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Chemotherapy
Chemotherapy is a drug treatment primarily used to treat cancer by employing cytotoxic medications to disrupt fast-growing cancer cells. Different classes of chemotherapeutic drugs, such as alkylating agents and antimetabolites, target various phases of the cell cycle, leading to side effects like nausea and bone marrow suppression. Additional cancer treatments mentioned include targeted therapy, radiation therapy, stem cell transplants, and hormone therapy, each with specific mechanisms and applications.
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Chemotherapy
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- 2. Definition: Chemotherapy isa drug treatment that uses powerful chemicals to kill fast- growing cells in your body. Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body. It involves the use of cytotoxic medication to cure cancers, such as leukemias,lymphomas, & some solid tumors; to decrease the tumor size, adjunctive to surgery & radiation therapy; or to prevent & treat suspected metastases. Action: chemotherapy disrupts the cell cycle in various phases by interrupting cell metabolism & replication. • It also works by interfering with the ability of the malignant cell to synthesize the vital enzymes & chemicals. • Phase specific drugs work during only some phases of the cell cycle ; non-cell specific drugs work through entire cell cycle. CHEMOTHERAPY
- 3. • ALKYLATING AGENTS •ANTIMETABOLITES • ANTITUMOR ANTIBIOTICS • MITOTIC INHIBITORS • HORMONES & HORMONES ANTAGONISTS • MISCELLANEOUS AGENTS CLASSIFICATION OF CHEMOTHERAREUTIC DRUGS:
- 4. Drug class & examples Mechanismof action Cell cycle specificity Common side effects Alkylating agents- busulfan, carboplatin, cisplantin, nitrigen mustard. Alter DNA structure by misreading DNA code, initiating breaks in the DNA molecule Cell-cycle non- specific Bone marrow suppression, stomatitis, alopesia ,nausea , vomiting, renal toxicity Nitrosureas- carmustine, lomustine, semustine Similar to alkylating agents Cell-cycle non- specific delayed & cumulative mylosuppression, especially thrombocytopenia, nausea, vomiting Topoisomerase Iinhibitor- irinitecan,topotecan Induce breaks in the DNA strands by binding to enzyme topoisomerase I,preventing cells from dividing. Cell-cycle specific (s phase) Bone marrow suppression,diarrhea, nausea,vomitting,hep atotoxicity ANTINEOPLASTIC AGENTS:
- 5. Antimetabolites- 5azacytadine,5- fluorouracil,methot rexate Interfere with the biosynthesisof metabolites or nucleic acids necessary for RNA& DNA synthesis Cell-cycle specific (s phase) Bone marrow suppression, diarrhea, nausea, vomiting ,hepatotoxicity ,stomatitis, renal toxicity Antitumor antibiotics- bleomycin, doxorubicin , mitomycin, licamycin Interfere with the DNA synthesis by binding DNA; prevent RNA synthesis Cell-cycle non- specific Bone marrow suppression, nausea, vomiting, cardiac toxicity ,stomatitis , renal toxicity , alopecia Mitotic spindle poisons: plant alkaloids vinblastine, vincristine , etoposide. Taxanes: dosetaxel Arrest metaphase by inhibiting mitotic tubular formation; inhibit DNA & protein synthesis Cell-cycle specific (m-phase) Bone marrow suppression, neuropathies, stomatitis.
- 6. Hormonal agents- androgens, anti- androgens, estrogens,anti- estrogens, steroids Bind to hormone receptor site that alter cellular growth Cell-cycle non- specific Hypercalcemia, jaundice, increased appetite, masculinization, feminization, sodium & fluid retention Miscellaneous agents- asparaginase, procarbazine Unknown or too complex to categorize varies Bone marrow suppression,diarrhe a,nausea,vomitting, hepatotoxicity,anap hylaxis,hypotension . Antineoplastic agents:
- 8. • Settings • Dosage Adversereaction: • Hypersensitivity reaction • Extravasations Toxicity: G.I.system, • Hematopoietic system ex- thrombocytopenia • Renal system, • CVS, • Reproductive system, • Neurologic system,miscellaneous. Administration of chemotherapeutic agents:
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- 10. Side effect • Hairloss • Nausea • Vomiting • Mouth sores • Loss of appetite • Tiredness, easy bruising or bleeding, and an increased chance of infection.
- 11. • Assessment • Administrationof chemotherapy • Routes of administration • Adverse reaction • Safe preparation, handling & disposal • Assessing fluid & electrolyte status. • Modifying risk for infection & bleeding. • Administering chemotherapy. • protecting caregivers. NURSING MANAGEMENT IN CHEMOTHERAPY
- 12. Targeted therapy: • Targetedtherapies are drugs that interfere with one specific property or function of a cancer cell, rather than acting to kill all rapidly growing cells indiscriminately.
- 13. Radiation therapy: Radiation therapyuses high energy radiation to target cancer cells. Radiation therapy may be used in the treatment of leukemia that has spread to the brain, or it may be used to target the spleen or other areas where leukemia cells have accumulated.
- 14. Stem cell transplant: •It includes approaches that correct genetic defects or manipulate genes to induce tumor cell destruction in the hope of preventing or combating disease. • Three general approaches have been used in the development of gene therapy-
- 16. HORMONAL THERAPY • Hormonetherapy can be used before or after surgery or other treatments to decrease the chance of your cancer returning. If the cancer has already spread, hormone therapy may shrink and control it • Oestrogen and progesterone for breast cancer
- 17. IMMUNOTHERAPY • Hormone therapycan be used before or after surgery or other treatments to decrease the chance of your cancer returning. If the cancer has already spread, hormone therapy may shrink and control it • Oestrogen and progesterone for breast cancer
- 18. Bone marrow transplantation •Bone marrow is the flexible tissue found in the hollow interior of bones. In adults, marrow in large bones produces new blood cells. It constitutes 4% of the total body weight of humans, i.e. approximately 2.6 kg (5.7 lbs.) in adults. • BMT is very much effective in the treatment of hematologic cancers. • Donor cells can be obtained by the traditional harvesting of large amount of bone marrow tissue under general anesthesia in the OT.
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