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 Notes rescue: mesna metabolite:...

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 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 Clinical Use 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 prevents microtubule assembly Vinblastine Etopisode teniposide podophyllotoxin inhibits dna topoisomerase II (dna gyrase) Clinical Use 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 lung cancer non hodgkins lymphoma bone marrow suppression alopecia Gi distress plant derivative: mayapples 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 Class anthracycline MOA inhibits topoisomerase II cell cycle non-specific Clinical Use breast cancer acute luekemias - idrarubicin: AML Adverse Effects dilated cardiomyopathy congeestive heart failure Notes rescue: dexrazoxane