Anti-Cancer Drugs PDF

ALKYLATING AGENTS bind to DNA bases to halt DNA replication; cell cycle non-specific Drug Similar Drugs Class Cyclophosphamide chlorambucil alkylating agent Cisplatin carboplatin alkylating agent platinum based oxaliplatin Busulfan Carmustine lomustine MOA Clinical Use Notes rescue: mes...

ALKYLATING AGENTS bind to DNA bases to halt DNA replication; cell cycle non-specific Drug Similar Drugs Class Cyclophosphamide chlorambucil alkylating agent Cisplatin carboplatin alkylating agent platinum based oxaliplatin Busulfan Carmustine lomustine MOA Clinical Use Notes rescue: mesna metabolite: acrolein advanced colon cancer nephrotoxicity acoustic nerve damage rescue: amifostine decreased nephrotoxicity by administering mannitol with forced hydration alkylating agent chronic myelogenous leukemia pulmonary fibrosis marrow sparing alkylating agent (nitrosurea) brain tumors CNS toxicity highly lipophilic → can cause BBB hodgkin's lymphoma non hodgkins lymphoma disulfiram-like reaction leukomogenic disulfiram: drug indicated for chronic alcoholics bc it causes hangover-like effect phototoxicity flu-like syndrome non-leukomogenic (unlike procarbazine) alkylating agent Dacarbazine alkylating agent forms hydrogen peroxide which generates free radicals that cause DNA strand scission non hodgkin's lymphoma chronic lymphocytic leukemia Adverse Effects hemorrhagic cystitis Procarbazine form dna cross-links leading to inhibition of DNA synthesis and function ANTIMETABOLITES purine and pyrimidine analogues that mimic DNA bases to prevent DNA replication; cell cycle specific Drug Similar Drugs Methotrexate 6-Mercaptopurine 6-thioguanine fludarabine cladribine 5-fluorouracil Class MOA Clinical Use Adverse Effects Notes antimetabolite DMARD inhibit dihydrofolate reductase decrease synthesis of thymidylate, amino acids, purine nucleotides choriocarcinoma primary CNS lymphoma rheumatoid arthritis psoriasis ectopic pregnancy bone marrow suppression hepatototxic rescue: leucovorin (folinic acid) antimetabolite (purine) inhibits de nove purine nucleotide synthesis activated by HGPRT acute leukemias (AML, ALL) hepatotoxic (cholestasis, jaundice, necrosis) metabolism is inhibited by allopurinol and febuxostat antimetabolite (pyrimidine) inhibits thimydylate synthase causes thymineless death of cells colorectal cancer skin cancer (basal cell, acitinic keratoses) bone marrow suppression GI irritation alopecia inhibits DNA synthesis and repair inhibits ribonucleotide reductase acute leukemias (AML, ALL) CML in blast crisis bone marrow suppression GI irritation nueurotoxicity pancreatic cancer bone marrow suppression neutropenia pulmonary toxicity Cytarabine Gemcitabine most specific for S-phase of cell cycle NATURAL PRODUCT ANTICANCER DRUGS cell cycle specific Drug Similar Drugs Vincristine Class vinca alkaloid MOA Clinical Use prevents microtubule assembly Vinblastine Adverse Effects Notes acute leukemias peripheral neuritis paralytic ileus cell arrest at metaphase testicular carcinoma kaposi sarcoma bone marrow suppression M phase plant derivative: madagascar periwinkle bone marrow suppression alopecia Gi distress plant derivative: mayapples Etopisode teniposide podophyllotoxin inhibits dna topoisomerase II (dna gyrase) lung cancer non hodgkins lymphoma Topotecan irinotecan camptothecin inhibits dna topoisomerase I topotectan: small lung cancer bone marrow suppression irinotectan: metastatic colorectal diarrhea cancer plant derivative: camptothecin (small durian-like) Paclitaxel docetaxel taxanes interferes with mitotic spindle prevents microtubule disassembly advanced breast and ovarian cancer plant derivative: pacific yew paclitaxel: neutropenia, thrombocytopenia, peripheral neuropathy docetaxel: bone marrow suppression ANTITUMOR ANTIBIOTICS -rubicin or -mycin Drug Doxorubicine Similar Drugs danorubicin idarubicin epirubicine mitoxantrone Bleomycin Class anthracycline MOA Clinical Use inhibits topoisomerase II cell cycle non-specific antitumor antibiotic intercalates with dna cell cycle specific Actinomycin D Adverse Effects Notes breast cancer acute luekemias - idrarubicin: AML dilated cardiomyopathy congeestive heart failure rescue: dexrazoxane testicular cancer pneumonitis pulmonary fibrosis most specific for G2 phase binds to dsDNA melanoma inhibits DNA dependent RNA synthesis Wilms tumor bone marrow suppression skin reactions Gi irritation MISCELLANEOUS Drug Imatinib Similar Drugs MOA Clinical Use Adverse Effects Notes tyrosine kinase inhibitors inhibits tyrosine kinase activity chronic myelogenous leukemia GI stromal tumor fluid retention drug interactions interacts with other drugs that depend on P450 system monoclonal antibody acts against cells that overexpress HER2-neu receptor metastatic breast cancer cardiotoxic (congestive heart failure) subcutaneous injection Bevacizumab inhibits binding of VEGF to VEGFR metastatic colorectal cancer non small cell lung cancer diabetic retinopathy hypertension arterial thrombosis impaired wound healing gastrointestinal perforation Rituximab binds to surface protein in NHL cells (CD20 inhibitor) non hodgkins lymphoma (low grade) hypersensitivity bone marrow suppression endogenous glycorpteins with antineoplastic immunosuppressive antiviral actions hairy cell leukema t-cell lymphoma bone marrow suppression neurologic dysfunction Trastuzumab Interferon-a dasatinib nilotinib Class interferon contraindications: - autoimmune disease - cardiac arrhythmias.dysrrhythmia - pregnancy