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What are antineoplastic drugs? –

Antineoplastic drugs are medications used to treat cancer. Other names for antineoplastic drugs are anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs. These drugs come in many forms, including liquids or pills.

What is the difference between cytotoxic and antineoplastic drugs?

Journal List Daru v.23(1); 2015 PMC4337101

As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more about our disclaimer. We would like to draw the attention of the readers to the inappropriate use of term “cytotoxic” as a substitute for “antineoplastic”.

1. This can be noticed in numerous scientific articles, especially those reporting the anticancer properties of certain chemical compounds.
2. For example, there are published studies reporting the anticancer activity of certain drugs/chemicals and the authors have assessed the anticancer activities of some novel drugs against certain target cancers.

These investigations have repeatedly involved the term “cytotoxic” instead of “antineoplastic”. For instance, recently a report has been published in DARU by Vosough et al. about the anticancer activities of some compounds. In this study, the derivatives of nonsteroidal aromatase inhibitors (triazole analogues) have been synthesized.

• Then, the newly synthesized derivatives were assessed for anticancer activity against breast cancer cell lines and the results showed that these newly synthesized compounds possess potent cytotoxic activity.
• Similarly, there are numerous other research reports published either in DARU or elsewhere.
• These authors also have reported the anticancer activities of different compounds against various cancer cell lines,

Nonetheless, these authors have assessed the cytotoxicity as a measure of anti-neoplastic potential of certain drugs, but, reporting the effect as “cytotoxic” instead of either “anticancer” or “antineoplastic” might reduce the interest of readers. Literally cytotoxic refers to “toxic to living cells” while, antineoplastic means inhibiting or preventing the development and spread of neoplasms.

1. For drugs that control or kill only neoplastic cells, the proper term that could describe this inherent activity of drugs is known as antineoplastic or anticancer activity.
2. Moreover, the physiology of a normal cell is entirely dissimilar to that of cancerous cells or neoplasms, having an excessive quantity of free radicals and subsequent oxidative stress,

Cytotoxicity is a general term used in toxicological studies describing the effect of particular toxins on cell viability, In that respect, there are many compounds that are cytotoxic but not antineoplastic, About anticancer drugs, data can be gathered using cytotoxicity test methods, but that necessarily be described as the antineoplastic or anticancer activity of that particular drug or agent, rather than stating cytotoxicity of anticancer drugs.

1. Because the term cytotoxicity is an umbrella term involving also other toxins which reduce normal cell viability.
2. In simpler words, we may say that a drug with antineoplastic activity possess cytotoxicity.
3. But any cytotoxic agent does not necessarily possess antineoplastic characteristics.
4. At the end, we are of the opinion that great care must be exercised while using the term cytotoxicity as an alternative to antineoplastic activity, particularly mentioning the activity of anticancer agents.

Also, the National Library of Medicine–Medical Subject Headings (MeSH) http://www.nlm.nih.gov/mesh/MBrowser.html does not suggest the term cytotoxic as a substitute for antineoplastic, but the opposite could easily be seen. Furthermore, MeSH is a very comprehensive controlled scientific terminology helping in proper indexing of the scientific article and books.

What are the effects of antineoplastic agents?

Overview – The adverse health effects associated with antineoplastic agents (cancer chemotherapy drugs, cytotoxic drugs) in cancer patients and some non-cancer patients treated with these drugs are well documented. The very nature of antineoplastic agents make them harmful to healthy cells and tissues as well as the cancerous cells.

For cancer patients with a life-threatening disease, there is certainly a great benefit to treatment with these agents. However, for the health care workers who are exposed to antineoplastic agents as part of their work practice, precautions should be taken to eliminate or reduce exposure as much as possible.

Pharmacists who prepare these drugs or nurses who may prepare and/or administer them are the two occupational groups who have the highest potential exposure to antineoplastic agents. Additionally, physicians and operating room personnel may also be exposed through the treatment of patients.

• Hospital staff, such as shipping and receiving personnel, custodial workers, laundry workers and waste handlers, all have potential exposure to these drugs during the course of their work.
• The increased use of antineoplastic agents in veterinary oncology also puts these workers at risk for exposure to these drugs.

In addition to acute or short-term effects related to treatment with antineoplastic agents, there are a number of long-term or chronic effects that have been identified in patients. These include liver and kidney damage, damage to the bone marrow, damage to the lungs and heart, infertility (temporary and permanent), effects on reproduction and the developing fetus in pregnant women, hearing impairment and cancer.

The International Agency for Research on Cancer external icon (IARC) in Lyon, France has identified a number of antineoplastic agents and two combination therapies as having an association with cancer in patients who are treated with them. These include both cancer and non-cancer patients. IARC currently lists eleven agents and two combined therapies as Group 1 (Human carcinogens), twelve as Group 2A (Probable human carcinogens) and eleven as Group 2B (Possible human carcinogens).

A number of studies have documented environmental and worker exposure to the antineoplastic agents. A variety of biological endpoints have been used to evaluate worker exposure. These include, urine mutagenicity, chromosomal damage, sister chromatid exchange, micronuclei induction, DNA damage, HPRT mutations, and thioether excretion.

• Additionally, analytical methods have been used to document worker exposure to antineoplastic agents by measuring these drugs and/or their metabolites in the urine of health care workers.
• Similar analytical methods are currently being employed to measure the level of environmental contamination in the workplace.

Although the studies on air sampling are limited, there have been numerous studies published on environmental wipe sampling for these drugs. In September, 2004, The National Institute for Occupational Safety and Health (NIOSH) published an Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings, 2004 pdf icon (DHHS (NIOSH) Publication No.2004-165),

What are the most common side effects of antineoplastic agents?

Pharmacological Management of Side Effects of Cancer Treatments – The use of drug interventions to manage side effects of antineoplastic drugs is critical to the success of oncology care. Maintaining chemotherapy dosing and cycle timing as close to regimen specificity is ideal.

• In many cases the only way to manage the rigors of the prescribed antineoplastic therapies is with careful pharmacological interventions that improve an individual’s tolerance to cancer treatments and improve quality of life during cancer care.
• However, the use of additional drugs for managing the side effects of cancer treatment carries implications and risk for further drug interactions.

Many of the medications used to manage the most common toxicities of antineoplastic therapies further alter body functions and can perpetuate a decline in functioning. One of the most common side effects of many antineoplastic drugs therapies is nausea/vomiting (N/V).

The key to treating N/V is prevention and there have been many therapeutic solutions that have come about in recent years. Unfortunately, current pharmacological options introduce side effects such as headache and constipation. In addition, they often are co-prescribed with corticosteroids for maximum benefit which can potentiate further adverse effects.

At times medications used to treat side effects can be so effective that they cause an opposite reaction to occur. For example, a patient experiencing diarrhea may be prescribed multiple anti-diarrhea medications to prevent dehydration and electrolyte imbalance resulting in severe constipation.

• Another example is the management of insomnia.
• Anxiety and insomnia are common symptoms experienced during treatment for cancer as patients are facing not only their mortality, but the stress of multiple medical appointments, struggling with side effect and their impact on daily function, and concerns regarding financial implications of their cancer medical care.

Many patients are prescribed anti-depressants, specifically benzodiazepines and serotonin reuptake inhibitors (SSRIs). These drugs can have a sedative effect and impair cognition or exacerbate memory loss. Although these drugs are prescribed to help to improve an individual’s quality of life, they may further complicate the common side effect referred to as “Chemo-Brain”.

1. The Mayo Clinic describes Chemo-Brain as, “a common term used by cancer survivors to describe thinking and memory problems that can occur after cancer treatment.
2. Chemo brain can also be called chemo fog, chemotherapy-related cognitive impairment or cognitive dysfunction”.20 Individuals experiencing chemo-brain symptoms may also be taking medication for anxiety or insomnia which may worsen delays in thinking and judgement, and increase sedation, malaise, and depression which can negatively impact quality of life.

Additionally, both benzodiazepines and hypnotics, commonly used medications to manage insomnia, are identified as PIMs by the Beers criteria as they may present significant risk to older adults.13 Table 3 outlines many of the standard pharmacological strategies for side effect management and provides insight to their potential impact on function.13, 14, 16 The NCCN Medications of Concern are designated in Table 3 and should serve as reminder to providers to assess for the presence of these drugs, recognize their indication in cancer care, and monitor for their functional impact.

Are antineoplastic drugs hazardous?

Hazardous Drugs include agents that exhibit one or more of the following characteristics in humans or animals:

1. Carcinogenicity
2. Teratogenicity or other developmental toxicity
3. Reproductive toxicity
4. Organ toxicity at low doses
5. Genotoxicity

Hazardous drugs include antineoplastic agents which are used to treat cancer. Many of these antineoplastics bind to or damage DNA (for example alkylating agents), interfere with cell growth and proliferation, or interfere with DNA synthesis. In some cases, the non-selective actions of antineoplastic agents disrupt the growth and function of both healthy and diseased cells, resulting in toxic side effects for treated patients.

• These nonselective actions can also cause adverse effects in occupational settings when workers are inadvertently exposed to hazardous drugs.
• Hazardous drugs are used at the University in work environments such as healthcare, veterinary healthcare, laboratory research and animal research.
• Examples of some of the hazardous drugs that are used at UNC-Chapel Hill are listed below.

For a more complete list see the NIOSH List of Hazardous Drugs,

• Arsenic trioxide
• Etoposide
• Bortezomib
• Fluorouracil (5-FU)
• Carboplatin
• Gemcitabine
• Cisplatin
• Irinotecan
• Cyclophosphamide
• Paclitaxel (Taxol)
• Docetaxel
• Streptozocin
• Doxorubicin
• Tamoxifen

The use of hazardous drugs should follow specific policies and procedures based on your work environment. Workers should be trained to recognize and understand the risks associated with hazardous drugs and be provided with proper engineering controls and personal protective equipment (PPE).

Is antineoplastic the same as chemotherapy?

Overview – Antineoplastic drugs, also known as chemotherapy, cytotoxic and oncology drugs, are used to treat cancer, as well as arthritis, multiple sclerosis, and other non-cancer medical conditions. Most antineoplastic drugs are classified by NIOSH as hazardous drugs,1 About 8 million U.S.

Leukemia Other cancers Adverse reproductive outcomes Chromosomal damage

Guidelines on the safe handling of antineoplastic drugs have been available for many years.3-6 This study was conducted to assess adherence to exposure controls and best practices in these guidelines. The antineoplastic drug administration survey module was mostly completed by oncology nurses, oncology/hematology nurses, and infusion nurses.

Can antineoplastic cause depression?

If you’re dealing with cancer, there are many reasons why you might be depressed. But cancer treatments like chemotherapy can also be a driving force behind your mood change. And depression can curtail your well-being in many ways. “Depression can get in the way of compliance with treatment,” says Susan Hedlund, LCSW, director of oncology patient and family services at the Oregon Health and Sciences University (OHSU) Knight Cancer Institute in Portland.

What is a contraindication of antineoplastic medications?

Indications – Alkylating agents are indicated for the following medical conditions:

Treatment of slow-growing cancers, like lymphomas, leukemias, myelomas, some ovarian, testicular, and breast cancers, and pancreatic cancers.

Here are some important aspects to remember for indication of antineoplastics in different age groups: Children

Treatment of pediatric cancers follow developed antineoplastic protocols and combination therapy is stressed to eliminate as many of the mutant cells as possible. Checking the dosage for children is crucial because of possible drug toxicity. In addition, the nutritional needs and hydration status of children should be included in the considerations for formulating a care plan. Even under therapy, children must be allowed to explore and learn like any other children. They would need extra support and comfort as body image problems, lack of energy, and risk for infection can isolate them. Lastly, bone marrow activity should be monitored carefully and dose should be adjusted carefully.

Adults

Adults are also challenged with changes in body image and activities that come with chemotherapy. It is usual for this age group to fear the diagnosis too. Therefore, establishing a good support system is important. Antineoplastic agents are contraindicated to pregnant and nursing women. Education, support, and referrals to appropriate specialists are important. Women of childbearing age should use barrier contraceptives when these drugs are being taken.

Older adults

Older patients are more susceptible to GI and CNS adverse effects of antineoplastic therapy, particularly those with hepatic and renal dysfunctions. Precautions are used accordingly. Protection from infection and injury should be the focus of nurses.

What causes antineoplastic?

Definition – Antineoplastic resistance, synonymous with chemotherapy resistance, is the ability of cancer cells to survive and grow despite different anti-cancer therapies, i.e. their multiple drug resistance, There are two general causes of antineoplastic therapy failure: Inherent resistance, such as genetic characteristics, giving cancer cells their resistance from the beginning, which is rooted in the concept of cancer cell heterogeneity and acquired resistance after drug exposure.

Do antineoplastic drugs directly damage cells?

An antineoplastic agent is a chemotherapeutic agent that controls or kills cancer cells. Antineoplastic drugs are cytotoxic (inhibit or prevent cell function) but generally more damaging to dividing cells than resting cells. Antineoplastic drugs are a subset of hazardous drugs.

A hazardous drug is identified by one of the following criteria: carcinogenicity; teratogenicity or developmental toxicity; reproductive toxicity in humans; organ toxicity at low doses in humans or animals; genotoxicity; or new drugs that mimic existing hazardous drugs in structure or toxicity. Occupational exposure to antineoplastic agents in healthcare settings can occur to several groups of workers ranging from the pharmacists and pharmacy technicians who prepare and measure the doses of medication that are to be administered to the patient and the physicians and nursing personnel who administer the drugs to patients, to housekeeping personnel who must dispose of drug contaminated waste, included discarded personal protective clothing.

Exposure to antineoplastic drugs can also occur to personnel responsible for maintaining and certifying biological safety cabinets used in the preparation and handling of these drugs. Another group of occupationally exposed workers can be found in the field of veterinary medicine.

How do you administer antineoplastic drugs?

Intravenous anti-cancer drug administration – © Cancer Institute NSW 2019 Intravenous anti-cancer drugs may be administered through a central venous access device (CVAD) or peripheral cannula. Administration may be via bolus injection, intermittent or continuous infusion as determined by the treatment protocol.

Before commencing anti-cancer therapy, the patient’s venous access requirements should be assessed according to the requirements of the treatment protocol, the patient’s peripheral vasculature, lymphoedema history or risk and personal preference. Throughout all anti-cancer drug administration, the patient should be monitored for signs and symptoms of hypersensitivity reactions.

It is important to:

• Check all syringes and infusion bags before use for any leakage, unexpected cloudiness or signs of precipitation or contamination
  • Some preparations may require gentle agitation to mix prior to administration to ensure an even dispersion of drug in the diluent, as medication can settle on storage.
• Use closed-system intravenous administration sets with luer lock fittings for administration of anti-cancer therapy

Which of the following neoplastic diseases is almost curable by chemotherapy?

The malignancies closely linked to VDJ and SHM, ALL, DLBCL, Hodgkin’s disease and Burkitt’s lymphoma are routinely curable with chemotherapy. However in contrast in malignancies arising distant from these genetic events; CLL, mantle cell lymphoma and multiple myeloma are not chemotherapy curable.

What is the difference between cytotoxic and chemotherapy?

What is chemotherapy? Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells.

What is a cytotoxic person?

Summary – Cytotoxic substances damage or kill cells. Medications like chemotherapy are cytotoxic. The venom produced by some animals can be cytotoxic. Even some of the cells in your body are considered cytotoxic. People who have to handle cytotoxic substances need to be very careful.

Which drug is classified as an antineoplastic hormone?

Antineoplastic Agents, Hormonal

Drug	Target	Type
Leuprolide	Gonadotropin-releasing hormone receptor	target
Goserelin	Lutropin-choriogonadotropic hormone receptor	target
Goserelin	Gonadotropin-releasing hormone receptor	target
Octreotide	Myeloperoxidase	enzyme

What is a non antineoplastic drug?

Group 2: Nonantineoplastic drugs. This group includes drugs from multiple classes, such as immu- nosuppressants and antivirals. Examples of non- antineoplastic HDs are mycophenolate mofetil, tacrolimus, conjugated estrogens, and ganciclovir (NIOSH, 2016).

Is methotrexate an antineoplastic drug?

Methotrexate is an antineoplastic agent used the treatment of a wide variety of cancers as well as severe psoriasis, severe rheumatoid arthritis, and juvenile rheumatoid arthritis. Methotrexate is a folate derivative that inhibits several enzymes responsible for nucleotide synthesis.

Is tamoxifen an antineoplastic agent?

Clinical analysis of tamoxifen, an anti-neoplastic agent, in plasma.