Cancer Chemotherapy And Drugs

1
Cancer Chemotherapy And Drugs In Pediatric
Oncology Practice
NTP - PPO, PHO, IAP. SS C - 12 Slides
2
Anticancer Drugs - Classification

• Alkylating Agents
• Other Agents With Alkylator Activity
• Antimetabolites
• Antitumour Antibiotics
• Plant Alkaloids
• Others Agents

NTP - PPO, PHO, IAP. SS C 2/12
3
Routes Of Administration

• Oral
• Intravenous
• Intrathecal
• Subcutaneous
• Intramuscular

NTP - PPO, PHO, IAP. SS C 3/12
4
Chemotherapy - Some Facts

• Pulsed Chemotherapy
• Damage To Cancer Cells, Normal Cells,
• Most Senstive Normal Cells
• Bone Marrow Function Assessment
• Blood Counts - Induction Period.

NTP - PPO, PHO, IAP. SS C 4/12
5
Anticancer Drugs Side Effects
Drug Toxicity Asparaginase Hypersensitivity
, N V Cyclophosphamide BM, N V,
A, Hemorrhagic Cystitis Cytosar BM, M, N
V, D Doxorubicin BM, N V, A, M, V 6 MP
(Purinethol) BM Methotrexate BM, M,
Renal (High Dose) Vincristine N,
Constipation, V, Jaw Pain
NTP - PPO, PHO, IAP. SS C 5/12
6
Long Term Side Effects
Cyclophosphamide Sterility Ifosphamide H.Cystit
is Doxo, Daunorubicin Cardiomyopathy Bleomycin
Pulmonary Fibrosis
NTP - PPO, PHO, IAP. SS C 6/12
7
Febrile Neutropenia- Treatment
Blood and Urine Cultures Gentamicin Ampicillin
IV 48 Hours Ciprofloxacin Amikacin IV 48
Hours Amphotericin B ? Flucytosine IV
or Fluconazole
NTP - PPO, PHO, IAP. SS C 7/12
8
Antiemetics
Emetogenicity Antiemetics Low None
Or Metaclopramide Moderate Dexamethasone
Metaclopramide High Ondansetron ?
Dexametasone Anticipatory Nausea And
Vomiting
NTP - PPO, PHO, IAP. SS C 8/12
9
Administration Of Cytotoxic Drugs

• Guide Lines
• Complete blood count
• Butterfly needle
• Metacarpal veins
• Vein-firm, straight, unused
• Vein-tested before flushed after
• Vesicants first

NTP - PPO, PHO, IAP. SS C 9/12
10
Other Drugs In Ped. Oncology Practice
Allopurinol Folinic Acid Antifungal
Interferons Acyclovir Corticosteroid Cotri
moxazole Analgesics Colony Stimulating Factors

NTP - PPO, PHO, IAP. SS C 10/12
11
Management Of Pain
Relieve the Pain to the Patients
Satisfaction Three Step Analgesic Ladder of
W.H.O. Step I Step II Step III Paracetamol
Para Dextro Pentazocine q.4.h propoxyphene
Morphine
NTP - PPO, PHO, IAP. SS C 11/12
12
Cell Cycle
Bleomycin, Etoposide, Teniposide
G2
Resting Cells
M
VCR VBL
G0
S
6 MP, MTX cytosar, hydroxyurea procarb, 6 TG
Refactory to Chemo
G1 L. apsara
NTP - PPO, PHO, IAP. SS C 12/12