ANTINEOPLASTIC DRUGS
Antineoplastic agents are a group of specialized drugs used primarily to treat cancer (the term "neoplastic" refers to cancer cells). The first antineoplastic agents, used in the 1940s, were made from either synthetic chemicals or natural plants. Antineoplastic agents are classified by origin and by how they work to destroy cancer cells. There are over fifty of these agents approved by the Food and Drug Administration (FDA) to be used in the United States. These include: methotrexate, 5-fluo-rouracil (fluorouracil), doxorubicin, paclitaxel and c
yclosphosphamide.
Antineoplastic agents can be administered to patients alone or in combination with other antineoplastic drugs. They can also be given before, during or after a patient receives surgery or radiation therapy. The treatment plan is disease-specific. It is important that patients receive treatment on schedule.
Antineoplastic agents travel the body and destroy cancer cells. Side effects are expected to occur when treated with these agents, and can include nausea, mouth sores, hair loss, and lowering of the blood counts. Many of the side effects associated with antineoplastic agents occur because chemotherapy treatment destroys the body's normal cells in addition to cancerous cells. Healthcare providers should be able to assist patients in managing these side effects so that antineoplastic therapy is a tolerable treatment.

INDICATIONS

Acute lymphoblastic leukemia (ALL), is a form of leukemia, or cancer of thewhitebloodcells characterized by excess lymphoblasts. Malignant, immature white blood cells continuously multiply and are overproduced in the bone marrow. ALL causes damage and death by crowding out normal cells in the bone marrow, and by spreading (metastasizing) to other organs. ALL is most common in childhood with a peak incidence at 4–12 years of age, and another peak in old age. The overall cure rate in children is 85%, and about 50% of adults have long-term disease-free survival. 'Acute' refers to the undifferentiated, immature state of the circulating lymphocytes ("blasts"), and to the rapid progression of disease, which can be fatal in weeks to months if left untreated.

Hodgkin's lymphoma, also known as Hodgkin's disease, is a type of lymphoma ( cancer originating from a type of white blood cells called lymphocytes). It was named after Thomas Hodgkin, who first described abnormalities in the lymph system in 1832. Hodgkin's lymphoma is characterized by the orderly spread of disease from one lymph node group to another, and by the development of systematic syndrome with advanced disease. The disease is characterized by the presence of Reed-Stern-berg (RS cells) on microscopic examination. Hodgkin's lymphoma was one of the first cancers which could be treated using radiation therapy and, later, it was one of the first to be treated by combination chemotherapy.

Multiple myeloma also known as myeloma, plasma cell myeloma, or as Kahler's disease is a cancer of the white blood cells known as plasma cells, which produce antibodies.These plasma cells, or B cells, are part of the immune system, formed in bone marrow, and numerous in lymphatics. Myeloma is incurable, but remissions may be induced with steroids, chemptherapy, thalidomide and stem cells transplants. Myeloma is part of the broad group of diseases called hematological malignancies.


Colorectal cancer, also called colon cancer or large bowel cancer, includes cancerous growths in thecolon, rectum and appendix. With 655,000 deaths worldwide per year, it is the third most common form of cancer and the third leading cause of cancer-related death in the Western world. Many colorectal cancers are thought to arise from adenomatous polyps in the colon. These mushroom-shaped growths are usually benign, but some may develop into cancer over time. The majority of the time, the diagnosis of localized colon cancer is through colonoscopy. Therapy is usually through surgery, which in many cases is followed by chemotherapy.
Local symptoms are more likely if the tumor is located closer to the anus. There may be a change in bowel habit and a feeling of incomplete defecation (tenesmus) and reduction in diameter of stool. Lower gastrointestinal bleeding, including the passage of bright red blood in the stool. Constitutional symptoms may include iron deficiency anemia, fatigue, palpitions and pallor (pale appearance of the skin). Colorectal cancer may also lead to weight loss, More unusual constitutational symptoms are an unexplained fever and one of several paraneoplastic syndrome. The most common paraneoplastic syndrome is thrombosis, usually deep vein thrombosis.

Melanoma is a
malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye. It is one of the less common types of skin cancer but causes the majority (75%) of skin cancer related deaths. Melanocytes are normally present in skin, being responsible for the production of the dark pigment melanin. Despite many years of intensive laboratory and clinical research, the greatest chance of cure is in the early surgical resection of thin tumours.

DRUGS
1. Doxorubicin HCl
Brand names: Adrim®, Axibin®,Adriblastina®
Specific Class: Cytotoxic Chemotherapy
Common Side Effects: vomiting, fever, nausea, myelosuppresion, stomatitis, alopecia,
Available Dosage Forms: Vial, Tablet
Contraindications:
Patients who have marked myelosuppression induced by previous chemotherapy or radiotherapy & those who have already received cumulative doses of anthracyclines, preexisting heart disease.
Pregnancy Category: Category D

2. Vincristine Sulfate
Brand names: Alcavixin®, Vinsulgen
Specific Class:Cytotoxic Chemotherapy
Common Side Effects: Constipation, hair loss, nausea, vomiting, muscle weakness
Available Dosage Forms: Vial
Contraindications: Demyelinating form of Charcot-Marie-Tooth syndrome. Pregnancy & lactation. Intrathecal administration. Radiation therapy through ports that include the liver.
Pregnancy Category: Category D
3. Dacarbazine
Brand Names: DTIC-Dome, Duticin,
Specific Class: Cytotoxic Chemotherapy
Side effect: Facial flushing, numbness or tingling; loss of appetite; metallic taste in mouth; muscle pain or weakness; nausea; temporary hair loss; vomiting.
Available Dosage Form: vial, powder
Contraindications: pregnancy, lactation
Pregnancy Category: Category C

4. Melphalan
Brand Names: Alkeran
Specific Class: Cytotoxic Chemotherapy
Side effects: Diarrhea; hair loss, mild GI effects, maculopapular rashes, severe allergic reactions
Available Dosage Form: tablet
Containdication: History of hpersensitivity to melphalan, history of resistance prior to therapy with melphalan, renal failure.
Pregnancy Category: Category D

5. Busulfan
Brand Names: Busulfex, Myleran
Specific class: cytotoxic chemotherapy
Side effects: Anxiety; asthma; back pain; blood clots; change in menstrual cycle; chest pain; confusion; constipation;
Dosage Form: tablet
Contraindications: patients with chronic myelogenous leukemia whose disease was resitant to prior therapy with the drug.
Preg cat.: D

6. Cyclophosphamide
Brand Names: Ledoxan®, Cytoxan, Xyclomed
Specific class: Cytotoxic Chemotherapy
Dosage Form: tablet, vial
Side effects: Appetite loss; absence of menstrual periods; color change in skin; diarrhea; general unwell feeling; hair loss; nausea; skin rash; stomach discomfort or pain; texture change in nails; vomiting; weakness.
Contraindications: Severe bone marrow depression. Pregnancy, lactation
Pregnancy Category:Category D:

7. Tamoxifen Citrate
Brand Names: Fenahex, Cytrolic, Gynatam
Specific Class: Hormonal Chemotherapy
Side effects: hot flushes, vaginal discharge, vaginal bleeding, menstrual period irregularities, skin rash
Available dosage form: film coated tablet, tablet
Contraindications: Pregnancy, Hypercalcemia, hypersensitivity to tamoxifen,
Pregnanct Category: Category D

8.Cytarabine
Brand Names: Cytosar-U, Cytox, Leucyt
Specific Class: Cytotoxic Chemotherapy
Side effects: anemia, Nausea, Bone pain, Myalgia, bleeding
Available Dosage Form: vial
Contraindications: Hypersensitivity, Pregnancy, Lactation
Pregnancy Category: Category D


Group Members:
Gapoleo, Deborah
Ordinario, Minerva
Palay, Eloisa

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