CHAPTER 21 Chemotherapy Drugs
Quiz Yourself
1. The physician must determine the type ofcancer and the stage of the cancer before
beginning treatment.
2. Neoplasm: Anew growth of cells that maybe malignant or benign.
Stage: The extent of cancer progression.
Adjuvant therapy: Chemotherapy (or radiationtherapy) given to cancer patients after
they have had surgery to remove a tumor.The purpose is to eradicate any remainingtumor cells.
Remission: The period of time when cancerouscells stop actively reproducing.
Analog: Adrug that is created by slightlymodifying the molecular structure of another substance.
Mitosis: The process of cell division.
Chemotherapy protocol: A combination ofseveral chemotherapy drugs and other
types of drugs that have been found to besuccessful in treating a particular type ofcancer. A protocol maximizes the effectivenessof therapy through the actions ofthe various drugs, but minimizes the sideeffects that would occur with a large doseof a single drug.
Leucovorin rescue: Administration of thedrug leucovorin to counteract the toxic
effects of methotrexate chemotherapy.
3. The word cancer is a Latin word meaningcrab, because cancer metastasizes or spreads
outward from the original site like the legsof a crab.
4. Purine analog chemotherapy drugs andpyrimidine analog chemotherapy drugs
are both examples of analogs or drugsthat are created by slightly modifying the
molecular structure of another substance(in this case purine or pyrimidine). Both
drugs are used to treat different types ofcancer and both keep DNA from being
produced so the cancer cell cannot divide.They are different because purine analog
chemotherapy drugs take the place ofthe purine base structure in the DNA,
whilepyrimidine analog drugs take theplace of the pyrimidine base structure in
the DNA.
5. The molecular structure of methotrexate isvery similar to the structure of the B vitaminfolic acid.
6. During the 1940s, researchers who werereviewing medical records from World War I
noticed that Allied soldiers who wereexposed to the chemical weapon nitrogen
mustard gas had a decreased level ofWBCs. It was thought that this adverse
effect could be used as a therapeutic effectin patients with leukemia whose WBC
counts were abnormally elevated. Nitrogenmustard (the drug mechlorethamine)
and its derivative drugs are still used totreat leukemia today.
7. Chemotherapy antibiotic drugs are notinterchangeable with regular antibiotic
drugs. Regular antibiotic drugs are used totreat infection act on the cell walls of bacteria.Human cells, which do not have a cellwall (they only have a cell membrane), arenot affected by antibiotic drugs. However,unlike regular antibiotic drugs, chemotherapyantibiotic drugs do affect human cells(and cancer cells).
8. The growth of breast cancer is influencedand promoted by female hormone levels.
Hormonal chemotherapy drugs changethe favorable hormonal environment by
supplying the opposite hormone, malehormone.
9. Cisplatin was the first of the platinumchemotherapy drugs. It was discovered
when a researcher at Michigan State Universitywas studying whether bacteria
could multiply in an electrical field. Heplaced platinum electrodes that would conductelectricity into a solution of bacteria.
When the electrical field was turned on, thebacteria did not multiply, but they also didnot multiply when the electrical field wasturned off. He found that it was the platinumin the electrodes that was toxic to the bacteria.This ability to stop a cell from dividingwas later applied to the treatment of cancer.
10. Chemotherapy enzyme drugs are enzymesthat break down the amino acid asparagine.Human cells can synthesize their ownsupply of asparagine, and so asparagineis not one of the eight essential aminoacids that the body needs to produce protein.Leukemia cells, however, cannot synthesizetheir own asparagine. By breakingdown asparagine, the cancer cell cannotuse it to build protein and cannot divide.
11. Raloxifene (Evista) and tamoxifen (Soltamox).
12. Retinoid chemotherapy drugs are structurallyrelated to vitamin A(retinoic acid).
Normally vitamin A regulates cell differentiationand growth, particularly in the
skin. Retinoid chemotherapy drugs bindto vitamin Areceptors on cancer cells and
help them become more normal in theircell differentiation and growth.
13. Interleukins are proteins that are secretedby white blood cells and act as a signal
when they encounter bacteria or antigensto tell the immune system to produce more
white blood cells to combat the infection orinflammation.
14. Chemotherapy drugs cause nausea andvomiting because they affect the rapidly
dividing cells in the mucous membrane ofthe GI tract, causing irritation. These drugs
also directly stimulate the vomiting centerin the brain. In addition, some chemotherapydrugs cause the release of serotonin in
the small intestine, which stimulates thevomiting reflex.
15. Doxorubicin is particularly toxic to theheart. Ifosfamide is particularly toxic to the
bladder. Cisplatin is particularly toxic tothe kidneys.
16. a. Chemotherapy enzyme drug
b. Retinoid chemotherapy drug
c. Chemotherapy antibiotic drug
d. Alkylating chemotherapy drug
e. Nitrogen mustard chemotherapy drug
f. Platinum chemotherapy drug
g. Nitrogen mustard chemotherapy drug
h. Chemotherapy antibiotic drug
i. Aromatase inhibitor hormonal chemotherapydrug
j. Granulocyte colony-stimulating factordrug
k. Purine analog chemotherapy drug
l. Pyrimidine analog chemotherapy drug
m. Monoclonal antibody drug
n. Gonadotropin-releasing hormone chemotherapydrug
o. Protein-tyrosine kinase inhibitor chemotherapydrug
p. Topoisomerase inhibitor chemotherapydrug
q. Epidermal growth factor receptor inhibitorchemotherapy drug
r. Nitrosurea chemotherapy drug
s. Folic acid blocker chemotherapy drug
t. Estrogen hormonal chemotherapy drug
u. Antiestrogen hormonal chemotherapydrug
v. Podophyllotoxin chemotherapy drug
w. Immunomodulator chemotherapy drug
x. Topoisomerase inhibitor chemotherapydrug
y. Monoclonal antibody drug
z. Chemotherapy antibiotic drug
aa. Vinca alkaloid chemotherapy drug
Clinical Applications Questions
1. a. paclitaxel
b. Taxol
c. taxane chemotherapy drugs
d. It allows the microtubules to form, butthe microtubules do not function properly,
and the cancer cell cannot divide.
e. It is a liquid drug contained in a vial thatmust be withdrawn with a syringe. The
printing says “Intravenous.”
f. The original natural source was extractof the bark of the Pacific yew tree. Now,
it is derived from the needles of Europeanand Himalayan yews.
g. [Only need to name three.]Daunorubicinand doxorubicin originally were extractedfrom a fungus-like bacterium found in soilnear an ancient castle in Italy. Podophyllotoxinchemotherapy drugs were createdfrom a toxin found in the fleshy rootof the Mayapple. Vinca alkaloid chemotherapydrugs were extracted from theMadagascar rosy periwinkle plant. Platinumchemotherapy drugs contain theprecious metal platinum.
2. doxorubicin (Adriamycin)
3. a. Epogen
b. epoetinalfa
c. in units/mL
d. It is used to stimulate red blood cell productionto treat anemia caused by the
cancer itself or by the treatment of chemotherapydrugs or radiation therapy.
4. a. Zometa
b. zoledronic acid
c. 4mg/5mL
d. Intravenous infusion
e. It is used to decrease elevated calcium levelscaused by cancer and bony metastases.
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