Cytostatics: what they are, list of drugs. Cytostatics - what are they? List of drugs Cytostatic drugs

Cytostatic agents (from Cyto... and Greek statikós - capable of stopping, stopping)

medicinal substances with different chemical structures that block cell division. The mechanisms of suppression of certain stages of cell division by these drugs are different. Thus, alkylating agents (for example, embiquin, cyclophosphamide) directly interact with DNA; antimetabolites suppress metabolism in the cell, entering into competition with normal metabolites-precursors of nucleic acids (antagonists of folic acid - methotrexate; purines - 6-mercaptopurine, thioguanine; pyrimidines - 5-fluorouracil, cytosine arabinoside). Some antitumor antibiotics (for example, chrysomallin, rubomycin) block the synthesis of nucleic acids, and plant alkaloids (for example, vincristine) block the divergence of chromosomes during cell division. The final effect of C. s. - selective suppression of dividing cells - in many ways similar to the biological effects of ionizing radiation (See Biological effects of ionizing radiation) , although the mechanisms of their cytostatic effect are different. Many C. s. are able to predominantly suppress tumor growth or inhibit the reproduction of normal cells of certain tissues. For example, myelosan is capable of inhibiting the progenitor hematopoietic cells of the bone marrow, but has almost no effect on lymphatic cells and intestinal epithelial cells, and cyclophosphamide inhibits lymphatic cells. Therefore, it is cyclophosphamide that is used as a means of suppressing immune reactions, and myelosan is effective in the treatment of certain tumors arising from bone marrow hematopoietic cells (for example, chronic mylosan leukemia).

Ability C. s. to suppress cell proliferation is used primarily in the chemotherapy of malignant tumors (see Antitumor drugs). Since malignant tumors contain sets of different cells (with unequal reproduction rates and metabolic characteristics), simultaneous treatment with several C. is often carried out, which prevents tumor relapses, which are caused by the proliferation of cells resistant to a particular drug. Application of combinations C, p. made it possible to achieve an increase in life expectancy (up to cases of practical recovery) of patients with lymphogranulomatosis, acute lymphoblastic leukemia of children, chorionepithelioma and some other types of tumors.

Some C. s. used as immunosuppressants - to suppress immune reactions in autoimmune diseases (See Autoimmune diseases) , caused by the appearance of antibodies to the body’s own tissues, and during organ transplantation (see Transplantation) , when it is necessary to suppress the production of antibodies to the tissues of the transplanted organ. This effect of C. s. is caused by stopping the division of the corresponding (so-called immunocompetent) lymphatic cells. Exposure to large doses of C. s. leads to the so-called cytostatic disease, which is characterized by inhibition of hematopoiesis, damage to the gastrointestinal tract, skin cells, and liver. This limits the therapeutic doses of C. s., in particular in the treatment of tumors.

Lit.: Petrov R.V., Manko V.M., Immunosuppressors. (Reference book), M., 1971; Sigidin Ya. A., Mechanisms of therapeutic action of antirheumatic drugs, M., 1972; New in hematology, ed. A. I. Vorobyova and Yu. I. Lorie, M., 1974: Mashkovsky M. D., Medicines, 7th ed., vol. 2, M., 1972.

A. I. Vorobiev. E. G. Bragina.

Great Soviet Encyclopedia. - M.: Soviet Encyclopedia. 1969-1978 .

See what “Cytostatic agents” are in other dictionaries:

- (syn. cytostatics) drugs that suppress cell division; Ch. are used arr. for the treatment of malignant tumors... Large medical dictionary- Anatomical therapeutic chemical classification (ATC) General articles

Cytostatics are drugs that slow down the process of cell division. Maintaining the vital functions of the body is based on the ability of its cells to divide, with new cells taking the place of old ones, and old ones, accordingly, dying. The rate of this process is determined biologically in such a way that a strict balance of cells is maintained in the body, and it is noteworthy that in each organ the metabolic process proceeds at a different speed.

But sometimes the rate of cell division becomes too fast, and old cells do not have time to die. This is how neoplasms form, in other words, tumors. It is at this time that the question of cytostatics - what they are and how they can help in the treatment of cancer - becomes relevant. And in order to answer it, it is necessary to consider all aspects of this group of drugs.

Cytostatics and oncology

Most often in medical practice, the use of cytostatics occurs in the field of oncology in order to slow down tumor growth. During treatment, the drug affects all cells of the body, so metabolism slows down in all tissues. But only in malignant neoplasms is the effect of cytostatics expressed in full, slowing down the rate of cancer progression.

Cytostatics and autoimmune processes

Cytostatics are also used in the treatment of autoimmune diseases, when, as a result of pathological activity of the immune system, antibodies destroy not antigens that penetrate the body, but cells of their own tissues. Cytostatics affect the bone marrow, reducing the activity of the immune system, as a result of which the disease can go into remission.

Thus, cytostatics are used for the following diseases:

• malignant oncological tumors in the early stages;
• lymphoma;
• leukemia;
• systemic lupus erythematosus;
• arthritis;
• vasculitis;
• Sjögren's syndrome;
• scleroderma.

Having considered the indications for taking the drug and the mechanism of its effect on the body, it becomes clear how cytostatics work, what they are, and in what cases they should be used.

Types of cytostatics

Cytostatics, the list of which is given below, are not limited to these categories, but it is customary to distinguish these 6 categories of drugs.

1. Alkylating cytostatics are drugs that have the ability to damage the DNA of cells that have a high rate of division. Despite the high degree of effectiveness, the drugs are difficult to tolerate by patients; among the consequences of the course of treatment, pathologies of the liver and kidneys, as the main filtration systems of the body, often appear. Such means include:

• chlorethylamines;
• nitrosourea derivatives;
• alkyl sulfates;
• ethyleneimines.

2. Cytostatic alkaloids of plant origin - preparations with a similar effect, but with a natural composition:

• taxanes;
• vinca alkaloids;
• podophyllotoxins.

3. Cytostatics-antimetabolites - drugs that inhibit substances involved in the process of tumor formation, thereby stopping its growth:

• folic acid antagonists;
• purine antagonists;
• pyrimidine antagonists.

4. Cytostatics-antibiotics - antimicrobial drugs with antitumor effects:

• anthracyclines.

5. Cytostatic hormones are antitumor drugs that reduce the production of certain hormones.

• progestins;
• antiestrogens;
• estrogens;
• antiandrogens;
• aromatase inhibitors.

6. Monoclonal antibodies are artificially created antibodies, identical to the real ones, directed against certain cells, in this case tumors.

Drugs

Cytostatics, the list of drugs of which is presented below, are prescribed only by prescription and are taken only according to strict indications:

• "Cyclophosphamide";
• "Tamoxifen";
• "Flutamide";
• "Sulfasalazine";
• "Chlorambucil";
• "Azathioprine";
• "Temozolomide";
• "Hydroxychloroquine";
• "Methotrexate".

The list of drugs that fit the definition of “cytostatics” is very wide, but these drugs are most often prescribed by doctors. The drugs are selected individually for the patient very carefully, and the doctor explains to the patient what side effects cytostatics cause, what they are and whether they can be avoided.

Side effects

The diagnostic process must confirm that a person has a serious disease, the treatment of which requires cytostatics. The side effects of these drugs are very pronounced; they are not only difficult for patients to tolerate, but also pose a danger to human health. In other words, taking cytostatic drugs is always a huge risk, but with oncology and autoimmune diseases, the risk from lack of treatment is higher than the risk from possible side effects of the drug.

The main side effect of cytostatics is its negative effect on the bone marrow, and therefore on the entire hematopoietic system. With long-term use, which is usually required both in the treatment of oncological tumors and in autoimmune processes, it is even possible to develop leukemia.

But even if blood cancer can be avoided, changes in blood composition will inevitably affect the functioning of all systems. If blood viscosity increases, the kidneys suffer, since a large load is placed on the membranes of the glomeruli, as a result of which they can be damaged.

When taking cytostatics, you should be prepared for permanent poor health. Patients who have undergone a course of treatment with drugs of this group constantly report a feeling of weakness, drowsiness, and inability to concentrate on a task. A common complaint is headache, which is constantly present and difficult to relieve with analgesics.

During treatment, women usually experience menstrual irregularities and the inability to conceive a child.

Digestive system disorders manifest themselves in the form of nausea and diarrhea. This often becomes the reason for a person’s natural desire to limit their diet and reduce the amount of food they eat, which, in turn, leads to anorexia.

Not dangerous to health, but an unpleasant consequence of taking cytostatics is hair loss on the head and body. After stopping the course, hair growth usually resumes.

Based on this, it can be emphasized that the answer to the question of what cytostatics are, contains information not only about the benefits of this type of drug, but also about the high risk for health and well-being during its use.

Rules for taking cytostatics

It is important to understand that a cytostatic has a direct effect on the activity of the immune system, inhibiting it. Therefore, during the course a person becomes susceptible to any infection.

In order to prevent infection, it is necessary to follow all safety measures: do not appear in crowded places, wear a protective gauze bandage and use local antiviral agents (oxolinic ointment), avoid hypothermia. If a respiratory infection does occur, you should immediately consult a doctor.

How to reduce side effects?

Modern medicine makes it possible to minimize the severity of side effects that occur while taking cytostatics. Special drugs that block the gag reflex in the brain make it possible to maintain normal health and performance during treatment.

As a rule, the tablet is taken early in the morning, after which it is recommended to increase the drinking regime to 2 liters of water per day. Cytostatics are predominantly excreted by the kidneys, so their particles can settle on the tissues of the bladder, causing an irritating effect. Drinking a large amount of fluid and frequent emptying of the bladder makes it possible to reduce the severity of the side effects of cytostatics on the bladder. It is especially important to empty your bladder thoroughly before going to bed.

Examinations during treatment

Taking cytostatics requires regular examination of the body. At least once a month, the patient must undergo tests showing the effectiveness of the kidneys, liver, and hematopoietic system:

• clinical blood test;
• biochemical blood test for creatinine, ALT and AST levels;
• complete urine analysis;
• CRP indicator.

Thus, knowing all the relevant information about what cytostatics are needed for, what they are, what types of drugs there are and how to take them correctly, you can count on a favorable prognosis for the treatment of cancer and autoimmune diseases.

Over the past 20-25 years, cytostatics have become an important part of the treatment of a large number of autoimmune diseases. Due to their action, such drugs have found their use not only in the treatment of cancer, but also in dermatology, dentistry, dermatovenerology and other areas. Cytostatics - what are they and what is their effect? You can learn about this from this article.

About cytostatics

Cytostatic drugs or cytostatics are a group of drugs that, when they enter the human body, can disrupt the processes of growth, development and division of cells, including malignant types. Treatment of neoplasms with medications of this type is prescribed only by a qualified doctor. The drugs can be produced in the form of tablets, capsules, or administered intravenously to patients using a drip or injections.

Literally all cytostatic drugs are chemical substances with high biological activity. Such drugs also have the ability to:

• inhibit cell proliferation;
• affect cells that have a high miotic index.

Where are they used?

Cytostatics have been widely used in the treatment of oncological diseases of varying complexity and different parts of the body. The drugs are prescribed for the treatment of malignant tumors in cancer, leukemia, monoclonal gammopathies, etc. In addition, cytostatics prevent rapid cell division:

• bone marrow;
• skin;
• mucous membranes;
• epithelium of the gastrointestinal tract;
• hair;
• lymphoid and myeloid genesis.

In addition to the above, cytostatics are actively used in the treatment of diseases of the digestive system, such as cancer of the stomach, esophagus, liver, pancreas, and rectum. Medicines are used where chemotherapy does not produce the desired positive results.

Having examined the detailed instructions for taking the drug, it becomes clear how cytostatics work, what they are, and in what cases they should be used. This type of drug is most often prescribed as autoimmune therapy. Cytostatics have a direct effect on the cells of the bone marrow, while reducing the activity of the immune system, which ultimately leads to stable remission.

Types of cytostatics

Correct classification of cytostatics allows you to determine which medications are needed in a particular case. Only a qualified doctor can prescribe drug therapy after receiving test results. Cytostatic drugs are divided into the following types:

1. Alkylating drugs that have the ability to damage the DNA of rapidly dividing cells. Despite their effectiveness, the drugs are difficult to tolerate by patients, and the negative consequences of therapy include liver and kidney pathologies.
2. Plant-type cytostatic alkaloids (Etoposide, Rosevin, Kolkhamin, Vincristine).
3. Cytostatic antimetabolites are drugs that lead to necrosis of tumor tissue and remission of cancer.
4. Cytostatic antibiotics are antitumor agents with antimicrobial properties.
5. Cytostatic hormones are medications that inhibit the production of certain hormones. They are able to reduce the growth of malignant tumors.
6. Monoclonal antibodies are artificially created antibodies that are identical to real immune cells.

Mechanism of action

Cytostatics, the mechanism of action of which is aimed at inhibiting cell proliferation and the death of tumor cells, have one of the main goals - affecting various targets in the cell, namely:

• on DNA;
• for enzymes.

Damaged cells, that is, modified DNA, disrupt metabolic processes in the body and the synthesis of hormones. Of course, the mechanism for achieving inhibition of the proliferation of tumor tissues may differ between different cytostatics. This is because they have different chemical structures and can affect metabolism differently. Depending on the group of cytostatic drugs, the cells may be affected:

• thymidylate synthetase activity;
• thymidylate synthetase;
• topoisomerase I activity;
• formation of a mitotic spindle, etc.

Basic admission rules

Cytostatics are recommended to be taken during or after meals. During the period of drug treatment with cytostatic drugs, it is prohibited to drink alcoholic beverages. Doctors do not recommend taking such medications during pregnancy or the lactation period.

Side effects

Cytostatics - what they are and what contraindications for use exist can be explained in each specific case by the attending physician. The frequency of side effects directly depends on such nuances as:

• the type of medication you are taking;
• dosage;
• scheme and mode of administration;
• therapeutic effect that preceded taking the drug;
• general condition of the human body.

In most cases, side effects are due to the properties of cytostatic drugs. Therefore, the mechanism of tissue damage is similar to the mechanism of action on the tumor. The most characteristic side effects inherent in most cytostatics are:

• stomatitis;
• inhibition of hematopoiesis;
• nausea, vomiting, diarrhea;
• alopecia of various types;
• allergies (skin rashes or itching);
• heart failure, anemia;
• nephrotoxicity or renal tubular damage;
• reaction from the veins (phlebosclerosis, phlebitis, etc.);
• headaches and weakness that is felt throughout the body;
• chills or fever;
• loss of appetite;
• asthenia.

In case of overdose, nausea, vomiting, anorexia, diarrhea, gastroenteritis or liver dysfunction may occur. Drug treatment with cytostatic drugs has a negative effect on the bone marrow, the healthy cells of which take in the wrong elements and cannot renew themselves at the same speed. In this case, a person may experience a lack of blood cells, which leads to impaired oxygen transport and a decrease in hemoglobin levels. This can be seen by the pallor of the skin.

Another side effect of taking cytostatics is the appearance of cracks, inflammatory reactions and ulcers on the mucous membranes. During therapy, such areas in the body are sensitive to the ingress of microbes and fungi.

Reduce side effects

Thanks to modern medications and vitamins, it is possible to reduce the negative effects of cytostatics on the body, without reducing the therapeutic effect. By taking special medications, it is quite possible to get rid of the gag reflex and maintain performance and good health for the whole day.

It is recommended to take such drugs in the morning, after which you should not forget about the water balance throughout the day. You should drink from 1.5 to 2 liters of clean water per day. This can be explained by the fact that literally the entire list of cytostatic drugs is characterized by excretion through the kidneys, that is, elements of the drugs settle in the bladder and irritate the tissues. Thanks to drinking water during the day, the organ is cleansed, and the negative consequences of cytostatic therapy are significantly reduced. Also, frequent consumption of liquids in small portions can minimize the risk of increasing the permissible limit of bacteria in the oral cavity.

In order to cleanse the body and improve the composition of the blood, doctors recommend blood transfusions, as well as enriching it with hemoglobin artificially.

Contraindications

• hypersensitivity to the drug or its components;
• suppression of bone marrow functions;
• chickenpox, shingles or other infectious diseases have been diagnosed;
• disruption of the normal functioning of the kidneys and liver;
• gout;
• kidney stone disease.

Commonly prescribed cytostatics

The question of cytostatics, what they are and their role in the treatment of malignant tumors has always been relevant. Frequently prescribed medications are:

1. "Azathioprine" is an immunosuppressant that has a partial cytostatic effect. Prescribed by doctors when a negative reaction occurs during tissue and organ transplantation, for various systemic diseases.
2. "Dipin" is a cytostatic drug that suppresses the proliferation of tissues, including malignant ones.
3. "Myelosan" is a drug that can inhibit the growth process of blood elements in the body.
4. "Busulfan" is an inorganic drug that has pronounced bactericidal, mutagenic and cytotoxic properties.
5. "Cisplatin" contains heavy metals and can inhibit DNA synthesis.
6. "Prospidin" is an excellent antitumor drug, which is most often taken for malignant neoplasms that have arisen in the larynx and pharynx.

Cytostatic drugs, the list of which is presented above, are prescribed only with a doctor's prescription. After all, these are quite strong means. Before taking medications, it is worth studying what cytostatics are, what they include, and what their side effects are. The attending physician will be able to select the most effective cytostatic drugs, depending on the patient’s condition and diagnosis.

Cytostatic therapy is an individual process that depends on the characteristics of the tumor, the condition of the body, as well as the results of previous courses of treatment. Treatment with chemotherapy drugs is divided into two groups: monochemotherapy and polychemotherapy. Monochemotherapy is a treatment that involves one chemotherapy drug, while polychemotherapy involves several.

In most cases, in order to obtain positive results, it is best to carry out treatment in the form of complex or combination therapy. For example, prospidinotherapy for ulcerative basal cell carcinomas is combined with superficial cryodestruction, which is performed twice. In this case, spontaneous thawing and exposure from 30 to 120 s are observed. If the patient has metatypical cancer, then a course of close-focus radiotherapy of the lesion is performed.

Basically, cytotoxic drugs are used as intradermal or subcutaneous injections and are administered locally. Intralesional injections of cytostatics are used if the patient has superficial, cystic and ulcerative forms of basal cell carcinoma, squamous cell skin cancer, keratoacanthoma, which transforms into succulent cell carcinoma, as well as recurrent epithelial tumors of the skin. The results were summed up and it became known that a three-week course of intralesional injections of 5-fluorouracil cured 90% of patients with small tumor basal cell carcinomas. In addition, intralesional injections can cure Kaposi's sarcoma with vincristine and bleomycin, and this treatment method is easily used along with traditional methods of treatment.

As is known, epithelial skin tumors are treated with external chemotherapeutic agents. For example, if 0.5% colchamine ointment is used in the treatment of epithelial skin tumors, then clinical cure can be obtained in 95% of cases; when using 5% ointment with 5-fluorouracil, cure will be achieved in 73-84% of cases. In addition, it is known that 1% bleomycin ointment has a good effect on the external treatment of epithelial skin tumors.

Supportive and accompanying therapies used for cancer have made treatment more effective. However, almost all cytostatic drugs have a number of side effects. The most common complications during chemotherapy are nausea and vomiting. Most patients refused or interrupted chemotherapy because they were unable to tolerate severe nausea and vomiting.

Nausea and vomiting caused by chemotherapy are divided into three groups:

1. acute, which manifests itself in the first 24 hours of treatment;
2. delayed - occurs a day after treatment;
3. preliminary, which occurs before the start of chemotherapy.

The basis for the development of acute nausea and vomiting is the neurotransmitter serotonin (5-HT), which is released during exposure to radiation therapy or the administration of cytostatic drugs. Serotonin acts on the 5-HT3 trigger zone receptors, which transmit signals to the vomiting center in the central nervous system, which contributes to the development of nausea and vomiting. Most 5-HT3 receptors stop in the central structures of the brain, as well as on neurons and the vagus nerve of the gastrointestinal tract. Of particular importance is the effect of 5-HT3 receptor antagonists on 5-HT4 receptors, since the administration of cytostatics triggers the release of serotonin.

Complications during chemotherapy also include refusal to eat, dehydration, malnutrition, disorders of the nervous and cardiovascular systems of the body, as well as disturbances in water and electrolyte balance. Such side effects develop difficult-to-control depression and also depress emotional status. As a result of all this, the length of hospitalization increases, as well as the costs of treatment. Therefore, an important task in the treatment of cancer patients is to overcome these symptoms in order to improve the quality of life of patients.

Cytostatic agents(from cyto... and Greek statikós - capable of stopping, stopping), medicinal substances of various chemical structures that block cell division. The mechanisms of suppression of certain stages of cell division by these drugs are different. Thus, alkylating agents directly interact with DNA; antimetabolites suppress metabolism in the cell by competing with normal metabolites-precursors of nucleic acids. Some antitumor antibiotics block the synthesis of nucleic acids, and plant alkaloids block the divergence of chromosomes during cell division. The final effect of cytostatic agents - selective suppression of dividing cells - is in many ways similar to the biological effect of ionizing radiation, although the mechanisms of their cytostatic effect are different. Many cytostatic agents are capable of predominantly suppressing tumor growth or inhibiting the reproduction of normal cells of certain tissues.

The ability of cytostatic agents to suppress cell proliferation is used primarily in the chemotherapy of malignant tumors (Antitumor agents). Since malignant tumors contain sets of different cells (with unequal reproduction rates and metabolic characteristics), simultaneous treatment with several cytostatic agents is often carried out, which prevents tumor relapses, which are caused by the proliferation of cells resistant to a particular drug. The use of combinations of cytostatic drugs has made it possible to achieve an increase in life expectancy (up to cases of practical recovery) of patients with lymphogranulomatosis, acute lymphoblastic leukemia of children, chorionepithelioma and some other types of tumors.

Some cytostatic agents are used as immunosuppressants - to suppress immune reactions in autoimmune diseases caused by the appearance of antibodies to the body's own tissues, and during organ transplantation (Transplantation), when it is necessary to suppress the production of antibodies to the tissues of the transplanted organ. This effect of cytostatic agents is due to stopping the division of the corresponding (so-called immunocompetent) lymphatic cells. Exposure to large doses of cytostatic agents leads to the so-called cytostatic disease, which is characterized by inhibition of hematopoiesis, damage to the gastrointestinal tract, skin cells, and liver. This limits the therapeutic doses of cytostatic agents, in particular in the treatment of tumors.