DNA Intercalators

Question 1

Doxorubicin
Daunorubicin
Dactinomycin

Answer 1

Type: DNA Intercalators

MOA: intercalated into DNA, disrupt the progress of the replication fork –> distort helix

AE:
1. Cardiomyopathy
–Prevention: Dexrazoxane (iron chelator) –> chelates iron –> decreases formation of supercoils
2. Urine discoloration (red)
3. Vesicant (causes severe skin necrosis)

Question 2

Cytarabine

Answer 2

AKA Ara-C

Type: DNA Polymerase Inhibitor

MOA: incorparates into DNA, blocks elongation
AE:
1. Hepatotoxicty (BBW)
2. BM Suppression (BBW)
3. Cerebellar Toxicity (–> ataxia, slurred speech)

Question 3

Irinotecan
Topotecan
Etoposide

Answer 3

*“I run to the can”

Type: Topoisomerase Inhibitor/DNA-Clearing Agents

MOA: inhibit topoisomerase** –> DNA strand breaks

AE:
1. Severe diarrhea (irinotecan is AChE inhibitor –> cholinergic symptoms)
–Premed: Atropine

**Topoisomerase: removes/releases supercoils

Question 4

Bleomycin