Antineoplastic Drugs Part 2: Cell-Cycle-Nonspecific & Miscellaneous Agents

Vocabulary flashcards covering mechanisms, drug examples, toxicities, and nursing considerations for cell-cycle-nonspecific and miscellaneous antineoplastic agents.

Cell-cycle-nonspecific (CCNS) drug

An antineoplastic agent that is active in all phases of the cell cycle, including resting (G0).

Alkylating drugs

CCNS agents that covalently bind to DNA, preventing cancer cell reproduction.

Classic alkylators (nitrogen mustards)

First-generation alkylating drugs, e.g., mechlorethamine, that cross-link DNA strands.

Nitrosoureas

Alkylating subclass that readily crosses the blood–brain barrier; used for brain tumors.

Bifunctional alkylator

Alkylating compound with two reactive sites able to form cross-links on DNA.

Polyfunctional alkylator

Alkylating compound with multiple reactive sites, producing extensive DNA damage.

Cisplatin (Platinol)

Platinum-based alkylating agent used for solid tumors; notable for nephro- and ototoxicity.

Cyclophosphamide (Cytoxan)

Nitrogen mustard used for bone, lymph, blood, and solid tumors; causes myelosuppression.

Mechlorethamine (Mustargen)

Prototype nitrogen mustard for Hodgkin’s and non-Hodgkin’s lymphoma.

Myelosuppression

Dose-limiting decrease in bone marrow function leading to anemia, neutropenia, thrombocytopenia.

Nephrotoxicity

Kidney damage; hydration is recommended to limit this effect with cisplatin and similar drugs.

Peripheral neuropathy

Tingling, numbness, or pain in extremities caused by certain alkylating agents.

Ototoxicity

Hearing damage (ringing/roaring) associated with cisplatin and other agents.

Extravasation

Leakage of IV antineoplastic drug into surrounding tissue, causing severe local injury.

Cytotoxic antibiotics

CCNS antitumor antibiotics (e.g., doxorubicin) that intercalate DNA and block synthesis.

Intercalation

Insertion of a drug molecule between DNA base pairs, disrupting replication and transcription.

Bleomycin

Cytotoxic antibiotic notable for pulmonary fibrosis/pneumonitis rather than myelosuppression.

Daunorubicin

Anthracycline antibiotic whose major toxicity is congestive heart failure; turns urine reddish.

Doxorubicin

Anthracycline that can cause acute left ventricular failure and cumulative cardiomyopathy.

Dexrazoxane

Cytoprotective agent given with doxorubicin to reduce cardiotoxicity.

Multiple-gated acquisition (MUGA) scan

Nuclear test used to monitor cardiac ejection fraction during anthracycline therapy.

Angiogenesis inhibitor

Drug class that blocks formation of new blood vessels feeding tumors.

Bevacizumab (Avastin)

Monoclonal angiogenesis inhibitor for metastatic colon, lung, and brain cancers; nephrotoxic.

Sunitinib (Sutent)

Oral multitargeted tyrosine kinase inhibitor for GI stromal, pancreatic neuroendocrine, and renal cell tumors.

Hydroxyurea (Hydrea)

Antimetabolite-like drug for squamous cell carcinoma and leukemias; may cause hyperuricemia and pulmonary fibrosis.

Imatinib (Gleevec)

Targeted tyrosine kinase inhibitor for chronic myeloid leukemia; strong CYP450 drug interactions.

Mitotane (Lysodren)

Adrenal cytotoxic agent for inoperable adrenal corticoid carcinoma; causes CNS depression and nausea.

Octreotide (Sandostatin)

Somatostatin analog used for carcinoid crisis and VIPoma-related diarrhea.

Aromatase inhibitor

Hormonal drug (e.g., anastrozole) that blocks conversion of androgens to estrogen in post-menopausal women.

Selective estrogen receptor modulator (SERM)

Agent such as tamoxifen that competitively blocks estrogen receptors in breast tissue.

Progestins (antineoplastic use)

Hormonal agents like megestrol used for palliative treatment of endometrial or breast cancer.

Antiandrogens

Drugs (e.g., bicalutamide) that block testosterone receptors in prostate cancer therapy.

Estramustine

Antineoplastic hormone combining estrogen with nitrogen mustard for prostate cancer.

Vesicant drug

IV chemotherapeutic capable of causing blistering and severe tissue necrosis on extravasation.

Amifostine

Cytoprotective agent that reduces cisplatin-induced renal toxicity.

Allopurinol (oncology use)

Xanthine oxidase inhibitor given IV or orally to lower uric acid levels and prevent tumor lysis syndrome.

Oncologic emergency

Acute, potentially life-threatening complication of cancer or therapy, e.g., infection, bleeding, metabolic derangement.