Anticancer Drugs
ANTICANCER DRUGS
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Introduction
· Anticancer drugs,
also known as antineoplastic or chemotherapy agents, are used in the treatment
of cancer, a condition characterized by uncontrolled and abnormal cell growth.
· These drugs aim to
kill or inhibit the growth of cancer cells, while ideally causing minimal
damage to normal, healthy cells.
Definition
· Anticancer drugs are
medications used to prevent, inhibit, or treat cancer by targeting rapidly
dividing cells.
· They work through
various mechanisms to destroy cancer cells, slow their growth, or prevent their
spread.
Classification
1.
Alkylating Agents
o
Example: Cyclophosphamide, Cisplatin
o
Mechanism: These drugs work by adding alkyl
groups to the DNA, which leads to DNA cross-linking and breaks, preventing cell
division and causing cell death.
2.
Antimetabolites
o
Example: Methotrexate, 5-Fluorouracil
o
Mechanism: Antimetabolites interfere with DNA
and RNA synthesis by mimicking the normal substrates of these molecules,
leading to faulty DNA replication and cell death.
3.
Antitumor Antibiotics
o
Example: Doxorubicin, Bleomycin
o
Mechanism: These drugs intercalate into DNA,
disrupting DNA function, and generate free radicals, leading to cell death.
4.
Plant Alkaloids
o
Example: Vincristine, Paclitaxel
o
Mechanism: Plant alkaloids inhibit mitosis by
preventing microtubule formation, thus stopping cell division.
5.
Hormonal Agents
o
Example: Tamoxifen, Letrozole
o
Mechanism: These drugs block hormone receptors
or lower hormone levels, particularly in hormone-sensitive cancers like breast
and prostate cancer.
6.
Targeted Therapy
o
Example: Imatinib, Trastuzumab
o
Mechanism: Targeted therapies are designed to
specifically target and inhibit cancer-specific molecules, minimizing damage to
normal cells.
7.
Immunotherapy
o
Example: Pembrolizumab, Ipilimumab
o
Mechanism: These drugs enhance the body’s immune
system to recognize and destroy cancer cells.
8.
Miscellaneous Agents
o
Example: Hydroxyurea, Asparaginase
o
Mechanism: These drugs have unique mechanisms
that do not fit into the above categories.
Pharmacokinetics
·
Absorption: Many anticancer drugs are
administered intravenously, providing direct access to the bloodstream.
·
Distribution: Anticancer drugs distribute through
the bloodstream to reach various tissues.
·
Metabolism: Most anticancer drugs are metabolized
in the liver by cytochrome P450 enzymes.
·
Excretion: Anticancer drugs and their
metabolites are primarily excreted through the kidneys, though some are
excreted via bile into the feces.
Mechanism of Action
· Anticancer drugs
target cancer cells by exploiting differences between cancerous and normal
cells.
· They interfere with
cell division, DNA replication, and cellular repair mechanisms.
· Depending on the
class, they may damage DNA, inhibit enzymes necessary for DNA synthesis, or
prevent microtubule formation, leading to cancer cell death.
Uses
·
Curative Treatment: In some cancers,
such as testicular cancer or certain leukemias, anticancer drugs can cure the
disease.
·
Adjuvant Therapy: To eliminate microscopic disease
after surgery or radiation.
·
Neoadjuvant Therapy: To shrink tumors
before surgery or radiation.
·
Palliative Treatment: To relieve symptoms
and improve the quality of life in advanced cancers.
Adverse Effects
·
Bone Marrow Suppression: Leading to anemia,
leukopenia, and thrombocytopenia.
·
Gastrointestinal Toxicity: Nausea, vomiting,
diarrhea, and mucositis.
·
Alopecia: Hair loss due to the impact on
rapidly dividing hair follicle cells.
·
Nephrotoxicity: Kidney damage, especially with drugs
like Cisplatin.
·
Cardiotoxicity: Heart damage, particularly with drugs
like Doxorubicin.
·
Neurotoxicity: Nerve damage, common with drugs like
Vincristine.
Contraindications
·
Pregnancy: Many anticancer drugs are teratogenic
and can cause birth defects.
·
Severe Infections: Due to immunosuppression caused by
chemotherapy.
·
Severe Organ Dysfunction: Particularly liver
and kidney dysfunction, as these organs are crucial for drug metabolism and
excretion.
·
Known Hypersensitivity: To a particular
anticancer drug or its components.
Role of Nurse
·
Pre-administration Assessment: Checking patient
history, lab values (CBC, liver, and kidney function), and potential drug
interactions.
·
Patient Education: Explaining the treatment plan,
potential side effects, and self-care measures.
·
Administration: Ensuring the correct dosage, route,
and timing of drug administration, and using protective measures to prevent
drug exposure.
·
Monitoring: Observing for adverse reactions,
managing side effects like nausea or neutropenia, and ensuring the patient’s
comfort.
·
Emotional Support: Providing psychological support to
patients and their families during treatment.
·
Documentation: Recording the drug administration
details and any adverse reactions.
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