Oncology Drugs: Alkylating Agents
Terms
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Nitrogen Mustards
Drug List -
Ifosfamide
Chlorambucil
Melphalan
Cyclophosphamide
Mechlorethamine -
Cyclophosphamide / Ifosfamide
Pro and AE -
Pro: Good CNS penetration
AE: Bone Marrow Suppression
Hemorrhagic cystitis
Nephrotoxicity (HYDRATE)
activated by CYP450 -
Mechlorathamine
AE - AE: Severe Nausea and Vomiting
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Melphalan
AE - AE: Prolonged Bone Marrow Suppression
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Chlorambucil
AE - Requires anti-emetic
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Nitrosouereas
Drug List -
Carmustine
Lomustine
Semustine
Streptozosin -
Carmustine/Lomustine
Pro and AE -
Pro: Good for CNS tumors (CSF levels =30%)
AE: prolonged bone marrow suppression -
Thiotepa
Class and AE -
Ethylenamines
AE: Severe Bone Marrow Suppression -
Busulfan
Class and AE -
Alkyl Sulfanate
AE:
SEIZURES - need to premedicate(Lorazepam)
Hepatotoxic -
Triazines
Drug List -
Dacarbazine (DCIT)
Procarbazine
Temozolamide -
Dacarbazine
AE - Nausea and Vomiting =>Premed
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Temozalamide
Pro: - Good CNS penetration! (works like DCIT)
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Platinum Analogs
Drug List -
Cisplatin
Carboplatin
Oxaliplatin -
Cisplatin
AE -
Synergistic action with Chemo or XRT
Nephrotoxic
Peripheral Neuropathy - trouble walking -
Carboplatin
AE - Marrow suppression (esp. platelets)
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Oxaliplatin
AE -
Advanced Colorectal Cancer
AE: Peripheral Neuropathy -
Alkylating Agents
MOA: -
Interferes w/DNA fxn by alkylating
Induces cell death rapidly -
Alkylating Agents
Resistance: -
^ DNA repair - cut out bad parts
v Permeability
occurs with monotherapy -
Alkylating Agents
Toxicities: -
Dose related
Marrow Suppression
Mucositis
Nephrotoxicity
Alopecia