Antineoplastic agents are drugs used for the treatment of cancer, malignancy, tumour, carcinoma, sarcoma, leukaemia, or neoplasm (Greek neo = new, Plasm = formation).
Antineoplastic Agents
INTRODUCTION
Antineoplastic
agents are drugs used for the treatment of cancer, malignancy, tumour,
carcinoma, sarcoma, leukaemia, or neoplasm (Greek neo = new, Plasm =
formation). Neoplasm refers to a group of diseases caused by several agents, namely,
chemical compounds and radiant energy. Cancer is characterized by an abnormal
and uncontrolled, division of cells, which produces tumours and invades
adjacent normal tissues. Often, cancer cells separate themselves from the
primary tumour, and are carried by the lymphatic system to reach distant sites
of the organs, where they divide and form secondary tumours (metastasis).
Two key
aspects of cellular life are the following:
1.
DNA
synthesis and mitosis to produce new cells.
2.
Cell differentiation
that produces specialized cells.
·Cancer cells very rapidly develop resistance to
antineoplastic drugs.
·Differences between normal and neoplastic human
cells are merely quantitative.
·Biochemical and morphological differences
between normal and neoplastic cells are slight; therefore, antineoplastic
agents are devoid of selective toxicity to tumour cells.
·Antineoplastic agents kill cells by first-order
kinetics, that is, they kill a constant fraction of cells.
However,
some of the cancer cells elude killing and one of these cells may restablize
the tumour. It is extremely difficult to kill all the malignant cells.
·Most antineoplastic drugs are highly toxic to
the patients.
The
prominent adverse effects of antineoplastic drugs are exerted on rapidly
proliferating normal tissues, in addition, to their chronic and cumulative
toxicities.
·Bone marrow toxicity: Bleomycin, L-asparaginase.
·Hair follicle toxicity: Methotrexate,
Vincristine, Cyclophosphamide, and Doxoroubicin.
·Hepatotoxicity: Azathiopurine, Mercaptopurine,
and L-asparaginase.
·Skin rashes: Vinca alkaloids, Nitrosourea,
Anthracyclins, and Mitomycin C.
·Pulmonary toxicity: Bleomycin, Methotrexate, and
Busulfan.
·Cardiac toxicity: Doxorubicin, Daunorubicin, and
Anthracyclins.
·Other toxicities: Intestinal epithelium, central
nervous system (CNS) toxicity, nephrotoxicity, immunosuppression, fever,
anaphylaxis, cataracts, haemolytic anaemia, pancreatitis, pituitary
insufficiency, adrenal insufficiency, coagulation problems, suppression of
growth, and carcinogenicity.
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