Antineoplastic Agents Cheet sheet

Administration of Chemotherapeutic Agents

Chemotherapeutic agents may be administered in the hospital, clinic, or home setting by topical, oral, intravenous, intramuscular, subcutaneous, arterial, intracavitary, and intrathecal routes. The administration route usually depends on the type of agent, the required dose, and the type, location, and extent of tumor being treated. Guidelines for the administration of chemotherapy have been developed by the Oncology Nursing Society. Patient education is essential to maximize safety if chemotherapy is administered in the patient’s home.

 

Antineoplastic Agents Cheet sheet

 

DRUG CLASS AND EXAMPLES

Alkylating Agents

  • busulfan, carboplatin, chlorambucil,
  • cisplatin, cyclophosphamide,
  • dacarbazine,
  • hexamethyl melamine, ifosfamide,
  • melphalan, nitrogen
  • mustard, thiotepa

MECHANISM OF ACTION

  • Alter DNA structure by misreading
  • DNA code, initiating
  • breaks in the DNA molecule,
  • cross-linking DNA strands

CELL CYCLE SPECIFICITY

  • Cell cycle–nonspecific

COMMON SIDE EFFECTS

  • Bone marrow suppression,
  • nausea, vomiting, cystitis
  • (cyclophosphamide, ifosfamide),
  • stomatitis, alopecia,
  • gonadal suppression, renal
  • toxicity (cisplatin)

 

Nitrosureas

  • carmustine (BCNU), lomustine
  • (CCNU), semustine (methyl
  • CCNU), streptozocin

 

MECHANISM OF ACTION

  • Similar to the alkylating agents;
  • cross the blood–brain barrier

CELL CYCLE SPECIFICITY

Cell cycle–nonspecific

COMMON SIDE EFFECTS

  • Delayed and cumulative myelosuppression,
  • especially thrombocytopenia;
  • nausea, vomiting

 

Topoisomerase I Inhibitors

  • irinotecan, topotecan

 

MECHANISM OF ACTION

  • Induce breaks in the DNA
  • strand by binding to enzyme
  • topoisomerase I, preventing
  • cells from dividing

Cell cycle–specific

COMMON SIDE EFFECTS

  • Bone marrow suppression,
  • diarrhea, nausea, vomiting,
  • hepatotoxicity

 

Antimetabolites

  • 5-azacytadine, cytarabine,
  • edatrexate fludarabine,
  • 5-fluorouracil (5-FU), FUDR,
  • gemcitabine, hydroxyurea,
  • leustatin, 6-mercaptopurine,
  • methotrexate, pentostatin,
  • 6-thioguanine

MECHANISM OF ACTION

  • Interfere with the biosynthesis of
  • metabolites or nucleic acids
  • necessary for RNA and DNA
  • synthesis

CELL CYCLE SPECIFICITY

Cell cycle–specific (S phase)

COMMON SIDE EFFECTS

  • Nausea, vomiting, diarrhea,
  • bone marrow suppression,
  • proctitis, stomatitis, renal toxicity
  • (methotrexate), hepatotoxicity

 

Antitumor Antibiotics

  • bleomycin, dactinomycin,
  • daunorubicin, doxorubicin
  • (Adriamycin), idarubicin,
  • mitomycin, mitoxantrone,
  • plicamycin

MECHANISM OF ACTION

  • Interfere with DNA synthesis by
  • binding DNA; prevent RNA
  • synthesis

CELL CYCLE SPECIFICITY

Cell cycle–nonspecific

COMMON SIDE EFFECTS

  • Bone marrow suppression,
  • nausea, vomiting, alopecia,
  • anorexia, cardiac toxicity
  • (daunorubicin, doxorubicin)

 

Mitotic Spindle Poisons

  • Plant alkaloids: etoposide, teniposide,
  • vinblastine, vincristine
  • (VCR), vindesine, vinorelbine
  • Taxanes: paclitaxel, docetaxel

MECHANISM OF ACTION

  • Arrest metaphase by inhibiting
  • mitotic tubular formation
  • (spindle); inhibit DNA and
  • protein synthesis
  • Arrest metaphase by inhibiting
  • tubulin depolymerization

CELL CYCLE SPECIFICITY

Cell cycle–specific (M phase)

COMMON SIDE EFFECTS

  • Bone marrow suppression (mild
  • with VCR), neuropathies
  • (VCR), stomatitis

 

Hormonal Agents

  • androgens and antiandrogens,
  • estrogens and antiestrogens,
  • progestins and antiprogestins,
  • aromatase inhibitors, luteinizing
  • hormone–releasing
  • hormone analogs, steroids

MECHANISM OF ACTION

  • Bind to hormone receptor sites
  • that alter cellular growth;
  • block binding of estrogens to
  • receptor sites (antiestrogens);
  • inhibit RNA synthesis; suppress
  • aromatase of P450 system,
  • which decreases estrogen
  • level

CELL CYCLE SPECIFICITY

Cell cycle–nonspecific

COMMON SIDE EFFECTS

  • Hypercalcemia, jaundice, increased
  • appetite, masculinization,
  • feminization, sodium
  • and fluid retention, nausea,
  • vomiting, hot flashes, vaginal
  • dryness

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