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

2020
Views:

279

Pages:

1
Author:

Carissa Thomas

2.3 – “Dox “Doxorubicin’s orubicin’s Locker”: B Bleomycin, leomycin, anthrac anthracyclines, yclines, doxor doxorubicin ubicin • Certain antibiotics have anti-tumor activity so are used on cancer treatment (cancer crab). • Bleomycin o Uses iron & oxygen to induce free-radical formation → breaks in the DNA strands (bleomycin beluga is holding a rust-colored crab and breathing out bubbles which are breaking the double helix of kelp). Acts primarily during G2 phase (Galleon). o Used to treat testicular cancer & Hodgkin’s lymphoma. o Adverse effects ▪ Inactivated in the body by bleomycin hydroxylase. Tissues with lower production of this enzyme, notably lungs and skin, have more toxic effects. ▪ Pulmonary fibrosis, pneumonitis, pulmonary infiltrates (lung-shaped coral) ▪ Skin hyperpigmentation, classically in a striated pattern termed “flagellate erythema” (hyperpigmented stripes on beluga) ▪ GI adverse effects (sea urchin being eaten in the background) ▪ Myelosuppression, although less so than some other anti-cancer agents (bone shaped chest is sitting empty and has been cleaned out of treasure) ▪ Alopecia (whales are pretty bald) • Anthracyclines o Most commonly used doxorubicin & daunorubicin; less commonly, idarubicin, epirubicin, & mitoxantrone (Santa Anthracycline was apparently a pirate ship; chests of rubies remind of the -rubicin suffix). o Several mechanisms interfere with cancer growth: ▪ 1) generate free radicals in the presence of NADPH, oxygen, and iron (bubbles rising from the treasure chest). ▪ 2) Intercalate into DNA, causing breaks in the DNA, inhibiting with replication and transcription (rubies have become incorporated into the double-helices of the kelp near the chest). ▪ 3) Interfere with the action of topoisomerase II, preventing repair of DNA. Used in the treatment of both solid tumors and hematologic malignancies. o Toxicities: ▪ Cardiotoxicity, most often a dilated cardiomyopathy → SHF with ↓LVEF (this is rarely seen at low doses) (dilated heartshaped sacks sit next to the ruby chest). • Prevented with dexrazoxane, an iron chelating agent (skeleton on deck is holding a non-dilated heart sack, waving a rusted iron razor; “deck razor” sounds a bit like dexrazoxane) ▪ Myelosuppression (empty bone-shaped chest sits on the deck of the ship) ▪ Alopecia (skeletons don’t have hair) ▪ Mucositis and stomatitis • Actinomycin D/dactinomycin o Intercalates in DNA, blocking RNA synthesis (artifacts from the ship have intercalated into the kelp helices). o Often used to treat pediatric malignancies, including Wilms tumor, Ewing’s sarcoma, rhabdomyosarcoma (the child-sized doll is sitting off to one side). o Toxicities are the usual: myelosuppression & alopecia (creepy bald doll).