Antitumor antibiotics: Nursing pharmacology

Antitumor antibiotics are chemotherapeutic agents used to treat various cancers, including leukemia, lymphoma, soft tissue sarcoma, osteosarcoma, as well as solid tumors, such as breast, bladder, ovarian, and lung cancers. Antitumor antibiotics include bleomycin, dactinomycin, mitomycin, as well as anthracyclines such as daunorubicin, doxorubicin, idarubicin, and epirubicin.

These medications are primarily given intravenously, but bleomycin can also be administered intramuscularly. Once administered they act as cell cycle nonspecific agents, which means they target cells in all phases of the cell cycle. The exception is bleomycin, which specifically goes for cells in the G2 phase. Now, the way they work is twofold: first, these medications disrupt protein synthesis in target cells; and second, they bind to DNA, causing its fragmentation. Ultimately, this stops the rapidly dividing cancer cells from replicating and eventually causes their death.

Unfortunately, antitumor antibiotics also act on rapidly dividing healthy cells in our body, like those in the bone marrow, skin, and gastrointestinal tract. So antitumor antibiotics, with the exception of bleomycin, can all cause bone marrow suppression, which is a boxed warning for all anthracyclines as well as mitomycin. Bone marrow suppression can lead to anemia, leukopenia, increasing the risk of infections, and thrombocytopenia, increasing the risk of bleeding. Moreover, they can all cause alopecia, as well as gastrointestinal toxicity, which can manifest as nausea, vomiting, diarrhea or stomatitis.