Antimetabolites and Hydroxyurea Unusual Toxicities

Question 1

Capecitabine and Cytarabine (Unusual Toxicity)

Answer 1

Hand and Foot Syndrome

Question 2

Mercaptopurine (Unusual Toxicity)

Answer 2

Pharmagenetic Dosing (TPMT Single Nucleotide Polymorphisms)

Question 3

Methotrexate (Unusual Toxicity)

• Protective agent?

Answer 3

• GI toxicity (mucostitis, esophagitis)
• Renal Precipitation
• (Levocorin rescue may be required in High dose)

Leucovorin = methotrexate rescue

Question 4

5-FU (Unusual Toxicity)

Answer 4

• Hand and Foot Syndrome

- GI Toxicity (mucostitis, esophagitis)

Question 5

Thioguanine (Unusual Toxicity)

Answer 5

Pharmacogenetic Dosing

Question 6

Hydroxyurea (Unusual Toxicity)

Answer 6

• Desquamative Interstitial Pneumonitis

- Skin toxicities (SKIN CANCER, SKIN DARKENING, RASH)

Question 7

WHAT IS THE DOSE LIMITING TOXICITY FOR ALL ANTI-METABOLITES AS WELL AS HYDROXYUREA?

Answer 7

MYELOSUPPRESSION

Question 8

Premetrexed (Unusual Toxicity)

• protective med?

Answer 8

• Hepatic Fibrosis

Leucovorin = methotrexate rescue

Question 9

Gemcitabine (Unusual Toxicity)

Answer 9

• Interstitial pneumonitis

- Peripheral neuropathy