Chemotherapy Pharmacology agents Flashcards
What are the cell cycle nonspecific agents?
- Alkylating agents
- Anthracyclines
- Nitrosoureas
- Platinum agents
What are the cell cycle specific chemotherapy agents?
- Antimetabolites
- Vinas
- Taxanes
What are some of the alkylating agents? (Creates direct crosslinks of base pairs)
- Cyclophhosphamide
- Ifosfamide
- Melphalan
- Busulfan
- Mechlorethamine
- Chlorambucil
- Thiotepa
What are some of the typical alkylator toxicities?
- Myelosuppression
- N/V
- Secondary malignancies
- Interfility/impaired fertility
- Hemorrhagic cystitis (ifosfamide>cyclophosphamide)
- Need to use Mesna with since acrolein metabolite is formed
What are some of the platinum compounds? (atypical alkylators)
- Cisplatin, carboplatin, oxaliplatin
What are some of the toxicities of platinum compounds (atypical alyklators)
- Peripheral neuropathies (oxaliplatin: cold sensitivity)
- Nephrotoxic (cisplatin)
- N/V
- Thrombocytopenia
What are some of the nitrosoureas? (Atypical alkylators)
- BCNu (Carmustine)
2. CCNu (Lomustine)
What are some of the toxicities of nitrosoureas?
- Pulmonary (BCNu)
- Myelosuppression
- N/V
- Phlebitis
- CNS (BCNU w/ etOH diliution)
What steps do antimetabolites inhibit?
Structurally similar to compounds needed for cell function. They inhibit DNA replication and repair with S phase specificity
What are some examples of folate antagonists (antimetabolites)?
- Methotrexate (Higher doseases require leucovorin for urine alklanization). Toxicities include mucositis and myelosuppression
- Pemetrexed: Need to supplement with folic acid and B12
What are some pyrimidine analogues (Antimetabolites)?
- Fluouracil (Can be given bolus or continuous. Continuous infusion may lead to GI symptoms. BOlus may lead to myelosuppression)
- Capecitabine (oral fluouracil prodrug that can cause hand-foot syndrome)
Leucovorin aids by what mechanism?
Increases 5FU binding affinity to thymidilate synthase. LCV leads to N5,N10 methylene THF
What are some pyrimidine antagonists (antimetabolites)?
- Cytarabine (Ara-C)
- Needs continuous infusion and high dose
- High dose may lead to cerebellar toxicity (increased incidence with renal dysfunction, creatinine>2)
- Conjunctivitis (excreted from tear ducts)
What are some of the purine antagonists?
- 6-Mercaptopurine
- Gemcitabine
- Cladribine (2-CDA)
- Fludarabine
What are the microtubule targetting agents?
- Vinca alklaloids (Vincristine, Vinblastine, VInorelbine)
2. Taxanes (Paclitaxel, docetaxel)