00:00 / 00:00
OTHER ANTINEOPLASTICS, PART 1/2 | |||
DRUG NAME | asparaginase (Elspar), pegaspargase (Oncaspar) *High Alert Medications* | altretamine *High Alert Medication* | azacitidine (Onureg, Vidaza) *High Alert Medication* |
CLASS | Other antineoplastic agents | ||
MECHANISM of ACTION | Deplete circulating asparagine levels → cancer cells can’t synthesize their own asparagine → impaired protein synthesis, apoptosis | Crosslinking of DNA → stops cancer cell division → cancer cell death | Damage to double stranded DNA during cell division |
INDICATIONS |
|
|
|
ROUTE(S) of ADMINISTRATION |
|
|
|
SIDE EFFECTS |
|
|
|
CONTRA-INDICATIONS & CAUTIONS |
| ||
|
|
OTHER ANTINEOPLASTICS, PART 2/2 | ||
DRUG NAME | hydroxyurea (Droxia, Hydrea, Siklos) *High Alert Medication* | irinotecan (Camptosar) *High Alert Medication* |
CLASS | Other antineoplastic agents Irinotecan: topoisomerase I inhibitor | |
MECHANISM of ACTION | Inhibits enzymes involved in DNA synthesis → stops cancer cell division | Inhibits enzymes involved in DNA synthesis (topoisomerase I) → stops cancer cell division |
INDICATIONS | Chronic myeloid leukemia; head and neck cancer | Metastatic colon cancer |
ROUTE(S) of ADMINISTRATION |
|
|
SIDE EFFECTS |
|
|
CONTRAINDICATIONS & CAUTIONS |
| |
|
|
NURSING CONSIDERATIONS for OTHER ANTINEOPLASTICS | ||
ASSESSMENT & MONITORING | Assessment
Administration
Monitoring
| |
CLIENT EDUCATION |
|
Antineoplastic agents are medications used to treat cancer. Except for the usual antineoplastics, there are other medications that can be also used to treat various forms of cancer, particularly acute lymphoblastic leukemia or ALL, ovarian cancer, and cutaneous T-cell lymphoma.
Other antineoplastics that are commonly used include asparaginase, and pegaspargase, which are given intramuscularly or intravenously to treat acute lymphoblastic leukemia, as well as altretamine, which is taken orally to treat ovarian cancer. Then there’s azacitidine, a medication that can be administered orally, intravenously or subcutaneously to treat myelodysplastic syndrome or acute myeloid leukemia; hydroxyurea, which is administered orally in clients with chronic myeloid leukemia or head and neck cancer; and irinotecan, which is administered intravenously to clients with metastatic colorectal cancer.
Once administered, what asparaginase and Pegaspargase do is break down asparagine, which is a non-essential amino acid, into aspartic acid and ammonia. Cancer cells can’t synthesize asparagine themselves, so this impairs their protein synthesis, ultimately stopping cellular processes and causing apoptosis.
On the other hand, the way altretamine works is not perfectly clear, but it could damage cancer cells by crosslinking of DNA, which means the agent links two DNA bases together, forming cross-bridges. Cross-linking prevents DNA from being separated for essential cell processes, like replication or transcription, eventually resulting in cancer cell death and stopping the multiplication of cancer cells.
Next, azacitidine causes damage to double stranded DNA during cell replication, while hydroxyurea and irinotecan inhibit enzymes involved in DNA synthesis, ultimately stopping cancer cell division. Irinotecan in particular belongs to a group of medications called topoisomerase I inhibitors, so it inhibits this enzyme to eventually cause double stranded DNA breaks and halt cell replication.
Copyright © 2024 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.