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IN
PHCHEM 49
ANTINEOPLASTIC DRUGS
SUBMITTED BY:
Alduheza, Shynne B.
Espaa, Lorebeth L.
Flores, Chiena Mae S.
Lo, Manuel Timothy Jude
C.
Tan, Marie Charmaine B.
SUBMITTED TO:
Mrs. Honeylene B. Paloma
CANCER
-uncontrolled growth of cells or tissues characterized with the
formation of a neoplasm
-classified according to:
cellular origin
benign or malignant state of histogenic differentiation
a.benign: fibroma
b.malignant: melanoma, sarcoma
ANTINEOPLASTIC DRUGS
-chemotherapeutic agents
-mechanism of action is targeted towards arresting aberrant cell
proliferation associated with cancerous cell growth
-carcinogenic, teratogenic, and mutagenic
CELL CYCLE
Phases:
Interphase
G0- resting stage, subphase of G1
G1- period between mitosis and DNA synthesis
last several hours to days
cell organelle synthesis and centriole replication
S- start of DNA synthesis and replication of chromosomes
G2- ends when mitosis start
M- begins with mitosis and ends with cytokinesis
Prophase, Metaphase, Anaphase, Telophase
Classes:
1. Pyrimidine analogs- 5-fluorouracil
2. Purine analogs- 6-mercaptopurine
3. Folate analogs- methotrexate
Acute toxicity
-GI: nausea, vomitting, diarrhea
-dermatologic: alopecia
-CNS: headache, blurred vision
-extravasation
-parenterally administered antimetabolites
-requires optimum administration technique:
a.discontinuation of medication
b.antidote administration
c.surgical debridement with skin grafting
d.antibiotic antineoplastics
Clinical Management of ADRs
-Leucovorin: specific antidote for MTX overdose as a therapeutic
modality
-rescue procedure permits the intracellular accumulation of MTX in
concentrations sufficient to inactive dihydrofolate
reductase
-used along with other chemotherapeutic agents in patients with
nonmetastatic osteosarcoma
B. Alkylating Agents
strong electrophiles: highly reactive carbonium ions
replacement with alkyl radicals: cross linking abnormal base pairing
net effect:
-production of defective DNA
-abortive reproduction of cells
effective on proliferative cells
not phase specific
act on any stage
Indications:
a.pallative treatment of malignancies susceptible to drugs
-malignant lymphoma
-leukemia
-germ cell, and progressive testicular, ovarian, and prostate
cancer
-myeloma
-brain tumor
b.others
-metastatic cancer
-neuroblastoma
-nonmalignant nephritic syndrome
Classes:
1. Nitrogen mustards- cyclophosphamide
2. Ethyleneamine and metyleneamine derivatives- thiotepa
3. Alkyl sulfonates- busulfan
4. Nitrosoureas- carmustine
5. Triazenes- dacarbazine
6. Platinum coordination complexes- cisplatin
Acute Toxicity
c. Epidophyllotoxins
- Etoposide (VePesid)
semisynthetic derivative of podophyllotoxin
G2- phase selective
high concentrations: cytolysis of cells entering mitosis
low concentrations: prevent cells from prophase entry
- Teniposide
causes single and double-stranded breaks by inhibiton of
type II topoisomerase activity
ADRs: severe myelosuppression and hypersensitivity reactions
d. Antibiotics
- MOA: disruption of DNA-dependent RNA synthesis, inhibition of
mitosis
- derived from eubacterial and actinomycetes genuses
- rapidly proliferating normal and neoplastic cells
- phase-specific
hemolytic uremic syndrome:
microangiopathic hemolytic anemia
thrombocytopenia
irrevesible renal failure
-S-phase specific
-interfere with conversion of ribonucleotides to
deoxyribonucleotides
-inhibits incorporation of thymidine into DNA
-treatment of melanoma and leukemia
-used concomittantly with irradiation therapy: squamous cell
carcinoma of head and neck