-Report In Pharmacology-

ANTINEOPLASTIC AGENTS:

“ANTINEOPLASTIC ANTIBIOTIC
AND
MITOTIC INHIBITORS”

Submitted by:
GROUP 8, BSN 2-2A
Sajulga, Sarah Lou
Salinas, Carmela
Salon, Ferdinand
Sanchez, Irish Love
Selibio, Rickmon

Submitted to:
Ms. Juliet Paraguya
-Instructor-

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 ANTINEOPLASTIC ANTIBIOTIC AGENTS
 Both targets bacterial and human cells
 More toxic to rapidly multiplying cells
 Cells in the bone marrow, GIT, skin
 Useful in treating certain cancers-too toxic to treat infections
 Are cell-cycle specific drugs- interferes cellular DNA causing cell death
 Main adverse effects are seen in cells that rapidly multiply
 Indications:
 Used in combination chemotherapy regimens
 Used to treat a variety of solid tumors and some hematologic
malignancies
 Leukemia, ovarian, breast, bone, others
 Squamous cell carcinomas
 AIDS-related Kaposi’s sarcoma (when intolerant to other
treatments)
 Examples:
 Anthracycline antibiotics: daunorubicin, doxorubicin, idarubicin,
others
 Anthracenedione antibiotics: mitoxantrone
 Other cytotoxic antibiotics: bleomycin, dactinomycin, mitomycin,
plicamycin, others

THERAPEUTIC ACTIONS
 They are cytotoxic antibiotics
 Interfere with a malignant cell’s ability to grow and reproduce
 insert themselves b/w base pairs in the DNA chain causing a
mutant DNA molecule leading to cell death

PHARMACOKINETICS
 Not absorbed well in the GIT - Given IV or injected into specific site
 Metabolized in the liver and excreted in the liver
 Many of its kind have very long half-lives
 They do not cross the blood-brain barrier
 Widely distributed in the body
 Taken up by the heart, lungs, kidneys and spleen

CONTRAINDICATIONS & CAUTIONS

 Contraindicated to patient with known allergy, pregnant and lactating
women
 Care should be taken to patients with:
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  Bone marrow suppression
 Suppressed renal or hepatic function
 GI ulcerations or ulcerative diseases
 Pulmonary problems w/ bleomycin or mitomycin
 Cardiac problems w/ idarubicin or mitoxantrone

ADVERSE EFFECTS
 B – bone marrow suppression w/ leukopenia, thrombocytopenia, anemia,
pancytopenia
 R – renal or hepatic toxicity (w/use of antimetabolites)
 A – Alopecia
 G – GI effects: nausea, vomiting, diarrhea, mucous membrane
deterioration
 T – toxic to the heart & lung

NURSING CONSIDERATIONS FOR PATIENTS RECEIVING ANTINEOPLASTIC

ANTIBIOTICS
 Assesment:
 Screen for contraindicated & cautioned patients
 vital signs
to evaluate respiratory & cardiovascular effects
 orientation & reflexes
to evaluate any CNS effects
 Bowel sounds & mucous membrane status
to monitor GI effects
 Evaluate CBC w/ differential & renal & liver function tests
to evaluate toxic drug effects used to monitor dosage
adjustments
 Diagnoses:
 Acute pain related to GI, CNS, local effects of drug
 Disturbed body image related to alopecia, skin effects
 Fear, anxiety related to diagnosis and treatment
 Deficient knowledge regarding drug therapy
 Implementation:
 Monitor blood tests & cardiac & respiratory function
 Protect patient from exposure to infection
 Administer medications according to scheduled protocol & in
combination with other dugs as indicated
 Ensure that patient is keep & well hydrated

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  Provide small, frequent meals; frequent mouth care; & dietary
consultation as appropriate
 Arrange for proper head covering at extremes of temperature
 Provide patient teaching
 Evaluation:
 Monitor patient’s response to the drug
 Monitor for adverse effects
 Evaluate the effectiveness of the teaching plan

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 MITOTIC INHIBITOR AGENTS
 Are drugs that kill cells as the process of mitosis begins
 Its main adverse effects occurs to cells that rapidly multiply
 Examples: docetaxel (Taxotere), etoposide (Toposar, VePesid), paclitaxel
(Taxol, Onxol), teniposide (Vulmon), vinblastine (Oncovin, Vincasar),
vinorelbine (Navelbine)

Therapeutic Actions
 A cell-cycle specific drug that inhibit DNA synthesis
 Work in the M phase of the cell cycle that block or alter DNA synthesis
needed for reproduction of the cell
 Used for the treatment of a variety of tumors and leukemias

Pharmacokinetics
 Not well absorbed in the GI tract
 Given intravenously
 Metabolized in the liver & excreted in the feces
 safer for patients w/ renal impairment

Contraindications & Cautions

 Caution to patients w/ known allergy to drug, during pregnancy and
lactation
 Care should be taken to patients who have:
 Bone marrow depression
 Renal or hepatic dysfunction
 Known GI ulcerations or ulcerative diseases

Adverse Effects
 Bone marrow depression – w/ leukopenia, thrombocytopenia, anemia &
cytopenia
 GI effects – nausea, vomiting, anorexia, diarrhea & mucuos membrane
deterioration
 Hepatic or renal toxicity
 Alopecia
 Extrasavation – cause necrosis & cellulitis, use antidote

Nursing Considerations for Patients Receiving Mitotic Inhibitors

 Assessment:
 Screen for contraindications and cautions

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  Physical assessment - orientation & reflexes, hair & hair distribution,
respiratory rate & adventitious sounds, bowel sounds & mucuos
membrane status
 Evaluate CBC w/differential & renal & liver function tests
 Regular evaluation of injection sites
 Diagnoses:
 Acute pain related to GI, CNS, local effects of drug
 Disturbed body image related to alopecia, skin effects
 Fear, Anxiety related to diagnosis & treatment
 Deficient knowledge regarding drug therapy
 Implementation:
 Arrange for blood test
 Avoid direct skin or eye contact w/ the drug – wear protective
clothing & goggles
 Administer medication according to scheduled protocol & in
combination w/other drugs
 Ensure that patient is well hydrated
 Monitor injection sites for extrasavation
 Protect patient from exposure to infection
 Provide small, frequent meals; frequent mouth care; & dietary
consultation as appropriate
 Arrange for proper head covering at extremes of temperature
 Provide patient teaching
 Evaluation:
 Monitor patient’s response to the drug
 Monitor for adverse effects
 Evaluate the effectiveness of the teaching plan