Chemotherapy II Alkylating Agents Flashcards
What is the action of alkylating agents?
Covalent binding to DNA by alkylating N-7 of guanine that is cell cycle non-specific
What is required for cyclophosphamide function?
Activation via a P450 oxidase enzyme
Cyclophosphamide Indications
- Breast Cancer
- Non-Hodgkin Lymphoma
Cyclophosphamide SE
- Nausea
- Vomiting
- Hair loss
- Myelosppressoin
- Hematuria
What is the difference between ifosfamide and cyclophosphamide?
Ifosfamide has 20% of the alkylating effect that cyclophosphamide does
Ifosfamide SE
- Hematuria
- Myelosuppression
- Hair loss
What must be coadministered with ifosfamide and why?
Coadminister with mesna which is a uroprotectant to prevent hematuria which occurs much more regularly with ifosfamide
Ifosfamide Indications
- Testicular Cancer
- Soft Tissue Sarcoma
Temozolomide MOA
Methylates the DNA and inhibits DNA function and DNA synthesis
Temozolomide SE
- Nausea
- Vomiting
- Hair loss
What is required for long term use of temozolomide?
Prophylaxis for pneumocystis carinii pneumonia
Temozolomide Indications
Primary brain tumors like glioblastoma
Cisplatin MOA
Binds covalently to DNA to produce cytotoxic interstrand and intrastrand crosslinks
Cisplatin SE
- Intense nausea and vomiting
- Renal toxicity is dose limiting
- Hearing loss
- Hypomagnesemia
What is given with cisplatin to prevent kidney damage?
Mannitol with saline hydration
Cisplatin Indications
- Testicular cancer (CURATIVE)
- Bladder cancer
- Head and neck cancer
- Ovarian cancer
- Small cell and non small cell lung cancer
What is the difference between cisplatin and carboplatin?
Carboplatin is not renal toxic and doses are instead limited by the myelosuppression
What cancer is very sensitive to cisplatin?
Testicular Cancer
What is the dose limiting toxicity for cisplatin?
Renal toxicity
Oxaliplatin Indications
Colorectal cancer
Oxaliplatin SE
- Acute cold induced neuropathy
- Chronic sensory neuropathy
Vincristine MOA
Prevents polymerization of tubular
What phase of the cell cycle is vincristine specific for?
M-phase
Vincristine SE
Neuropathy
Vincristine Indications
- Non-Hodgkin’s lymphoma
- Acute lymphoblastic leukemia
- Lymphoma
Paclitaxel MOA
Prevents tubulin disassembly
What phase of the cell cycle is paclitaxel specific for?
M-phase
Paclitaxel SE
- Myelosuppression
- Hair loss
- Nausea/vomiting
- Peripheral sensory neuropathy
- Myalgia
How is paclitaxel metabolized?
Predominantly hepatic metabolism
Paclitaxel Indications
Ovarian, gastroesophageal, breast and non-small cell lung cancers
Etoposide MOA
Targets topoisomerase II and produces DNA double strand breaks
What cell cycle phase is etoposide specific for?
G1-S phase
Etoposide SE
- Nausea/vomiting
- Hair loss
- Myelosuppression
- Can cause leukemia
Etoposide Indications
- Testicular cancer
- Lung cancer
- Lymphoma
