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Truvada works by blocking an enzyme called HIV reverse transcriptase. By blocking this enzyme, it prevents HIV from making more copies of itself in the body. However, trials are currently underway to determine if they are effective and in a few years we will know more. The medication works by binding to and disabling an enzyme called HIV reverse transcriptase. By disabling this enzyme, it prevents HIV from making more copies of itself in the body.

Tenofovir works by blocking an enzyme called HIV reverse transcriptase.

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If a daily dose is missed, the level of HIV protection may decrease. It only works if you take it. There are not enough data available to provide specific timing guidance on non-daily use, so the FDA recommends PrEP be used daily to achieve the highest level of protection. A few things to note:. Truvada for PrEP is generally safe and well tolerated. Think of this son especially like his mother.

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Comments are closed. The folic acid analogs methotrexate and pemetrexed specifically interfere with the normal use of folic acid by cells. Antimetabolites Table 3. In a normal cell, an enzyme converts folic acid to a form that the cell can use as it makes the purines it needs. Cells constantly and rapidly divide and grow in developing embryos.

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This is why folic acid analogs given to a pregnant woman are toxic to the embryo and can cause miscarriage if taken during pregnancy. Methotrexate is used for the treatment of gestational choriocarcinoma, chorioadenoma destruens, and hydatidiform mole. These are cancers arising from abnormal fertilization and growth of an embryo. Methotrexate can be used alone or in combination with other anticancer agents to treat breast cancer, squamous cell cancers of the head and neck, advanced mycosis fungoides a type of lymphoma , and lung cancer, particularly squamous Antimetabolites cell and small cell types.

It is also approved for treating some noncancerous diseases such as psoriasis and certain types of arthritis, and may be given orally or intravenously.

Pemetrexed is used, in combination with cisplatin, for the treatment of malignant pleural mesothelioma. This is a rare cancer of the cells of a membrane pleura that lines the abdominal cavity, heart, and lungs, and often occurs in response to asbestos exposure. Pemetrexed is given by intravenous infusion only. Patients also receive folic acid and vitamin B12 supplements during therapy to help their normal cells recover from toxicities.


When doctors want to precisely describe a lung cancer, they try to determine what kind of lung cell the cancer arose from. Non-small cell cancer accounts for about 80 percent of lung cancer and there are nine subtypes. The majority of NSCLC cancers fall into three of these subtypes: Squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. There are some other types of tissue in the lung, but these rarely become cancerous, and account for only a small percentage of lung cancers. Some of these drugs can do both.

What is the difference between PrEP and PEP?

Floxuridine and capecitabine are metabolized by the liver, which turns them into 5-FU. Their anticancer activities are caused by the 5-FU that is produced. As a result, cell growth is impaired. Cells that are actively growing incorporate these drugs more readily, so tumor cells and the frequently dividing cells of the body such as those in the bone marrow, gastrointestinal tract, hair follicles, and nails are most affected. The activity of 5-FU is enhanced by a chemical called leucovorin, and patients often receive these drugs in combination. The FDA has not approved a tablet form of the drug, which is in common use in other countries.

Floxuridine is given by intraarterial into the artery injection into the liver to treat gastrointestinal tumors that have spread to the liver. Capecitabine is an oral drug that is used in combination therapy to treat advanced and metastatic cancer that has spread to a site in the body that is distant from where it originated colon and breast cancers. Diarrhea can be a serious problem for patients who take this drug. Gemcitabine both inhibits the cell enzymes that create the pyrimidine bases and replaces cytosine in the manufacture of DNA, effectively stopping the production of any DNA strand into which it is incorporated.

It is used in combination therapy for advanced or metastatic breast and non—small cell lung Antimetabolites cancers and as a single agent treatment for advanced or metastatic pancreatic cancer.

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Once it is metabolized in the liver, cytarabine, like gemcitabine, inhibits DNA synthesis and gets incorporated into DNA. Also like gemcitabine, it is effective because it stops the manufacture of DNA so that the cell cannot grow and divide. It can be given by intravenous infusion or injection, subcutaneously under the skin or intrathecally into the spinal fluid. Cytarabine is approved for use in combination therapy for the treatment of certain kinds of leukemia.

In addition to the expected reactions to drugs of this class, cytarabine may cause a collection of symptoms called cytarabine syndrome, which can include fever, muscle aches, bone pain, chest pain, and rash. These problems can be treated with corticosteroids, which are potent anti-inflammatory drugs. Purine Analogs and Related Inhibitor Purine analogs and their related inhibitors include mercaptopurine, thioguanine, pentostatin, cladribine, and fludarabine.

Mercaptopurine and thioguanine become analogs of guanine after they are metabolized in the body. Pentostatin is an analog of adenosine, and blocks an enzyme that normally processes adenosine. These agents strongly inhibit enzymes that are needed to synthesize DNA and RNA and may even be incorporated into their strands.

As a result, they sabotage the production of both the nucleic acids and protein building blocks of cell replication. Mercaptopurine is an oral drug approved for use alone and in combination therapy for certain types of leukemia. In addition to the expected bone marrow suppression, this drug may cause liver toxicity. Thioguanine is close in chemical structure to mercaptopurine. It is also given orally. It is approved for use in combination therapy for nonlymphocytic leukemia. Cancer cells can resist therapy. When this happens, a tumor that originally responded to therapy may start to grow again.

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  6. Resistance is not fully understood, but it may result from a kind of selective breeding. In Chapter 1, cancer cells were described as being able to keep dividing even when their DNA is damaged.

    Because these cells cannot repair their DNA, scientists think that a tumor is made up of a lot of mutant cells. Some of these mutations make the cells able to survive the activity of the drugs that are sent to kill it. Whether this means the cells simply make more of the enzyme or protein that the drug is inhibiting, or they create proteins that block the drugs, the mutants survive to replicate.

    When the survivors replicate, they are likely to pass on their special survival ability, and the tumor gradually becomes resistant. This is why combination regimens of chemotherapy are often used, to try to hit cancer cells in several different ways. If cancer cells become resistant to one drug in the regimen, they might still be vulnerable to the others.

    Two possible mechanisms of drug resistance have already been mentioned: making more of the enzyme or protein that the cancer drug blocks and making proteins that block or deactivate the drug. There are other ways that cancer cells compensate for or evade the action of a drug, but one mechanism that can make the cell resistant to several drugs at once is the development of a multidrug resistance protein.

    These proteins act like a pump, moving potentially deadly drugs out of the cell. Research is ongoing into ways to reverse this defensive mechanism. Antimetabolites Pentostatin is used as a single-agent treatment for hairycell leukemia. Hairy-cell leukemia is an uncommon type of leukemia, accounting for less than 2 percent of all leukemias. The white blood cells in this cancer look fuzzy, or hairy, when viewed under the microscope.

    Rashes are common with this intravenous drug.