CH 14 ANTINEOPLASTIC AGENTS NUR187 EXAM
QUESTIONS AND VERIFIED ANSWERS
(?) drug used to combat cancer or the growth of neoplasms
antineoplastic agent
(?) inhibition of the blood-forming components of the bone marrow; a common
adverse effect of many antineoplastic drugs, which are more effective against
rapidly multiplying cells, such as those in bone marrow; seen as anemia,
thrombocytopenia, and leukopenia
bone marrow suppression
(?) new or cancerous growth; occurs when abnormal cells have the opportunity
to multiply and grow
neoplasm
ANTIMETABOLITES
methotrexate
MITOTIC INHIBITORS
vincristine
HORMONES AND HORMONE MODULATORS
tamoxifen
Antineoplastic drugs alter human cells in a variety of ways. Their intended action
is to target the abnormal cells that compose the neoplasm, or cancer, and impact
,abnormal cells more than normal cells. Unfortunately, normal cells also are
affected by antineoplastic agents.
Only one branch of chemotherapy involves drugs developed to act on and kill or
alter human cells—the antineoplastic agents, which are designed to fight
neoplasms, or cancers.
This area of pharmacology, which has grown tremendously in recent years, now
includes many drugs that act on or are part of the immune system. These
substances fight the cancerous cells using components of the immune system
instead of directly destroying cells.
Antineoplastic drugs alter human cells in a variety of ways. Their intended action
is to target the abnormal cells that compose the neoplasm, or cancer, and impact
abnormal cells more than normal cells. Unfortunately, normal cells also are
affected by antineoplastic agents.
Antineoplastic drugs can work by affecting cell survival or by boosting the
immune system in its efforts to combat the abnormal cells. Chapter 17 discusses
the immune agents that are used to combat cancer. The present chapter focuses
on those drugs that affect cell survival.
Antineoplastic drugs commonly used today include alkylating agents,
antimetabolites, antineoplastic antibiotics, mitotic inhibitors, hormones and
hormone modulators, cancer cell–specific agents including protein tyrosine
kinase inhibitors (which target enzymes specific to the cancer cells), and a group
of antineoplastic agents that cannot be classified elsewhere. Other drugs are
used as adjunctive therapy to combat the serious adverse effects associated with
,the antineoplastic drugs. Figure 14.4 shows sites of action of antineoplastic
agents.
As discussed in Chapter 7, all cells progress through a cell cycle. Different types
of cells progress at different rates (see Fig. 7.6). Rapidly multiplying cells, or cells
that replace themselves quickly, include those lining the gastrointestinal (GI) tract
and those in hair follicles, skin, and bone marrow. These cells complete the cell
cycle every few days. Cells that proceed very slowly through the cell cycle
include those in the breasts, testicles, and ovaries. Some cells take weeks,
months, or even years to complete the cycle.
Older Adults
Older adults may be more susceptible to the CNS and GI effects of some of these
drugs. Older patients should be monitored for hydration and nutritional status
regularly. Safety precautions should be instituted if CNS effects occur, including
increased lighting, assistance with ambulation, and use of supports.
Many older patients have decreased renal and/or hepatic function. Many of these
drugs depend on the liver and kidney for metabolism and excretion. Renal and
liver function tests should be done before (baseline) and periodically during the
use of these drugs, and dose should be adjusted accordingly.
Older Adults
Protecting these patients from exposure to infection and injury is a very
important aspect of their nursing care. Older patients are naturally somewhat
immunosuppressed because of age, and giving drugs that further depress the
, immune system can lead to infections that are serious and difficult to treat.
Monitor blood counts carefully and arrange for rest or reduced dose as indicated.
Cancer cells tend to move through the cell cycle at about the same rate as their
cells of origin. Malignant cells that remain in a dormant phase for long periods
are difficult to destroy. These cells can emerge long after cancer treatment has
finished—weeks, months, or years later—to begin their division and growth cycle
all over again. For this reason, antineoplastic agents are often given in sequence
over periods of time, in the hope that the drugs will affect the cancer cells as they
emerge from dormancy or move into a new phase of the cell cycle.
A combination of antineoplastic agents targeting different phases of the cell cycle
is frequently most effective in treating many cancers.
The goal of cancer therapy, much like that of anti-infective therapy, is to limit the
offending cells to the degree that the immune system can respond without
causing too much toxicity to the host. However, this is a particularly difficult task
when using antineoplastic drugs because, for the most part, these agents are not
specific to mutant cells and affect normal human cells as well. In most cases,
antineoplastic drugs primarily affect human cells that are rapidly multiplying, with
many cells in many phases of the cell cycle (e.g., those in the hair follicles, GI
tract, and bone marrow).
Much research is being done to develop drugs that affect only the abnormal
cells. Imatinib, released in 2001, was the first of a growing number of drugs to
target the enzymes used by very specific abnormal cells. A growing list of agents
that affect only the mechanisms of cancer cells have been marketed.
QUESTIONS AND VERIFIED ANSWERS
(?) drug used to combat cancer or the growth of neoplasms
antineoplastic agent
(?) inhibition of the blood-forming components of the bone marrow; a common
adverse effect of many antineoplastic drugs, which are more effective against
rapidly multiplying cells, such as those in bone marrow; seen as anemia,
thrombocytopenia, and leukopenia
bone marrow suppression
(?) new or cancerous growth; occurs when abnormal cells have the opportunity
to multiply and grow
neoplasm
ANTIMETABOLITES
methotrexate
MITOTIC INHIBITORS
vincristine
HORMONES AND HORMONE MODULATORS
tamoxifen
Antineoplastic drugs alter human cells in a variety of ways. Their intended action
is to target the abnormal cells that compose the neoplasm, or cancer, and impact
,abnormal cells more than normal cells. Unfortunately, normal cells also are
affected by antineoplastic agents.
Only one branch of chemotherapy involves drugs developed to act on and kill or
alter human cells—the antineoplastic agents, which are designed to fight
neoplasms, or cancers.
This area of pharmacology, which has grown tremendously in recent years, now
includes many drugs that act on or are part of the immune system. These
substances fight the cancerous cells using components of the immune system
instead of directly destroying cells.
Antineoplastic drugs alter human cells in a variety of ways. Their intended action
is to target the abnormal cells that compose the neoplasm, or cancer, and impact
abnormal cells more than normal cells. Unfortunately, normal cells also are
affected by antineoplastic agents.
Antineoplastic drugs can work by affecting cell survival or by boosting the
immune system in its efforts to combat the abnormal cells. Chapter 17 discusses
the immune agents that are used to combat cancer. The present chapter focuses
on those drugs that affect cell survival.
Antineoplastic drugs commonly used today include alkylating agents,
antimetabolites, antineoplastic antibiotics, mitotic inhibitors, hormones and
hormone modulators, cancer cell–specific agents including protein tyrosine
kinase inhibitors (which target enzymes specific to the cancer cells), and a group
of antineoplastic agents that cannot be classified elsewhere. Other drugs are
used as adjunctive therapy to combat the serious adverse effects associated with
,the antineoplastic drugs. Figure 14.4 shows sites of action of antineoplastic
agents.
As discussed in Chapter 7, all cells progress through a cell cycle. Different types
of cells progress at different rates (see Fig. 7.6). Rapidly multiplying cells, or cells
that replace themselves quickly, include those lining the gastrointestinal (GI) tract
and those in hair follicles, skin, and bone marrow. These cells complete the cell
cycle every few days. Cells that proceed very slowly through the cell cycle
include those in the breasts, testicles, and ovaries. Some cells take weeks,
months, or even years to complete the cycle.
Older Adults
Older adults may be more susceptible to the CNS and GI effects of some of these
drugs. Older patients should be monitored for hydration and nutritional status
regularly. Safety precautions should be instituted if CNS effects occur, including
increased lighting, assistance with ambulation, and use of supports.
Many older patients have decreased renal and/or hepatic function. Many of these
drugs depend on the liver and kidney for metabolism and excretion. Renal and
liver function tests should be done before (baseline) and periodically during the
use of these drugs, and dose should be adjusted accordingly.
Older Adults
Protecting these patients from exposure to infection and injury is a very
important aspect of their nursing care. Older patients are naturally somewhat
immunosuppressed because of age, and giving drugs that further depress the
, immune system can lead to infections that are serious and difficult to treat.
Monitor blood counts carefully and arrange for rest or reduced dose as indicated.
Cancer cells tend to move through the cell cycle at about the same rate as their
cells of origin. Malignant cells that remain in a dormant phase for long periods
are difficult to destroy. These cells can emerge long after cancer treatment has
finished—weeks, months, or years later—to begin their division and growth cycle
all over again. For this reason, antineoplastic agents are often given in sequence
over periods of time, in the hope that the drugs will affect the cancer cells as they
emerge from dormancy or move into a new phase of the cell cycle.
A combination of antineoplastic agents targeting different phases of the cell cycle
is frequently most effective in treating many cancers.
The goal of cancer therapy, much like that of anti-infective therapy, is to limit the
offending cells to the degree that the immune system can respond without
causing too much toxicity to the host. However, this is a particularly difficult task
when using antineoplastic drugs because, for the most part, these agents are not
specific to mutant cells and affect normal human cells as well. In most cases,
antineoplastic drugs primarily affect human cells that are rapidly multiplying, with
many cells in many phases of the cell cycle (e.g., those in the hair follicles, GI
tract, and bone marrow).
Much research is being done to develop drugs that affect only the abnormal
cells. Imatinib, released in 2001, was the first of a growing number of drugs to
target the enzymes used by very specific abnormal cells. A growing list of agents
that affect only the mechanisms of cancer cells have been marketed.
