Professional Documents
Culture Documents
Sealed Source RT
( Brachytherapy)
Un Sealed- Source RT
Sealed- Source RT
1. Time of exposure.
• Antimetabolites
• Genotoxic Drugs
• Spindle Inhibitors
• Other Chemotherapy Agents
Anti- Metabolites
• Drugs that interfere with the formation of
key bio-molecules within the cell including
nucleotides, the building blocks of DNA.
• These drugs ultimately interfere with DNA
replication and therefore cell division.
Types of Anti- metabolites
• Folate Antagonists
• Purine Antagonists
• Pyrimidine Antagonists
Folate Antagonist
• also known as antifolates
• It inhibit dihydrofolate reductase (DHFR), an
enzyme involved in the formation of
nucleotides.
• When this enzyme is blocked, nucleotides are
not formed, disrupting DNA replication and cell
division
• Methotrexate and Pemetrexed
Purine Antagonists
• 6-Mercaptopurine, Dacarbazine,
Fludarabine
Pyrimidine Antagonists
– 5-fluorouracil
– Arabinosylcytosine
– Capecitabine
– Gemcitabine
– Decitabine
Genotoxic Drugs
• Drugs that damage DNA. By causing DNA
damage, these agents interfere with DNA
replication, and cell division
• 3 Treatments:
– Alkylating Agents
– Intercalating Agents
– Enzyme Inhibitors
The genotoxic chemotherapy
treatments include:
Alkylating agents:
• The first class of chemotherapy agents
used. These drugs modify the bases of
DNA, interfering with DNA replication and
transcription and leading to mutations
Intercalating agents
• These drugs wedge themselves into the
spaces between the nucleotides in the DNA
double helix. They interfere with
transcription, replication and induce
mutations.
Enzyme inhibitors
• These drugs inhibit key enzymes, such as
topoisomerases, involved in DNA replication
inducing DNA damage.
Spindle Inhibitors
• These agents prevent proper cell division by
interfering with the cytoskeletal components
that enable one cell to divide into two.
• Vinca Alkaloids
Paclitaxel (Taxol®)
Docetaxel (Taxotere®)
Ixabepilone (Ixempra®)
Additional Chemotherapy Agents
• Drugs that work through mechanisms that
do not neatly fit into one of thecategories.
Encourage OFI,
Cyclophosphamide Hemorrhagic Cystitis unexpected bleeding,
hematuria or dysuria.
IRRITANTS
Drugs that are capable of producing pain
at the IV site or along the vein, with or
without inflammatory reaction.
EXTRAVASATION
Escape of agents from a vein to a tissue
NON VESICANTS
Drugs that can be given by IV bolus
through the side arm of free flowing IV
containing no additives.
VESICANTS
Drugs that are capable of causing blister
formation and tissue destruction.
STEM CELL
TRANSPLANTATION
STEM CELLS
• Stem cells are able to
grow into other blood
cells that mature and
function as needed in
the body.
• Stem cells create the
three main types of
blood cells:
– red blood cells
– white blood cells
– platelets
Where are stem cells located?
• Bone marrow (the spongy center of the bone
where blood cells are made)
• Peripheral blood (found in blood vessels
throughout the body)
• Cord blood (found in the umbilical cord and
collected after a baby’s birth)
Stem cells for transplantation are obtained from any of these three places.
STEM CELL TRANSPLANT
• Is a process that
takes healthy stem
cells from a donor
and gives them to
the patient through a
central line.
Types of Stem Cell
Transplants
• Bone marrow transplants are those that
are obtained from the bone marrow
• Peripheral blood stem cell (PBSC)
transplants are obtained from the
peripheral blood.
• Cord blood transplants refer to
transplants where the stem cells are
obtained from umbilical cord blood.
Stem cell transplants are further
categorized based on the donor who
provides the stem cells.
PAIN
In cancer is the most feared
and distressing symptom
of the disease.
THE CANCER PAIN
PROBLEM
• WHO reveals that everyday at least 4
million people suffer from cancer pain.
• 30 – 50% of cancer patients undergoing
treatment, and up to 95% of patients with
advanced disease, suffer from pain.
• More than 50% of patients still suffered
from unrelieved cancer pain.
WHO: 3 Step Analgesic Ladder For Cancer
Pain Management
Basic Principles:
• BY THE MOUTH
If the patient can swallow, oral
administration is the route of choice.
• BY THE CLOCK
Analgesics should be given regularly and
prophylactically.
• BY THE LADDER
Use a few drugs well than many badly.
3 Medications for Pain Ladder
• Non- Opoid Analgesics
• Opoid Analgesics
• Adjuvant Drugs
• “There is an UPPER LIMIT to how
effective they are.”
THANK YOU!
• If pain occurs, there should be prompt oral administration
of drugs in the following order: nonopioids (aspirin and
paracetamol); then, as necessary, mild opioids (codeine);
then strong opioids such as morphine, ntil the patient is
free of pain. To calm fears and anxiety, additional drugs –
“adjuvants” – should be used. To maintain freedom from
pain, drugs should be given “by the clock”, that is every 3-
6 hours, rather than “on demand” This three-step
approach of administering the right drug in the right dose
at the right time is inexpensive and 80-90% effective.
Surgical intervention on appropriate nerves may provide
further pain relief if drugs are not wholly effective.