Antineoplastic

Antineoplastics are drugs that inhibit and combat the development of neoplasms.^[1][2]

In the Anatomical Therapeutic Chemical Classification System, they are classified under L01.

Health effects/occupational exposure

The adverse health effects associated with antineoplastic agents (cancer chemotherapy drugs, cytotoxic drugs) in cancer patients and some non-cancer patients treated with these drugs are well-documented. The very nature of antineoplastic agents makes them harmful to healthy constantly dividing cells and tissues, as well as the cancerous cells. For cancer patients with a life-threatening disease, there is a great benefit to treatment with these agents. However, for the healthcare workers that are exposed to antineoplastic agents as part of their work practice, precautions should be taken to eliminate or reduce exposure as much as possible.There already is a limitation in cytotoxics dissolution in Australia and the United States to 20 dissolutions per pharmacist/nurse, since pharmacists that prepare these drugs or nurses that may prepare and/or administer them are the two occupational groups with the highest potential exposure to antineoplastic agents. In addition, physicians and operating room personnel may also be exposed through the treatment of patients. Hospital staff, such as shipping and receiving personnel, custodial workers, laundry workers, and waste handlers, all have potential exposure to these drugs during the course of their work. The increased use of antineoplastic agents in veterinary oncology also puts these workers at risk for exposure to these drugs.^[3]

Modes of action

There are many classes of antineoplastics:

• Alkylating agents
• Antimetabolites
• Antimitotics: bind to tubulin and inhibit spindle dynamics and thus block cell division
• topoisomerase II inhibitors, stopping DNA from being unwound, which is required for both DNA replication and RNA/protein synthesis.
• Generating free radicals.^{[citation needed]}

Examples

• actinomycin (L01DA01).
  • The most important immunosuppressant from this group is dactinomycin, which is used in kidney transplantations.
• anthracyclines
  • doxorubicin (L01DB01)
  • daunorubicin (L01DB02)
  • Valrubicin
  • Idarubicin
  • epirubicin (L01DB03), which also inhibit topoisomerase II)
• other cytotoxic antibiotics
  • bleomycin (L01DC01). Bleomycin acts in unique way through oxidation of a DNA-bleomycin-Fe(II) complex and forming free radicals, which induce damage and chromosomal aberrations.
  • plicamycin (L01DC02)
  • mitomycin (L01DC03)

References

External links

• University of Nebraska
• Formulary by category
• Antineoplastic at eMedicine Dictionary
• National Institute for Occupational Safety and Health - Occupational Exposure to Antineoplastic Agents