Categories
Chemotherapeutic Agents Nursing Pharmacology

Antineoplastic Agents

Antineoplastic Agents

Neoplasm Cancer—Mechanisms of Growth

  • Anaplasia
    • Cancerous cells lose cellular differentiation and organization and are unable to function normally
  • Autonomy
    • Cancerous cells grow without the usual homeostatic restrictions that regulate cell growth and control
    • This allows the cells to form a tumor
  • Metastasis
    • Cancer cells travel from the place of origin to develop new tumors in other areas of the body
  • Angiogenesis
    • Abnormal cells release enzymes to generate blood vessels and supply oxygen and nutrients to the cells, generating growth
    • Cancerous cells rob the host cells of energy and nutrients and block normal lymph

The Body’s Immune System Response to Cancerous Cells

  • Can damage or destroy some neoplastic cells
  • T cells recognize the abnormal cells and destroy them
  • Antibodies form in response to parts of the abnormal cell protein
  • Interferons and tissue necrosis factor (TNF) play a role in the body’s attempt to eliminate the abnormal cells

Possible Causes of Cancer

  • Genetic predisposition
  • Viral infection
  • Constant irritation and cell turnover
  • Stress
  • Lifestyle factors
  • Environmental factors

Classifications of Tumors

  • Solid tumors
    • May originate in any body organ
    • Carcinomas (originate in epithelial cells)
    • Sarcomas (originate in the mesenchyma)
  • Hematologic malignancies
    • Leukemias and lymphomas that occur in the blood-forming organs

Mechanisms of Antineoplastic Drugs

  • Affect cell survival
  • Boost the immune system in its efforts to combat the abnormal cells

Goal of Cancer Treatment

  • To destroy cancer cells using the following methods:
    • Surgical removal
    • Stimulation of the immune system to destroy them
    • Radiation therapy to destroy them
    • Drug therapy to kill them during various phases of the cell cycle

Categories of Antineoplastic Agents

  • Alkylating agents
    • React chemically with portions of the RNA, DNA, or other cellular proteins
  • Antimetabolites
    • Have chemical structures similar to those of natural metabolites
  • Antineoplastic antibiotics
    • Not selective for bacterial cells only; toxic to human cells
  • Mitotic inhibitors
    • Drugs that kill cells as the process of mitosis begins
  • Hormones and hormone modulators
    • Used in cancers that are sensitive to estrogen stimulation
  • Cancer-cell–specific agents
    • Treat chronic myeloid leukemia (CML) and CD117-positive unresectable or metastatic malignant GI stromal tumors (GIST)

Sites of Action of Non-Cell-Cycle–Specific Antineoplastic Agents

Sites of Actions of Non-Cell-Cycle-Specific Antineoplastic Agents
Sites of Actions of Non-Cell-Cycle-Specific Antineoplastic Agents

 

 

Sites of Action of Cell-Cycle–Specific Antineoplastic Agents

Sites of Action Cell-Cycle-Specific Antineoplastic Agents
Sites of Action Cell-Cycle-Specific Antineoplastic Agents

Alkylating Agents

  • Actions
  • Pharmacokinetics
  • Contraindications
  • Adverse reactions
  • Drug-to-drug interactions

Antimetabolites

  • Actions
  • Pharmacokinetics
  • Contraindications
  • Adverse reactions
  • Drug-to-drug interactions

Antineoplastic Antibiotics

  • Actions
  • Pharmacokinetics
  • Contraindications
  • Adverse reactions
  • Drug-to-drug interactions

Mitotic Inhibitors

  • Actions
  • Pharmacokinetics
  • Contraindications
  • Adverse reactions
  • Drug-to-drug interactions

Hormones and Hormone Modulators

  • Actions
  • Pharmacokinetics
  • Contraindications
  • Adverse reactions
  • Drug-to-drug interactions

Prototype Alkylating Agent

Prototype Alkylating Agent
Prototype Alkylating Agent

 

 

Prototype Antimetabolite Agent

Prototype Antimetabolite Agent
Prototype Antimetabolite Agent

 

 

Prototype Antineoplastic Antibiotics

Prototype Antineoplastic Antiboitics
Prototype Antineoplastic Antiboitics

 

 

Prototype Mitotic Inhibitors

Prototype Mitotic Inhibitors
Prototype Mitotic Inhibitors

 

Prototype Hormones and Hormone Modulators

Prototype Hormones and Hormone Modulators
Prototype Hormones and Hormone Modulators

 

 

Use of Antineoplastic Across the Lifespan

Use of Antineoplastic Across the Lifespan
Use of Antineoplastic Across the Lifespan

 

 

Nursing Considerations for Alkylating Agents

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Antimetabolites

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Antineoplastic Antibiotics

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Mitotic Inhibitors

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation

Nursing Considerations for Hormones and Hormone Modulators

  • Assessment (history and physical exam)
  • Nursing diagnosis
  • Implementation
  • Evaluation
Categories
Chemotherapeutic Agents Nursing Pharmacology

Introduction to Cell Physiology

Introduction to Cell Physiology

Chemotherapeutic Agents

  • Alter cellular function or disrupt cellular integrity, causing cell death
  • Prevent cellular reproduction, eventually leading to cell death

Chemotherapeutic Drugs

  • Destroy organisms that invade the body
    • Bacteria, viruses, parasites, protozoa, fungi
  • Destroy abnormal cells within the body
    • Neoplasms and cancers

Parts of a Human Cell

  • Nucleus
  • Cell membrane
  • Cytoplasm

Structure of a Cell

Stucture of a Cell
Stucture of a Cell

Cell Nucleus

  • Contains genetic material
    • Necessary for cell reproduction
    • Regulates cellular production of proteins
  • Each cell is “programmed” by the genes for the production of specific proteins
    • Allows the cell to carry out its function
    • Maintains cell homeostasis or stability
    • Promotes cell division

Cell Membrane

  • Surrounds the cell
  • Separates the intracellular fluid from the extracellular fluid
  • Essential for cellular integrity

Structure of a Lipid Cell Membrane

Structure of a Lipid Cell Membrane
Structure of a Lipid Cell Membrane

Organelles of the Cytoplasm

  • Mitochondria
  • Endoplasmic reticulum
  • Free ribosomes
  • Golgi apparatus
  • Lysosomes

Components of Cell Membrane

  • Cell membrane is made up of lipids and proteins
  • Several lipids make up the cell membrane
    • Phospholipids
    • Glycolipids
    • Cholesterol
  • Lipid layer provides a barrier for the cell and maintains homeostasis of the cell

Receptor Sites

  • Found on the cell membrane
  • Specific receptor sites allow interaction with various chemicals

Identifying Markers

  • Surface antigens
  • Important in the role of cellular immunity
  • Histocompatibility proteins allow for self-identification
  • The body’s immune system recognizes these proteins and acts to protect self-cells and to destroy non–self-cells

Channels

  • Channels or pores allow for the passage of substances into and out of the cell
  • Some drugs are designed to affect certain channels within the cell

Cell Properties

  • Endocytosis
    • Involves incorporation of material into the cell
    • Pinocytosis and phagocytosis occur
  • Exocytosis
    • Allows a cell to move a substance to the cell membrane and secrete the substance outside the cell
    • Hormones, neurotransmitters, and enzymes are excreted into the body by this process

Homeostasis of the Cell

  • Passive transport
    • Happens without the expenditure of energy and can occur across any semipermeable membrane
    • Occurs by diffusion, osmosis, and facilitated diffusion
  • Active transport
    • Energy-requiring process
    • Movement of particular substances against a concentration gradient
    • Important in maintaining cell homeostasis

Passive Transport

  • Diffusion
    • Does not require energy
    • The movement of solutes from a region of high concentration to a region of lower concentration across a concentration gradient
  • Osmosis
    • Does not require energy
    • Movement of water from an area low in solutes to an area high in solutes

Phases of the Cell Cycle

  • G0 phase
    • Resting phase
  • G1 phase
    • Gathering phase
  • S phase
    • Synthesizing phase
  • G2 phase
    • Last substances needed for division are collected and produced
  • M phase
    • Actual cell division occurs, producing two identical daughter cells

Cell Cycle

Cell Cycle
Cell Cycle

Cell Physiology

  • May alter the cell membrane, causing the cell to rupture and die
  • May deprive the cell of certain nutrients, altering the proteins that the cell produces and interfering with normal cell functioning and cell division
  • May affect the normal cells of patients to some extent