University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

292

Pages:

1
Author:

gewoekerdodx

2.5 – “Me taxane taxane,, You Christine Christine”: ”: Microtubu Microtubule le inhibitors • The taxols and the vinca alkaloids are all plant derived (yew and Vinca rosea, or periwinkle, respectively) and used in the treatment of cancer (forest setting; crab dinner). • Vinca alkaloids o bind β-tubulin, inhibiting polymerization into microtubules (woman – Cristine – is caught up in vines that look like metaphase spindles; the vines are breaking). This prevents mitotic spindle formation and results in M-phase arrest (monkey is swinging on vine, forming M shape). o Vincristine ▪ treats ALL, multiple myeloma, Hodgkin & non-Hodgkin lymphoma, and some pediatric tumors (Cristine). ▪ Toxicities: • Neurotoxicity, presenting with areflexia, peripheral neuritis and sensory neuropathy in a stocking glove pattern (Cristine is wearing stockings and gloves). Results d/t inhibition of axonal transport in the nerves. • Constipation and paralytic ileus (monkey with a plunger sitting on the outhouse) • Alopecia (bald monkey) o Vinblastine ▪ treat lymphomas and solid tumors (hunter blasting away with his gun). ▪ Toxicities • Myelosuppression (bones at the hunter’s feet). Note that this is not a side effect of vincristine. • Alopecia • Taxanes o hyper-stabilize β-tubulin in polymerized microtubules, arresting cells at the metaphase/anaphase transition (Tarzan is stabilized by a monkey holding his vine). o Used in breast and ovarian carcinomas, other solid tumors, small cell & non-small cell lung carcinomas. Are also a component of drug-eluting stents to prevent neointimal hyperplasia. o Toxicities: ▪ Hypersensitivity reactions are extremely common, in as many as 30% of patients. Can treat prophylactically with steroids, antihistamines. ▪ Alopecia ▪ Neurotoxicity, often presenting with burning paresthesias on extremities (Tarzan is holding Cristine’s glove) ▪ myelosuppression