The conundrums of delivering chemotherapy care: tackling the educational challenges
Lorna Foyle, Janis Hostad, Nigel Sykes in Innovations in Cancer and Palliative Care Education, 2017
In many clinical areas, nurses have developed into skilled practitioners with excellent capabilities, while in others the acquisition of skills has been less rigorous. Nurses joining the specialty often have little or no skill in chemotherapy delivery, and their development is largely dependent upon the standards set in the environment in which they work (Kelly and Crowe, 2004). Yet chemotherapy administration is a complicated process that requires a constantly changing body of knowledge and presents a high risk to the patient (Kanaskie and Arnold, 1999). Cytotoxic agents are often highly toxic, as they are rarely, if ever, selective solely for cancer cells (Neal and Hoskin, 1994). At worst, incorrectly administered chemo-therapy can prove fatal, and there is a need for a nursing workforce that is able to respond to the increasingly complex nature of treatment administration in this field. Nursing has progressed rapidly and is at the forefront in ensuring that patients receive their treatment safely. This can only be achieved through the acquisition of specialist knowledge and skills and the development of competence. As the specialty develops, it is becoming more common to find nurse-led chemotherapy services. Increasingly, nurses are taking responsibility for the assessment of patient toxicities, organisation and management of the patient pathway, and the patient care needed for chemotherapy complications through the manning of 24-hour telephone advice lines.
Oncology
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
These drugs are classed as antineoplastics and are often referred to as cytotoxic agents since their use in cancer treatment is to destroy the abnormal cells. Hormonal therapy is employed to treat tumors that arise from hormonally mediated tissues such as the breast, prostate, and endometrium. Chemotherapeutic regimens of multiple agents are often used and are commonly referred to by abbreviations listed in Table 18.3 A number of adverse effects on various parts of the body are associated with the use of these antineoplastic drugs. Some of the terms frequently associated with these adverse effects are listed in Table 18.4
Hyperthermia and Hypoxic Cell Radiosensitizers in Combination
Leopold J. Anghileri, Jacques Robert in Hyperthermia In Cancer Treatment, 2019
Many nitro-heterocyclic compounds can act as potent anaerobic antibiotics,6 and therefore, it is perhaps not surprising that agents of this type have a marked differential toxicity towards hypoxic, relative to well-oxygenated, mammalian cells. This was first shown by Sutherland,7 who using an in vitro spheroid system, found that metronidazole preferentially kills those cells located towards the center of the spheroid. These inner, noncycling cells are considered to be hypoxic. The extent of hypoxic toxicity in vitro depends on drug concentration and contact time, and is sufficiently large to predict some direct cytotoxicity towards hypoxic tumor cells in vivo. In order to demonstrate this, misonidazole was administered to tumor-bearing mice after treatment with a radiation dose sufficient to sterilize the oxic tumor cells. Cytotoxicity has been observed in 7 out of 14 tumor types treated in this way, but the effect is small in comparison to giving the electron-affinic agent before radiation, which exploits the radiosensitizing properties of these drugs.
Biomedical application of chondroitin sulfate with nanoparticles in drug delivery systems: systematic review
Published in Journal of Drug Targeting, 2021
Abebe Feyissa Amhare, Jian Lei, Huan Deng, Yizhen Lv, Jing Han, Lei Zhang
Cytotoxicity is referring to the quality of being toxic to cells. If cells are treated with the cytotoxic compound, it may lose membrane integrity and even rapidly die (undergo necrosis) due to cell lysis. The cells can stop actively growing and decrease in cell viability [62]. The cytotoxicity test is one of the biological evaluations by using cells in vitro to observe cell growth and morphological changes by developed drugs [63–65]. It has a series of advantages along with the preferred and mandatory items [64]. Cytotoxicity testing is important in ensuring safety ranging from environmental exposures to medical devices [66]. The previous study reported that cytotoxic drugs can kill cancer cells but they can also damage normal cells which are considered as the side effects of most chemotherapy drugs [67]. So, precautions are recommended specifically to avoid carcinogenicity and mutagenicity.
Atorvastatin-loaded lipid nanoparticles: antitumor activity studies on MCF-7 breast cancer cells
Published in Drug Development and Industrial Pharmacy, 2018
Vaishali M. Gambhire, Shital M. Salunkhe, Makarand S. Gambhire
Cancer is a leading cause of death worldwide and is responsible for approximately 13% of all deaths, according to the World Health Organization [1]. Several obstacles frequently encountered with cytotoxic agents are normal tissue toxicity, poor specificity and stability and a high incidence of drug resistant tumor cells. Conventionally administered cytotoxic agents often extensively and indiscriminately bind to body tissues and serum protein in a highly unpredictable manner. Only a small fraction of the drugs reach the tumor site [2]. This may reduce therapeutic efficacy and increase systemic drug toxicity. Moreover, even though cytotoxic drugs ideally should only kill cancer cells, in reality they are also toxic to noncancerous cells, especially to rapidly dividing cells, for example bone marrow cells and cells of the gastrointestinal tract [3]. The normal tissue toxicities routinely occur even when standard therapeutic doses of anticancer drugs are administered. The poor specificity of cytotoxic drugs in terms of both drug biodistribution as well as pharmacology at the cellular level poses a significant challenge to effective anticancer treatment. This poor side effect profile of cytotoxic drugs has substantially diminished the therapeutic value of the drugs. Depending on the choice of drugs, different organs or tissues can be irritated or damaged by the nonspecific action of the cytotoxic agents [4].
Development and validation of HPLC method for simultaneous estimation of erlotinib and niclosamide from liposomes optimized by screening design
Published in Journal of Liposome Research, 2023
Amruta Prabhakar Padakanti, Sachin Dattaram Pawar, Pramod Kumar, Naveen Chella
Cancer remains a life-threatening disease, resulting in millions of worldwide deaths (Sung et al. 2021). Current approaches for cancer management include chemotherapy, surgery, radiotherapy, immunotherapy, and targeted therapy (Wang et al. 2019; Wang and Huang 2020). Drug-based therapies such as chemotherapy using cytotoxic agents have been widely used among the available options. However, 90% of clinical failures observed in chemotherapy were due to resistance from chronic administration (Maeda and Khatami 2018). Literature has reported that resistance development can occur through factors like insensitivity to mono-drug therapy, increased drug efflux, genetic mutations, and alteration in cell regulatory pathways (Mansoori et al. 2017). Multi-drug combination therapy is an emerging new strategy to treat complex diseases like cancer (Wang and Huang 2020; Plana et al. 2022). Combination therapy targets cancer cell signaling pathways via a synergistic mechanism that significantly overcomes the resistance and minimizes adverse effects (Bluthgen and Besse 2015). Combination drug therapies are the cornerstone to targeting advanced cancer; these therapies are superior and show more effective responses than conventional monotherapy. Indeed, combining conventional anticancer molecules with repurposed existing drugs provides synergistic activity with numerous advantages, such as reduced research and development cost and minimized drug development timeline (Sun et al. 2016; Mokhtari et al. 2017).