Anti-cancer drugs

Chemotherapy

• More toxic to tissues with high growth fraction

• Bone marrow suppression

• Alopecia

• Reproductive toxicities

• Stomatitis

• Diarrhea

Schedule cycles so that enough time between rounds for normal cells to rejuvenate

Doxorubicin

• Adjuvant chemotherapy

• Inhibits topoisomerase 2→ breaks in DNA strands and prevents replication of cancer cells

• Vesicant – avoid extravasation, give via central line

• Associated with cardiomyopathy

• Contraindicated for patients with recent MI, arrhythmias, etc. 

Cyclophosphamide

• Adjuvant chemotherapy

• Forms cross links between DNA strands, preventing DNA from unwinding and separating → Inhibits DNA replication and transcription

• Hydration during and after infusion to reduce risk of hemorrhagic cystitis 

Paclitaxel

• Adjuvant chemotherapy

• Stabilizes microtubules → inhibits mitosis and cell division

• May cause severe hypersensitivity reactions

• Monitor for chemotherapy-induced peripheral neuropathy

Trastuzumab

• Targeted therapy

• AKA Herceptin

• Monoclonal antibody, targets HER2 receptor → inhibits proliferation of cancer cells that overexpress HER2

• Associated with cardiotoxicity and pulmonary toxicity

Anastrozole

• Hormone therapy

• Aromatase inhibitor

• Reduces production of estrogen

• Helpful if hormone-receptor positive breast cancer 

• Given post-chemo

• Adverse effects:

  • Vasodilation

  • Hot flash

  • GI distress

  • Asthenia

  • Depression

  • Fatigue

  • Arthritis

  • Back pain