Medico Guides 8th Block (Module No 16) Pharmacology Guidelines

by

Prepared by:

                           Chaman Zulfiqar (G12)

Compiled by:

                     Hafiz Muhammad Umair Noor (G12)

Reference Books:

  • Mini Katzung Pharmacology Edition 2024-25

(N-Ph-001)

Chapter 54:

  • Cell cycle kinetics
  • The log kill hypthesis
  • Fig 54.1

(N-Ph-002)

Chapter 54:

  • Page 457, from alkylating agents to page 461, upto mitomycin.
  • This topic is quite lengthy, so for quick revision go for drug summary table given at end of chapter.

Anti-Tumor Drugs Associated with Rehabilitation

Anti-tumor drugs related to rehabilitation are given in a scattered way, I’m attaching  this topic below:

Drugs Causing Neuropathy (Physical Rehab needed)

  1. Vincristine (Vinca alkaloid) – M-phase specific
  2. Paclitaxel / Docetaxel (Taxanes) – M-phase specific

Rehab: Gait training, balance therapy, TENS, fine motor coordination

Drugs Causing Fatigue & Muscle Wasting

  • Methotrexate (Antimetabolite – S-phase)
  • 5-Fluorouracil (5-FU) – S-phase specific
  • Cisplatin (Platinum compound – non-specific)

Rehab: Graded exercise therapy, energy conservation, physiotherapy

Drugs Causing Cardiotoxicity (Cardiac Rehab needed)

  • Doxorubicin (Anthracycline – CCNS)
  • Cyclophosphamide (Alkylating agent – CCNS)

Rehab: Cardiac monitoring, endurance training under supervision

Drugs Causing Cognitive Dysfunction (Chemo Brain)

  • Cytarabine (S-phase)
  • Ifosfamide

Rehab: Memory training, concentration techniques, mental exercises

Drugs Causing Bone/Muscle Issues (Orthopedic Rehab)

  1. Anastrozole / Letrozole (Aromatase inhibitors – Hormonal therapy)

Rehab: Joint mobility exercises, bone-strengthening routines

Drugs Causing Psychological Disturbance

  1. Tamoxifen (SERM – Hormonal therapy)

Rehab: Counseling, support groups, psychiatric intervention

Drugs for Tumor Lysis Syndrome (TLS)

Drugs for tumor lysis sundrome are also not given in summarized way, you can do this topic as given below:

  1. Allopurinol – Prevents uric acid formation
  2. Rasburicase – Rapidly lowers existing uric acid
  3. IV Fluids – Flush out toxins, protect kidneys
  4. Insulin + Glucose – Shifts potassium into cells (for hyperkalemia)
  5. Calcium Gluconate – Stabilizes heart in severe hyperkalemia
  6. Loop Diuretics (e.g. Furosemide) – Increases excretion of potassium/phosphate
  7. Phosphate Binders (e.g. Sevelamer) – Treat hyperphosphatemia
  8. Potassium Binders (e.g. Patiromer) – Lower high potassium
  9. Dialysis – For severe cases or kidney failure

Drugs Used To Treat Complications Of Cancer

(Beside Surgical Resection)

1. Chemotherapy – Destroys cancer cells systemically

  • Used for: Tumor shrinkage, metastasis, pain relief
  • Examples: Cyclophosphamide, Doxorubicin, Methotrexate

2. Radiotherapy – Local tumor control, pain relief

  • Used in: Brain mets, bone pain, spinal cord compression

3. Hormonal Therapy – Blocks hormones that fuel certain cancers

  • Used in: Breast (Tamoxifen), Prostate (Leuprolide) cancers

4. Targeted Therapy – Blocks specific tumor growth pathways

  • Examples: Imatinib (CML), Trastuzumab (HER2+ breast cancer)

5. Immunotherapy – Boosts immune response against cancer

  • Examples: Pembrolizumab, Nivolumab

6. Bisphosphonates – Manage bone mets, reduce fractures

  • Example: Zoledronic acid

7. Steroids – Reduce edema, especially in brain/spinal mets

  • Example: Dexamethasone

8. Anti-emetics, painkillers, growth factors – Supportive care during treatment

Glucocorticoids In Anti-Cancer Drug Cocktails

Glucocorticoids (e.g., prednisone, dexamethasone) are steroid hormones used in many anti-cancer drug regimens, especially in hematological malignancies. Here’s how they help:

Mechanisms & Roles in Cancer Therapy

1. Cytotoxic to lymphoid cells

  • Directly induce apoptosis in leukemias and lymphomas (esp. ALL, NHL).

2.Anti-inflammatory& Immunosuppressive

  • Reduce tumor-associated inflammation.
  • Prevent hypersensitivity or allergic reactions to other chemo drugs.

3. Part of Chemotherapy Regimens

  • ALL (Acute Lymphoblastic Leukemia): Used in VDP or Hyper-CVAD protocols.
  • NHL (Non-Hodgkin’s Lymphoma): In CHOP regimen:
  • Cyclophosphamide, Hydroxydaunorubicin, Oncovin (vincristine), Prednisone.

4. Supportive Role

  • Manage nausea/vomiting in chemotherapy.
  • Reduce edema in brain tumors.
  • Improve appetite and energy in terminal cases (palliative care)

Common Glucocorticoids Used

  • Prednisone
  • Dexamethasone
  • Methylprednisolone

Side Effects (Long-Term Use)

  • Immunosuppression
  • Hyperglycemia
  • Osteoporosis
  • Mood swings
  • Cushingoid features
DOWNLOAD NOW

Leave a Comment