10.1: Chemotherapy

Learning Objectives

• Define chemotherapy (from a chemical and cultural perspective)
• Explain the FDA drug categories on this page.
• Recall benefits and side effects of corticosteroids (like Prednisone).
• Correlate a drug's chemical name with Brand and generic names (while using the internet).
• List the signs of anaphylaxis.
• Be aware of drug/vitamin interactions when reading an information pack.
• Provide a list of remedies for anaphylaxis.

Chemotherapy, broadly defined, means the treatment of any disease by chemicals including infectious and non-infectious diseases. The original definition applied only to drugs that were used in the treatment of infectious diseases. The proper term for the treatment of non-infectious diseases is pharmacodynamics.

Figure \(\PageIndex{1}\): Medicines at 1752 Apothercary, Moravian Bethlehem.
(Copyright; Bestbudbrian)

A very broad definition of a drug would include "all chemicals other than food that affects living processes." If the effect helps the body, the drug is a medicine. However, if a drug causes a harmful effect on the body, the drug is a poison. The same chemical can be a medicine and a poison depending on conditions of use and the person using it. Another definition would be "medicinal agents used for diagnosis, prevention, treatment of symptoms, and cure of diseases." Contraceptives would be outside of this definition unless the pregnancy was considered a disease.

FDA Drug Categories

The Food and Drug Administration has over 40 different drug families. To access this listing, scan the QR code below.

Figure \(\PageIndex{2}\): QR code for comprehensive listing of drugs. (Copyright; fda.gov)

For this term, we will be focusing on a few of these categories. When understanding basic pharmaceutical chemistry, review the following terms:

• Analgesics-drugs that relieve pain.
• Antihistamine- drugs that help with allergic responses.
• Antibiotics- medications that fight bacterial infections.
• Decongestant- drug that relieves a stuffy nose
• Antivirals- medications used to combat viruses.
• OTC- over-the-counter medications that do not require a prescription.
• Antipyretics- medications that reduce fevers
• Anticoagulants- substances that reduce blood clotting.
• NSAID- nonsteroidal anti-inflammatory drug- medications that reduce inflammation, but are not steroids.
• Controlled substance- an addictive medication or illegal drug that is regulated by the Drug Enforcement Agency. For legal prescriptions, identification must be presented in order to pick up medication.
• Corticosteroid- prescription steroids that reduce inflammation.

• Definition: What is a steroid?

  A steroid is a chemical that can be naturally found or synthetically made. Many of these are present in the human body and are called hormones. Examples of these types of steroids are testosterone and estrogen. On the image below, Estradiol is a form of estrogen. This chemical can be synthetic and is used in birth control pills and hormone replacement therapy (HRT).

                                                  

  Figure \(\PageIndex{3}\): Structure of estradiol (Copyright, https://commons.wikimedia.org/wiki/User:NEUROtiker)

  Anabolic steroids are a class of chemicals that can increase bodyweight and muscle size. Overuse and abuse of these types of steroids are common. As a result, the Drug Enforcement Agency regulates and controls anabolic steroids. Click here to read about the illegal use of anabolic steroids in athletics.

                                                           

                 Figure \(\PageIndex{4}\): Stanozolol. (Copyright, https://commons.wikimedia.org/wiki/User:J%C3%BC).

  Corticosteroids are medications that reduce inflammation and immunity. These steroids are used to treat asthma, arthritis, allergic reactions, and other conditions/diseases ( reduction of organ rejection, Lupus, Irritable Bowel Diseases, Irritable Bowel Syndrome, Addison's Disease, Chronic Pulmonary Disease (COPD), and Multiple Sclerosis.

  Corticosteroids can be found in creams, eye drops, ear drops, and inhalers. In addition, these medications can be administered as a injections, liquids, or pills. The last three of these formulations are most likely to produce unwanted side effects.

  Prednisone, a common corticosteroids, is commonly prescribed to reduce allergic reactions. For example, individuals who develop hives to certain plants or insect stings might be prescribed a short protocol of steroids. When asthma patients cannot keep their symptoms under control by using their inhalers, they might be switched to a short treatment of an oral steroid (prednisone). Lastly, patient with long-term Irritable Bowel Diseases (Crohn's or Ulcerative Colitis) can be prescribed prednisone to achieve remission.

                                                           

                                                      Figure \(\PageIndex{5}\): Prednisone-2D-skeletal.

  Click on this link and answer the questions below:

  1) For children taking oral corticosteroids, how can their height be affected?

  2) If you are on steroids for over a month, how will your face change?

  3) Will you lose or gain weight on steroids?

  4) Should diabetics limit their use of corticosteroids? Why or why not?

  5) How could your sleeping and mood be affected by taking oral steroids?

  6) During flu season, what types of things should steroid patients do to remain healthy?

  7) Have you ever been prescribed oral steroids? What type of side effects did you experience?

 

Drug Names

Drugs have three or more names including a: chemical name, brand/ trade name, and generic or common name. The chemical name is assigned according to the rules of nomenclature of chemical compounds. The brand name is always capitalized and is selected by the manufacturer. The generic name refers to a common established name irrespective of its manufacturer.

 

Figure \(\PageIndex{6}\): A package of capsules. (Copyright; Photo was taken for Wikipedia by Moriori Transferred from English Wikipedia; en:Image:Tamiflu.JPG)

In most cases, a drug bearing a generic name is equivalent to the same drug with a brand name. However, this equivalency is not always true. Although drugs are chemically equivalent, different manufacturing processes may cause differences in pharmacological action. Several differences may be crystal size or form, isomers, crystal hydration, purity-(type and number of impurities), vehicles, binders, coatings, dissolution rate, and storage stability.

Exercise \(\PageIndex{1}\)

Using the fda.gov website, determine the use and brand names for the following pharmaceuticals:

Figure \(\PageIndex{7}\): 3-D structure of Ibuprofen. (Copyright, Benjah-bmm27.)

a) Alprazolam (generic name)

b) Ibuprofen (generic name)

c) Fluoxetine (generic name)

Answer

a) This drug has a Trade name of Xanax©.  It is used to as a short-term antianxiety agent.  This medication can be addictive.

b) This drug has a Trade name of Advil © or Motrin©.  Ibuprofen can be used to treat fevers, inflammation, and general pain.

c) This drug has a Trade name of Prozac©.  It is classified as being an antidepressant.  This medication can be used to treat depression and anxiety.  For young people, the FDA has put a Black Box warning on all antidepressants.  Younger patients are more likely to suddenly stop an antidepressant without consulting a medical professional.  This quick change of brain chemistry can cause suicidal tendencies. 

Drug Reactions

Before taking a new medication, review the patient information packet or access the drug's information on the fda.gov website. Foods (like grapefruit), Vitamins, and OTC drugs (antacids) can affect the potency of prescribed medication. In addition, combining alcohol with antidepressants, tranquilizers, and narcotics could result in serious health issues or even death.

Allergic responses to medications and the environment can arise at any time of one's lifetime. It is important to keep track of these allergies and report them when you see a medical professional. Allergic responses to medication can result in hives, rash, itching, fever, swelling, shortness of breath, wheezing, runny nose, and itchy, watery eyes.

  

Figure \(\PageIndex{8}\): A medical illustration depicting urticaria.(Copyright, :BruceBlaus)

Anaphylaxis

A severe allergic response to a medication, food, or the environment is called anaphylaxis. Symptoms of this condition include the following: trouble breathing, tightening of chest and throat, dizziness, seizure, vomiting/diarrhea, change in pulse, drop in blood pressure, and nausea. If the patient has issues breathing or experiences seizures, they need to be transported to the hospital ASAP. For less severe symptoms, calling a medical professional would be an appropriate plan.

Over-the-counter antihistamines can be effective in reducing some of the symptoms of anaphylaxis. Generic forms of Benadryl©, Zyrtec©, Claritin©, and Allegra© can help alleviate an allergic response. If a patient continues to have issues with severe allergic reactions, then they should be prescribed an epinephrine pen (Epi-pen). Individuals who have experienced anaphylaxis should keep an Epi-pen close at all times.

 

References

1) Fda.gov

2) Mayoclinic.org

Contributors

Charles Ophardt (Professor Emeritus, Elmhurst College); Virtual Chembook