Pharmacology for chemotherapy and immunosuppressants

Abstract

Cancer is the second leading cause of death globally and accounts for 10% of deaths in South Africa.^1,2 Patients with a history of cancer have shown increased survival with the use of treatment. Anaesthetists frequently encounter patients in all stages of cancer and cancer treatment.³

There is a global increase in solid organ transplantation. Increased survival amongst transplant recipients is observed due to improved surgical techniques and immunosuppressive therapy. Patients on immunosuppressive treatment therefore present for transplant and non-transplant related surgery.⁴  

The majority of chemotherapy targets cancer cells during rapid division and proliferation. However, the disruption of cell division also affects normal functioning cells in organs involved and uninvolved, resulting in acute/chronic injury after exposure. By understanding the mechanisms of chemotherapy drugs on targeted cancer cells, it is possible to predict what injuries might occur in the rest of the body.³ Consequently, to understand how chemotherapy interferes with cell division, we must revisit the cell cycle.