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