Section 1– Introduction

Malignant
also called cancer is a disease in which abnormal cells split uncontrollably
and can attack surrounding tissues.1 Cancerous cells scatter to
other body parts through the lymph and blood system. There exist various types
of malignancy such as Sarcoma, Carcinoma, lymphoma, leukemia, multiple myeloma,
lymphoma, and central nervous system cancers. Cancer has a primary effect on
the community in the U.S. and the world in general.2Globally cancer
is well-known to be among the chief causes of death. New cases in 2012 were
about 14 million and deaths related to cancer were 8.2 million. Prediction
about the new cancer issues within the next 20 years is approximated to rise to
22 million. Approximately 60 percent of cancer cases in the world happen in
Asia, Africa, and South and Central America. 70 percent of cancer death
globally is also said to occur in these areas.3

Genetic
mutations are in charge for the creation of cancer cells and therefore found in
all cancers. These mutations change the function or quality of protein products
that manage the growth of the cell and DNA and division repair. Two main groups
of mutated genes are tumor suppressor genes and oncogenes. Cellular kinetics of
specific tumors, on the other hand, is an essential consideration in the
structure of antineoplastic drug administrations and may affect the timing
period of treatment and dosing schedules.4Several drugs of
antineoplastic like antimetabolites are most efficient when cells are dividing
actively, and other drugs function during a different cell cycle phase. As
such, they need a continuous administration to get hold of dividing cells
during maximal sensitivity phase.

 

 

Treatment

There
are several methods of cancer treatment. These treatments rely on the type of
cancer and its advancement. Some individuals use a single treatment while
others combine treatments such as surgery with radiation and chemotherapy.
There are several agents of chemotherapy used to treat cancer. First, is
cisplatin which comprises of platinum and is administered through injection
into a vein. Secondly, is docetaxel which is used to treat breast cancer,
advanced stomach cancer, among others. Administration of the drug is through a
vein. Thirdly, is doxorubicin which treats a lot of cancers including breast
cancer and gastric cancer.5Drug administration is through an
intravenous injection via a peripheral venous line. Lastly, is gefitinib which
treats mesothelioma and non-small lung cancer. It obstructs the cancer cell’s
ability to activate enzyme tyrosine kinase.

The rationale of
this paper is to focus on agents of chemotherapy and mostly on cisplatin. The
drug assists in saving lives from testicular cancer. When applied together with
other drugs of chemotherapy, its rate of curing is about 90%. Cisplatin has the
ability to fight many cancer types. It is a combination therapy backbone for an
extensive range of solid tumors. These include cervical, lung, breast, bladder,
ovarian, gastric, and neck and head cancersas well as malignant mesothelioma.
The paper will also discuss cell viability analysis in vitro, ADMET issues or
physiochemical properties, Ringsdorf model, microbiological Quality Control
tests of cisplatin, and Pharmaceutical practice and care.

Section 2 – Results

MTS
analysis was used to test the cetuximab and gefitinib effects on the
development of Non–small-cell Lung Cancers (NLCLC)
cell lines in vitro. A549, H1666, H441 are the three lines that possess
Epidermal growth factor receptor (EGFR) have been discovered to be defiant
(H441 and A549) or delicate (H1666) to gefinitib
to vitro.6     

Figure 1

The
study found out that carboplatin has IC50 values ranging from 0.5-1.6 ?g/mL. Epidoxorubicin
have IC50 values ranging from 2-3 ?g/mL for drug incubation and seeding density
for 48 hours. Cisplatin has IC50 values of between 2-4 ?g/mL but is rarely
consistent. Gefitinib has an IC50 value
ranging from 3-5 ?g/mL and is associated with both negative and positive impacts
when administered with a combination of various cytotoxics.

 

 

 

 

Cisplatin

Figure 2 cellular growth
of glioma cells when exposed to cisplatin.

The
graph represents a curve for dose-response of 4 glioma cell lines administered
with rising cisplatin concentrations (0.01 to 100 ?M) and evaluated after 120 h
medication using the assay of XTT.

Section
3 – Physicochemical Properties/ADMET Issues

The
manner of administering a drug determines whether a patient receives clinical
benefit and whether they experience severe medical effects. Some factors
determine whether the medication will reach its planned action site in the
body. Drug bioavailability is one of the elements which is the relative amount
of a given drug that enters to the systematic circulation and is thus ready for
distribution to the action site. Drugs
administered by direct injection possess 100% bioavailability.7
Medications given orally lack such proportions and therefore are higher than
those applied parenterally. 
Administration route and formulation such as capsule, tablet, and liquid
can influence the drug bioavailability.

 

Section 4 –
Formulation/Delivery

The
Ringsdorf model is especially useful to scientists of drug delivery, whose
primary goal is the unique delivery of therapeutic agents to their destined
action site to minimize toxicity and improve efficacy. These polymer-drug
conjugates provide some advantages. First, a combination of a soluble water
polymer can enhance the aqueous solubility of a drug. Secondly, it gives the
ability of drug deliverance in a controllable manner, with drug discharge from
the compound taking place over a defined interval of time. Thirdly, it offers a
chance to change biodistribution and pharmacokinetics of a drug.8To
develop a successful Ringsdorf model, therapeutic index improvement for
medicines that permits clinician the ability to administer medications of
higher concentration to tumor tissue while monitoring controllable side effects
should be done.

Key Features of Ringsdorf Model

 

Section 5 – Safety/QAC

 Microbiological Quality Control tests include
necessary examinations for pharmaceutical forms of dosage. They explain readily
and simple, applicable criteria for validating the status of several
pharmaceutical dosages and substances forms, and materials of medicinal plant
in use. These include podophyllin resin, sennaeFructus,
ipecacuanha radix, and sennae folium.
While the extent of examination for disease staging and detection is expanding
rapidly, most clinicians lack the skills and knowledge needed to recognize the
tests to ask for and techniques of interpreting the results. As such, they
should focus on molecular diagnostics as it offers full instruction to the
interpretation and use of molecular testing in the arena of clinics.

Section 6 – Pharmaceutical Care
and Practice

Opioid-induced
side effects such as vomiting, nausea, and constipation in a cancer patient can
be reduced and sometimes eradicated by minimizing the amount of medication being
administered.  Additionally, these
effects can be minimized by interchanging a single opioid for another. Both
differential response and individual variability to opioids influence the will
to substitute medications.9The change is an effect brought about by
several factors including drug metabolism, absorption, and other factors. To
counter with the side effects, opioids can be given using many routes. These
routes include, transdermal and oral. The oral route is noninvasive, easy to
administer and relatively cheaper. Transdermal is employed when patients find
it difficult absorbing or swallowing oral opioids.

Conclusion

Genetic
mutations are in charge for the creation of cancer cells and therefore found in
all cancers. These mutations change the function or quality of protein products
that manage the growth of the cell and DNA and division repair. Cellular
kinetics of specific tumors, on the other hand, is an essential consideration
in the structure of antineoplastic drug administrations and may affect the
timing period of treatment and dosing schedules.