Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Clinical PharmacologyChapter 50Antineoplastic Drugs Introduction to Clinical PharmacologyChapter 50Antineoplastic Drugs
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell Cycle–Specific Drugs: Actions and UsesCell Cycle–Specific Drugs: Actions and Uses•Plant alkaloids:–Vinca alkaloids: Interfere with amino acid production in S phase and formation of microtubules in M phase–Taxanes: Interfere in M phase with microtubules–Podophyllotoxins: Cells are unable to divide since cells are stopped during S and G2phases by the podophyllotoxins
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell Cycle–Specific Drugs: Actions and Uses (cont.)Cell Cycle–Specific Drugs: Actions and Uses (cont.)•Antimetabolites: –Interfere with synthesis of RNA and DNA, make it impossible for cancerous cell to divide into two daughter cells –Drugs are used to treat:•Leukemia, lymphoma, solid tumors, autoimmune diseases
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell Cycle–Nonspecific Drugs: Actions and UsesCell Cycle–Nonspecific Drugs: Actions and Uses•Alkylating agents:–Change cell to more alkaline environment, which in turn damages the cell •Antineoplastic antibiotics: –Interfere with DNA and RNA synthesis, delaying or inhibiting cell division •Miscellaneous antineoplastic drugs:–A number of drugs are used for antineoplastic actions, do not belong to any one category
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell Cycle–Nonspecific Drugs: Adverse ReactionsCell Cycle–Nonspecific Drugs: Adverse Reactions•Nausea and vomiting from highly emetic drugs or potential of IV extravasation of irritating solutions•Adverse reactions common to antineoplastic drugs:–Bone marrow suppression; stomatitis; diarrhea; hair loss –Leukopenia and thrombocytopenia may cause cycles of chemotherapy to be delayed until blood cell counts can be raised –Damage gonads, causing fertility problems
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell Cycle–Nonspecific Drugs: Contraindications and PrecautionsCell Cycle–Nonspecific Drugs: Contraindications and Precautions•Antineoplastic drugs are contraindicated in patients: –With leukopenia, thrombocytopenia, anemia, serious infections, renal disease, and hypersensitivity to drug; during pregnancy or lactation •Used cautiously in: –Patients with renal or hepatic impairment, active infection, and debilitating illnesses; those who have completed treatment with other antineoplastic drugs or radiation therapy
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Cell Cycle–Nonspecific Drugs: Interactions Cell Cycle–Nonspecific Drugs: Interactions Interactant drugEffect of interaction Plant alkaloidsDigoxin Decreased serum level of digoxin Phenytoin Increased risk for seizures Oral anticoagulants Prolonged bleeding
