ANTI-NEOPLASTIC AGENTS

Anti-neoplastic agents are fairly unique in that the majority of these solutions may harm not only the patient when given incorrectly, but the provider as well. They require a great deal of caution when they are in use. Most of these medications when they are mixed require the use of a level II biohazard chamber. Additionally, protective gloves must be replaced every 30 minutes when transporting with these agents.

ALKYLATING

Mechanism: Causes cross-linking of DNA strands which effectively halts cellular mitosis. Alkylating agents are cell cycle phase nonspecific.86

Indications: Lymphoma, Brain cancer, Leukemia, Tumors, etc.

Examples: Busulfan, Carboplatin, Carmustine, Ifosfamide, Melphalon, Thiotepa

Side effects: Nausea and vomiting, Hyperuricemia, Tinnitus

ANTI-METABOLITES

Mechanism: Inhibits DNA synthesis by replacing proteins that are necessary for replication. Anti-metabolites are cell cycle phase specific.

Indications: Hairy cell leukemia, GI adenocarcinoma, Colon, Rectal, Breast, Stomach, and/or pancreatic cancer, melanomas, etc.

Examples: Clodribine, Floxuridine, Flourouracil, Mercaptopurine, Thioguanine

Side effects: Alopecia, Stomatitis, Diarrhea, Hyperuricemia

ANTI-TUMOR ANTIBIOTICS

Mechanism: Non-specific cell cycle phase agent which inhibits DNA synthesis.

Indications: Various forms of cancers

Examples: Bleomycin, Dactinomycin, Doxorubicin, Mitomycin, Pentostatin

Side effects: Alopecia, Stomatitis, Phlebitis, CHF, Cardiomyopathy

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HORMONAL AGENTS

Mechanism: Disrupts the normal effects of hormones in the host that is afflicted with hormone sensitive tumors.

Indications: Various forms of cancers

Examples: Aminoglutethimide, Diethylstilbestrol, Megastrol, Mitotane, Prednisone

Side effects: Edema, Impotence, Hypercalcemia

VINCA ALKALOIDS

Mechanism: Inhibits cellular replication by disrupting DNA synthesis. These agents are cell cycle specific.

Indications: Various forms of cancer

Examples: Asparaginase, Etoposide, Paclitaxel, Vindosine

Side effects: Peripheral neuropathy, Anorexia, Constipation, Bradycardia

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COMMONLY TRANSPORTED ANTI-NEOPLASTIC PHARMACOLOGIC AGENTS

This section is left blank for the services medical director or training officer to review those agents which are commonly used for transport. Topics which should be covered include dosages, indications, side effects, and any transport considerations.

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