pharm 2 cancer treatment

Methotrexate drug class

antimetabolite

Methotrexate MOA

prevents the production of folic acid

Methotrexate unique adverse effects

reproductive toxicity, risk of pulmonary toxicity, folate deficiency

Methotrexate DI

Salicylates, NSAIDS, penicillin, sulfonamides, and tetracyclines can cause methotrexate toxicity

Doxorubicin drug class

antitumor antibiotic

Doxorubicin MOA

binds to DNA and alters structure, inhibits synthesis of RNA and DNA

Doxorubicin unique caution

cardiac problems

Doxorubicin unique AE

cardiac toxicity, red body fluids

Doxorubicin DI

drugs that produce cardiac toxicity - CCBs can increase the risk of cardiotoxicity

Vincristine drug class

Mitotic inhibitor

Vincristine

MOA

stops cell division during mitosis

Vincristine

special caution

neurologic disease

Vincristine

AE

BM suppression, GI effects, alopecia, injury to autonomic nerves (constipation, urinary hesitancy), peripheral neuropathy (parasthesia, decreased reflexes, and sensory loss), ataxia, cranial nerve abnormalities, nerve pain

Vincristine DI

digoxin (can reduce the effects of dig)

Cyclophosphamide

drug class

Alkylating agent

Cyclophosphamide

MOA

produce cytotoxic effects by affecting RNA and DNA

Cyclophosphamide

special indication

slow growing cancers

Cyclophosphamide

Special AE

Hemorrhagic cystitis (bladder)

Cyclophosphamide

DI

do not use with succinylcholine – increased neuromuscular blockage

Tamoxifen drug class

NCCT hormonal agent for breast cancer

Tamoxifen MOA

Estrogen receptor blocker. blocks growth of estrogen dependent cancers

Tamoxifen

indications

Breast, ovarian, uterus, prostate, and teste cancer. Also used to prevent return of cancer

Tamoxifen

special CI

history of clots/PE

Tamoxifen AE

endometrial Cancer, hypercalcemia, thrombolytic events, hot flashes, vaginal spotting/dryness

Tamoxifen DI

Warfarin (tamoxifen increases anticoagulation effects), increased risk of thrombus if taking with other chemo agents

Leuprolide

drug class

NCCT hormonal agent for prostate cancer

Leuprolide

MOA

prevents testosterone production by testicles

Leuprolide

indication

Advanced prostate cancer

Leuprolide

AE

Hot flashes, decreased libido, erectile dysfunction, gynecomastia, decreased bone density, disease flare (rise before fall), dysrhythmias, pulmonary edema

Interferon Alfa-2b

drug class

NCCT Biologic Response Modifiers

Interferon Alfa-2b MOA

increases immune response and decreases production of cancer cells

Interferon Alfa-2b indication

Leukemias/lymphomas

Interferon Alfa-2b CI

SI!

Interferon Alfa-2b AE

flu-like symptoms, depression, anxiety, insomnia, altered mental status, cardio/neuro toxicity – with prolonged therapy, bone marrow suppression

Interferon Alfa-2b

DI

theophylline (increased risk of theophylline toxicity), live vaccines

Bevacizumab drug class

NCCT Targeted Antineoplastic Medications

Bevacizumab

MOA

prevents neoangiogenesis

Bevacizumab special indication

Organ rejection

Bevacizumab

cautions

hypersensitivity, cardiac/renal disease

Bevacizumab

AE

pulm edema/fluid retention, GI perforation, hemorrhage, thromboembolism, hypertension, renal injury, heart failure, impaired healing

Bevacizumab

DI

any other immunosuppressant drug

Filgrastim

drug class

Leukopoietic Growth Factors

Filgrastim MOA

stimulate bone marrow to increase production of neutrophils

Filgrastim indication

reduce infection risk, decrease neutropenia in those with transplants and cancer

Filgrastim special caution

bone cancer

Filgrastim CI

E.coli sensitivity

Filgrastim AE

generalized bone pain, leukocytosis; splenomegaly and risk of splenic rupture (with long-term use)