These side effects are considered dose- limiting, which means these severe side effects may prevent a dose increase during treatment. In addition, these medications also cause severe stomach issues, ulcers, and increased reaction to sunlight. Many antineoplastic agents, including mitotic agents, can cause extravasation —the leaking of drugs intended for intravenous (IV) administration —which leads to the destruction of the surrounding skin and tissue. Antitumor Antibiotics Antitumor antibiotics specifically target and kill cancer cells. They do this through interactions with the genetic material inside the cancer cell. The most well-known antitumor antibiotic is doxorubicin, which has a maximum lifetime dose limit and can only be used for a specific period due to heart damage (cardiotoxicity). Doxorubicin plays a major role in the treatment of a wide variety of
Biologics The purpose of biologics is to give the immune system a boost to be able to fight off cancerous cells more effectively. Biologics can be considered active (direct) or passive (indirect). This distinction is important to understand the way these two types of biologics work; active biologics use the body’s natural immune system, while passive biologics use components created outside the body. Active biologics include interferons, and passive biologics include monoclonal antibodies (mAbs). The most frequently used interferon is called interferon alfa, which treats a wide variety of cancers and other conditions, such as hepatitis and multiple sclerosis. Interferons have many uncomfortable side effects, which include flu-like symptoms, stomach issues, sleep disturbances, and anemia. Monoclonal antibodies are given intravenously, and examples include Avastin and Herceptin. Avastin treats carcinoma of the colon, kidney, or lungs, while Herceptin is used for breast cancer. A unique feature of these medications is how they are created in the lab; they only target cancer cells, which helps minimize toxicities and side effects. Patients receiving mAbs may still experience fevers, chills, headaches, dizziness, nausea, and vomiting. In addition, there are severe reactions, including low blood pressure, shortness of breath, heart problems, kidney failure, and more. These more serious reactions can be minimized by giving specific medications before administering mAbs. Targeted Cancer Therapies
These therapies are some of the newest on the market. One is called Gleevec, which is considered a signal transduction inhibitor (STI). An STI is a medication that can block signals inside a cell that are being passed from one molecule to another. Some of these substances have been found to be useful in inhibiting cancer growth and development. Gleevec is specifically approved for chronic myelogenous leukemia and, unlike other antineoplastic agents, is given orally. Vaccines Vaccines can be either preventative or used as treatments, both of which help the immune system against disease, in this case, cancer. Currently, there are two FDA- approved vaccines to protect against the human papillomavirus (HPV), which can cause cervical cancer. These two vaccines are known as Gardasil and Cervarix. Provenge, the first vaccine approved to treat cancer, is uniquely created for each individual patient to help treat prostate cancer. Radioactive Isotopes Radioactive isotopes can be used as a targeted cancer treatment by using a radioactive drug that interacts with cancer cells but has minimal impact on nearby healthy cells. This treatment is administered orally or by injection and is often used in conjunction with other medications to protect nearby healthy cells or to target cancer cells. Radioactive isotopes are important to understand so that healthcare professionals can prevent unnecessary exposure. A common treatment is radioactive sodium iodine, which is administered by mouth to treat thyroid cancer. Healthcare professionals should use extreme caution when handling the medication in addition to a patient’s bodily secretions. Antihypertensive drugs are medications used to lower and control high blood pressure (hypertension). They work by targeting different mechanisms that regulate blood pressure, such as blood vessel tone, heart rate, and blood volume. Main Classes of Antihypertensives
