drugs lack selectivity to these types of cells
cells with high growth fraction
amount of cells required to present symptoms
1 billion (1g)
neutropenia
causes a risk for infection, treated with filgrastim, etc.
thrombocytopenia
causes a risk for bleeding, treated with neumega
anemia
low oxygen to tissues, treated with erythropoietin
intra-arterial drug delivery
delivers drug to a specific region of the body
intrathecal drug delivery
delivers drug to the brain or CNS
Cell cycle phase specific drugs
administered by prolonged infusion or multiple doses with short intervals (i.e. vinblastine, vincristine)
Cell cycle phase non-specific drugs
can be administered as a single bolus dose, toxic to ALL cells with a high growth fraction, development of RESISTANCE is common
Alkylating agents
cell cycle phase non-specific drugs that inhibit DNA replication by creating cross links between DNA strands (i.e. nitrogen mustards and nitrosoureas)
Platinum compounds
cell cycle phase non-specific drugs that are highly emetogenic and can cause renal toxicity (i.e. cisplatin, carboplatin, oxaliplatin)
Antimetabolics
methotrexate is an example = S phase specific
Mitotic Inhibitors
M phase specific
Vincristine
a mitotic inhibitor that is neurotoxic, but does not cause myelosuppression
Vinblastine
a mitotic inhibitor that causes myelosuppression, but is not neurotoxic
Antitumor Antibiotics
injures the cell directly by attacking DNA, always given via IV due to poor GI absorption (i.e. doxorubin, bleomycin)