Chemo Drugs Reduced 2 Flashcards
Alkylating Agents
Bind covalently to DNA
cell cycle non specific
DNA drug intrastrand and interstrand crosslink
Alkylate N-7 guanine
Resistance to Alkylating agents
enhanced DNA repair or binding to sulfur containing molecules
cyclophosphamide and ifosfamide
mensa for hematuria(active in urine)
myelosuppression dose limiting
Temozolomide
monofunctional alkylating agent
Prophylaxis PCP pneumonia with long term use
TREAT: Primary brain tumor (glioblastoma with radiation treatment)
Pt Coordination Compounds
Non classical DNA alkylating agent Pt 2+ oxidation state leaving group cis N7 of adenine and guanine Aquation to DNA reactive species -can be bound by sulfur and not make it
Cisplatin
Nephrotoxic and Ototoxic
Chloruresis helps protect kidney (can’t do if heart failure can’t handle)
TREaT: Testicular cancer (CURATIVE)
Carboplatin
Not nephrotoxic
Myelosuppression dose limiting
LInear relationship between GFR and plasma clearance
-AUC calculation:
dose=AUC X (GFR +25)
Cross resistant with cisplatin
Oxaliplatin
Myelosuppression dose limiting
vein irritant
Acute induced neuropathy
chronic sensory neuropathy
TREAT: Metastatic colorectal cancer (doubling survival rate)
Vincristine, Vinblastine
periwinkle plant
M phase specific
prevents polymerization of tubulin
Excretion via bile
-patients with elevated bilirubin require dose reduction
Vincristine:
Neuropathy dose limiting
No myelosuppression
(christ my nerves)
(blast my bones)
Paclitaxel
M phase
Prevent tubulin disassembly
Hepatic metabolism
Myelosuprresion and Neuropathy
Premedication to prevent allergic reactions
Dose reduction needed in hepatic dysfunction
Used in: ovarian and breast lung, gastroesophageal
Docetaxel and Cabazitaxel
prostate
Albumin bound paclitaxel
-albumin bound paclitaxel (no allergic reactions, less myelosuppression and neuropathy)
Etoposide
G1-S phase Topoisomerase 2 target Produces DNA double strand breaks Myelosuppression dose limiting Dose reduction for renal/hepatic dysfunction
Testicular, lung, lymphoma
