Cytotoxic drug classes Flashcards
Cytotoxic antibiotics
Radiomimetic - avoid concomitant radiotherapy as it causes toxicity
1. Anthracyclines
2. Antineoplastic antibiotics
Anthracyclines
“RUBICIN”
- Doxorubicin (excreted in bile, reduce dose if high bilirubin)
- Epirubicin
- Idarubicin
- Daunorubicin
Anthracyclines - SE
Cardiotoxicity (dose related - higher risk if given with herceptin
Red urine
Doxorubicin - liposomal formulations
Reduce incidence of cardiotoxicity and extravasion but cause hand and foot syndrome:
- Macular (red skin eruptions)
Hand and foot syndrome - treatment
Derazoxane
- Given for anthracycline induced SE, extravasion + overdose
- Cool hands and feet/avoid socks and gloves for 4-7 days after treatment.
Antineoplastic antibiotics
Bleomycin
Bleomycin - side effects
- Pulmonary fibrosis (basal lung crepitations)
- Respiratory failure in anaesthesia
- Hypersensitivity (chills, fever, give IV hydrocortisone as prevention)
- Dermatological toxicity (hyperpigmentation, sclerotic plaques)
Vinca alkaloids
- Vincristine
- Vinblastine
- Vindesine
- Vinflunine
- Vinorelbine
Vinca alkaloids - route of administration
IV only!!
Never give intrathecally - fatal neurotoxicity
NPSA alerts:
- Adults/teenagers unot receive doses in 50 ml mini bag.
- Children unit receive doses by syringe.
Vinca alkaloids - side effects
CNS toxicity
- Peripheral/autonomic neuropathy
Antimetabolites
- Methotrexate
- Capecitabine (pro-drug of 5-FU)
- Fluorouracil (5-FU)
Antimetabolites - SE
Oral mucositis
Myelosuppression
Folinic acid = speeds up recovery in MTX side effects and overdose
Alkylating drugs
- Cyclophosphamide (casues urothelial toxicity)
- Carmustine
- Lomustine
- Mephalan
- Chlorambucil
- Ifosfamide
Alkylating drugs - side effects
- Permanent male sterility
- Non-lymphatic leukaemia
Aromatase inhibitos
- Anastrazole
- Letrozole
NOT FOR PREMENOPAUSAL WOMEN
- Aromatase inhibitors are anti-oestrogens
