CYTOTOXIC DRUGS examples Flashcards
Anthracyclines examples
- Daunorubicin
- Doxorubicin
- Epirubicin
- Idarubicin
Anthracyclines: SE
- rubi-red urine
- cardio toxic
- Dehydration/diarrhoea
Anthracyclines: formulations
- Formulations not interchangeable (conventional, liposomal, pegylated liposomal)
- Liposomal → reduced cardiotoxicity but causes painful macular skin eruptions
What is important safety information regarding Doxorubicin
- Hand-foot syndrome (painful reddening skin eruptions)
- Treat by cooling hands or feet and avoid using gloves and socks
Alkylating agents - examples
- Cyclophosphamide
- Ifosfamide
- Melphalan
- Bendamustine
Alkylating agents - side effects
- Urothelial toxicity
- Increased risk of permanent male sterility
Cyclophosphamide - SE
- cardiotoxicity (high doses)
- cystitis
- pigmentation in nails
- anorexia, weight loss
Antimetabolites - examples
- Cytarabine
- Fluorouracil
- Methotrexate
- Mercaptopurine
Methotrexate - MOA
It inhibits the enzyme dihydrofolate reductase
Methotrexate - SE
- Bone marrow suppression
- Renal/hepatic impairment
- Respiratory problems
- Ulcerative stomatitis
Methotrexate - monitoring
- FBC
- Repeated every 1-2 weeks until stable
- Then every 2-3 months - Renal function
- Repeated every 1-2 weeks until stable
- Then every 2-3 months - Liver function
- Repeated every 1-2 weeks
- Then every 2-3 months
How often is
Methotrexate administered?
WEEKLY
It the patient is taking it orally, then should take it ONCE a
week, on the same day i.e. every mondays
What is the max
Methotrexate dose?
20-30mg a WEEK
Methotrexate 10mg every day is an overdose!!
Why is Folic acid used?
- Folic acid reduces the side effects of Methotrexate
- Folic acid decreases mucosal (e.g. oral mucositis) and Gl side-effects (E.g. ulcerative stomatitis
How often does Folic acid need to be administered? And what strength?
5mg of Folic acid ONCE a week
To be taken on a different day to Methotrexate
What is the difference between Folic acid and Folinic acid?
- They both reduce the side effects of Methotrexate
- However, Folic acid is more common in practice community as it is an oral preparation
- Folinic acid is given IV, and can also be used for acute toxicity and overdose of Methotrexate
Which medication should Methotrexate
NOT be taken with?
- Trimethoprim
- NSAIDS, aspirin
- Penicillins
- PPIs
Doxorubicine - SE
- dehydration
- diarrhoea
- cardiomyopathy
Cytotoxic Antibiotics
Bleomycin
Mitomycin
Platinum Compounds: Carboplatin Cisplatin Oxaliplatin.
Cytotoxic Antibiotics - side effects
- Progressive pulmonary fibrosis
- Pulmonary toxicity
Taxanes - examples
Cabazitaxel
Docetaxel
Paclitaxel
Taxanes - side effects
- Hypersensitivity reactions → premedicate with corticosteroids and antihistamines
- Monitor cardiac output
- Monitor for signs and symptoms of pneumonitis and sepsis
Paclitaxel
Arrythmias
Vinca Alkaloids - examples
Vinblastine
Vincristine
Vindesine
Vinca Alkaloids - side effects
- Bronchospasm
- Neurotoxicity - neuropathy, motor weakness, myalgia
What are the signs of neurotoxicity with Vincristine?
- Neuralgia
- Jaw pain
- Burning sensation
- Muscle spasm
What should Vinca alkaloids NOT be administered by?
INTRATHECALLY
It can ONLY be given as
INTRAVENOUSLY (IV)
which chemotherapy agent is NOT associated with bone marrow suppression
vincristine
bleomycin
