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Week 4 – Chapter 37-39, 32-33
Chapter 37: Antineoplastic
Agents
• Cancer
• Cancer (malignant, neoplastic) cells are characterized by unregulated growth, lack of
differentiation and spread (metastasis) to other places in the body.
• Anticancer Therapy:
• Chemotherapy is the use of chemicals to kill cancer cells by inhibiting or preventing cell
reproduction.
Classes of Chemotherapy Drugs:
- Alkylating Agents
- Antimetabolites
- Antitumor Agents
- Mitotic Inhibitors
- Hormonal Agents
• Antimetabolites
Folic Acid Antagonist
- Methotrexate (Trexall) – Used to treat cancer, rheumatoid arthritis, psoriasis.
INDUCES MISCARRIAGES in patients with ectopic pregnancy.
⇨ General side effects: Bone suppression leading to leukopenia, thrombocytopenia, and anemia. Can
cause stomatitis, vomiting, alopecia, and hepatic/renal dysfunction.
Patients should report any signs of bleeding and have platelet levels checked.
• Alkylating Drugs
Nitrogen Mustard
- Cyclophosphamide (Cytoxan) is used to treat Hodgkin’s disease and many other types of cancer.
- This drug can cause hemorrhagic cystitis as result of severe bladder inflammation
- This drug should be taken with copious amounts of water and early in the day, so it does not
accumulate in the bladder.
Chapter 38: Targeted Therapies to treat cancer
Targeted Therapy:
NUR 2407Pharm Study Guide Exam 2 Week 4 – Chapter 37-39, 32-
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- Drugs or other substances that block the growth and spread of cancer by interfering with specific
molecules in tumor growth and progression.
- Cancers that do not have sufficient quantities of the specific molecular target will not respond to
targeted therapy.
Chapter 39: Biological Response Modifiers
Colony Stimulating Factors:
- Erythropoietin (Epoetin Alpha) stimulates red blood cell production, and increases the risk of
death when a patient’s hemoglobin is >12
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Chapter 32: Anti-TB, Antifungal, Peptides, Metronidazole
Tuberculosis is caused by a bacterium call mycobacterium tuberculosis. The bacteria usually attack the
lungs, but TB bacteria can attack any part of the body, such as the kidney, spin, and brain. If not treated
properly, TB disease can be fatal.
- TB is one of the world’s top health challenges: More than 2 billion people, equal to a
QUARTER of the world’s population are infected with TB.
- Each year there is 9 million new cases and 1.5 million deaths
- Each day there is 24,000 new cases, 4000 deaths and 8,000 missed.
Latent TB Infection – TB bacteria can live in the body without making you sick. This is called Latent TB
Infection. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria
to stop them from growing. People with this condition do no not feel sick and do not have any symptoms.
People with this condition are not infectious and cannot spread TB bacteria to others.
TB Disease – TB bacteria becomes active if the immune system can’t stop them from growing. When TB
bacteria are active, multiplying in your body, this is called TB disease. People with TB disease are sick. They
may also be able to spread the bacteria to people they spend time with every day.
- Mycobacterium have a thick, way cell wall. It is very tough!
Main Symptoms of Pulmonary Tuberculosis:
- Appetite Loss
- Fatigue
- Chest Pain
- Coughing up blood
- Productive, prolonged cough
- Night sweats, pallor
Anti- Tuberculars
• TB Treatment
- To prevent drug resistance – Multidrug Therapy (The golden standard of treatment)
- Drugs: Isoniazid, Rifampin, Ethambutol, and Pyrazinamide*******
Rifampin
- Antimycobacterial
- Must be taken daily for several months with no break.
- Can stain body fluids orange.
- Can cause hepatotoxicity
- Take on empty stomach or absorption reduced by >30%***
- First discovered in soil from the French Riviera
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Isoniazid
- Antimycobacterial
- BLACK BOX WARNING: Hepatoxicity
- Drug to Drug Interactions: Acetaminophen due to increased risk of liver damage***
- Drug of choice for pregnant women with TB
- Treats Latent and Active TB
- Can cause peripheral neuropathy in patients with vitamin B6 deficiencies
- First tested in the Navajo community Many Farms, AZ
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