Anthracyclines drugs are used as a treatment regime to combat cancer owing to their great chemotherapeutic potential. They are characterized by the presence of a wide range of derivatives, the most famous are doxorubicin and daunorubicin. The proposed action mechanism of anthracyclines and their derivatives to exert cytotoxic effect involves the intercalation of the drug molecule into nucleic acid and inhibition of the activity of topoisomerases. These events consequences in halting DNA replication and transcription mechanisms of the cell. Understanding of the structural and conformational changes associated with nucleic acid after binding with drugs provides significant knowledge for the development of more effective drugs. A comprehensive elucidation of the molecular mechanism(s) of action of anthracyclines drugs plays a significant role in the rational drug designing to obtain an effective, selective, and safe anti-cancer drugs.
Part of the book: Advances in Precision Medicine Oncology
Depression is a serious concern among patients and their family members undergoing treatment for acute and chronic illnesses. The quality of palliative care has great significance in improving the mental health of patients. The patient usually undergoes various stages of treatment before reaching the palliative care stage. Therefore, the tendency of denying treatment at later stages of illness increases. Depression could arise either early or at later stages of treatment. Most doctors feel restrained to prescribe antidepressants to the patient, as antidepressants could have a serious side effect on the physiology of the patient. Antidepressants only work for a smaller group of patients. A proper diagnostics and structured interview with extensive checks of reliability and viability could be used for assessment. Various factors like sociodemographic, gender, age, support health groups have a drastic effect on the mental health of the patient. Palliative care to the patients with social health support groups psychotherapy, relaxation meditation yoga, along with the appropriate pharmacological approach, works wonders for some patients. Continued efforts should be made to treat and deal with depression in palliative care.
Palliative care is an essential component in any disease management. Pain assessment acts as the connecting link between the nerves, brain and spinal cord. Classification and assessment of the pain have great significance in controlling the pain-related symptoms. Pain is broadly divided into three types nociceptive, neuropathic and mixed depending upon the damage caused. Nociceptive pain is caused due to the stimulation of the pain receptors in the tissues and is further divided into visceral and somatic depending on the pain site. Neuropathic pain arises when the nervous system gets damaged or start dysfunctioning. Cancer pain assessment includes several factors like the site, intensity, syndrome, timing and temporal variation of pain. Edmonton staging system for cancer pain prognostic is widely used for pain management includes emotional/psychological distress cognitive impairment caused by pain. A comprehensive understanding of pain assessment will help in enhancing the quality of life of the patients.