such as increased bone mineral densitry reduction of HDL elevation of HDL ii

Such as increased bone mineral densitry reduction of

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such as (increased bone mineral densitry, reduction of HDL, elevation of HDL) . ii.Prevents receptor activation by estradiol, principal endogenous estrogen. Estrogen acts on tumor cells to stimulate growth and proliferate which in this case the tumor cells proliferation declines. b.Adverse effect: endometrial cancer (endometrial hyperplasia) and thrombosis risk. Other side effects, hot flash, fluid retention, menstrual irregularities, vaginal discharge, n/v. iv.Raloxifene (Evista): it is a selective estrogen receptor modulator just like tamoxifen, only approved for Post menopausal women. v.Leuprolide (Lupron): Gonadotropin-releasing Hormone Agonists (GnRH)a.MOA: suppress production of androgens by testes but not by adrenal gland or prostate cancer cells. b.It is a synthetic analog of GnRH, aka luteinizing hormone hormone releasing hormone (LHRH). For advanced carcinoma of prostate. c.Cells of the prostate are androgen dependent. This medicineprovides palliation by suppressing ANDROGEN production in testes. It mimics GnRH which acts on pituitary to stimulate release of interstitial cell stimulating hormone (ICSH) which acts on testes to increase production of testosterone and as a result there is transient flare in prostate cancer symptoms but with continuous use to leuprolide, GnRH in pituitary become desensititized and
as a result ICSH declines which cause testosterone levels todrop. d.Adervse effects: hot flash which declines over continued use. Reduced testosterone, erectile dysfunction, loss of libido, gynocomastia, reduced muscle mass, new onset diabetes, MI, stroke. Increased risk of osteoporosis and related fractures. C.Identify the anticancer drugs that exert selective toxicities that are not shared by many or any other anticancer agents, focusing on pulmonary, cardiac, renal, and hepatic toxicity and neurotoxicity. a. Nitrosoureas: Streptozocin (Zanosar) nephrotoxic b. Busulfan (Myleran, Busulfex) pulmonary fibrosis c. Platinum Compounds: Cisplatin nephrotoxic, Oxaliplatin (Eloxatin) peripheral neuropathy d. Antitumor antibiotics: Anthracyclines, Cardiotoxic i. Daunorubicin (conventional) Cerubidine ii. Daunorubicin (liposomal) DaunoXome iii. Doxorubicin (Conventional) Adriamycin iv. Doxorubicin (liposomal) Doxil, Carlyx- heart failure v. Epirubicin (Ellence) vi. Idarubicin (Idamycin) vii. Valrubicin (Valstar) viii. Mitoxantrone (Novantrone) e. Nonanthracyclines: Bleomycin Pulmonary fibrosis f. Vinca Alkaloids: Peripheral Neuropathy i. Vincristine (conventional) Oncovin, Vincasar PFS ii. Vincristine (liposomal) Marqibo g. Eribulin (Halaven) peripheral neuropathy h. Lxabepilone (Ixempra) neurotoxic i. GnRH Antagonist i. Degarelix (Firmagon) hepatotoxicity j. Androgen Receptor Blockers: hepatotoxicity i. Flutamide ii. Bicalutamide (Casodex) iii. Nilutamide (Nilandron, Anandron: hepatotoxic and Pulmonary k. CYP17: Abiraterone (Zytiga) hepatotoxic l. EGFR Tyrosine Kinase Inhibitor i. Cetuximab (Erbitux) interstitial lung disease ii. Panitumumab (Vectibix) interstitial pneumonitis iii. Gefitinib (Iressa) interstitial lung disease iv. Erlotinib (Tarceva) interstitial lung disease v. Lapatinib (Tykerb) cardiotoxic m. BCR-ABL Tyrosine Kinase Inhibitors i. Bosutinib (Bosulif) hepatotoxic ii. Ponatinib (Iclusig) Cardiotoxic

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