Alkylating Agents Flashcards
MoA of Busulfan
Cross-links DNA
What is used to ablate patient’s bone marrow before bone marrow transplantation?
Busulfan
Use of Busulfan
CML
ablating bone marrow before BM transplant
Tox of Busulfan
Severe Myelosuppression (in almost all cases)
Pulmonary Fibrosis
Hyperpigmentation
MoA of Cyclophosphamide, Ifosfamide
Cross-links DNA
Where do Cyclophosphamide and Ifosfamide cross-link DNA at?
cross-links DNA at Guanine N-7
What must happen to Cyclophosphamide and Ifosfamide before they work?
bioactivation in the liver
Clinical Use Cyclophosphamide, Ifosfamide
solid tumors
leukemias/lymphomas
Vasculitides
Tox of Cyclophosphamide, Ifosfamide
Myelosuppression
Hemorrhagic Cystitis
How do you prevent Cyclophosphamide, Ifosfamide Hemorrhagic Cystitis?
Mesna
N-Acetylcysteine
How does Mesna work?
Mesna prevents Cyclophosphamide induced Hemorrhagic Cystitis by a thiol group binding to toxic metabolites
What are the Nitrosureas? (4)
Carmustine
Lomustine
Semustine
Streptozocin
MoA of Nitrosureas
cross-link DNA
crosses BBB
What must happen to Nitrosureas before they work?
Require Bioactivation
Use of Nitrosureas
Brain Tumors
Glioblastoma Multiforme