Anticancer - Alkylating Agents Flashcards
What are the Alkylating agents
Nitrogen mustards Alkyl sulfonate Nitrosureas Triazene Methylhydrazine Platinum compounds
What activates Cyclophosphamide
Hepatic enzymes
What is the function of Alkylating agents
Alkylate N7 of Guanine
Abnormal base pairing with T or excision
Strand breakage
Cell-cycle non-specific
What is the more potent version of Cyclophosphamide
Ifosfamide
What is the toxic metabolite of Cyclophosphamide
Acrolein
How does Acrolein cause Hemorrhagic cystitis
Irritates bladder mucosa
What is given to inactivate Acrolein
Mesna
What are the Nitrogen mustards
Cyclophosphamides Ifosfamide Chlorambucil Mechlorethamine Melphalan
What is the Alkyl sulfonate
Busulfan
What are the Nitrosureas
Carmustine
Lomustine
Semustine
What is the Methylhydrazine
Procarbazine
What are the Platinum compounds
Cisplatin
Carboplatin
Oxaliplatin
What are the other Cyclophosphamide AE
SIADH
BM/Immuno suppression
N/V, alopecia, gonadal failure
What is the problem with Ifosfamide
Higher risk of hemorrhagic cystitis
Pretreat with Mesna every time
What do you give for CLL
Chlorambucil
What do you give Mechlorethamine for
Non-Hodgkin’s Lymphoma
What do you give for Multiple Myeloma
Melphalan
What do you give Busulfan for
CML
What are the Busulfan AE
Pulm fibrosis
Adrenal insufficiency
Skin pigmentation
Can Nitrosureas cross the BBB
Yes
What part of the Nitrosureas do the alkylation
Chloroethyl moiety
What are Nitrosureas given for
Adjuvant for brain tumors (Primary or mets)
Nitrosurea AE
GI distress
Delayed myelosuppression
CNS dysfunction
What activates Dacarbazine
Hepatic enzymes
What is Dacarbazine given dor
Hodgkin’s Lymphoma
Soft tissue Sarcolemma
Melanoma
What are the Dacarbazine AE
Myelosuppression
N/V
What are the problems with Procarbazine
Teratogenic
Mutagenic
Leukemogenic
What do you give Procarbazine for
Hodgkin’s Lymphoma
What are the main Procarbazine AE
Hemolytic anemia
Pulm effects
Disulfiram-like rxns
What are the other Procarbazine AE
Myelosuppression
Peripheral neuropathy
N/V
Which Platinums are less toxic and emetic but more myelosuppressive
Carboplatin
Oxaliplatin
What happens when you combine Cisplatin with Amifostine
Reduce nephro/oto/neuro toxicity and myelosuppression
What do you give Platinums for
Solid tumors
NSCLC
Platinum AE
N/V
Neurotox (peripheral nerve damage and deafness)
Nephrotox
What do you give for Platinum Nephrotoxicity
Mannitol
NaCl
Amifostine
What is the problem with all Alkylating agents
Mutagenic
Carcinogenic
What do you give for Hodgkin’s Lymphoma
Dacarbazine
Procarbazine
Mechlorethamine AE
Blisters
