Chemotherapy

CLASSIFICATION OF CHEMOTHERAPEUTIC AGENTS DRUG CLASS AND EXAMPLE

MECHANISM OF ACTION

CELL CYLCE SPECIFICITY

COMMON SIDE EFFECTS

ALKYLATING AGENTS Busulfan, carboplatin,chlorambucil, Cisplatin, Cyclophosphamide, dacarbazine,hexamethyl melamine,ifosfamide, melphalan,nitrogen mustard, thiotepa

Alter DNA Cell cyclestructure by misreading nonspecific DNA code, initiating breaks in the DNA molecule, cross-linking DNA strands.

Bone marrow suppression, Nausea,vomiting,cystitis (cyclophosphamide,ifosfamide) stomatitis,alopecia,gonadal suppression,renal toxicity(cisplatin)

Similar to the alkylating agents;cross the blood-brain barrier

Cell cyclenonspecific

Delayed and cumulative myelo-suppression,especially thrombocytopenia;nausea, Vomiting

Induce breaks in the DNA strands by binding to enzyme topoisomerase I,preventing cells from dividing

Cell cyclespecific

Bone marrow suppression,diarrhea,nausea, Vomiting,hepatotoxicity

Interfere with the biosynthesis of metabolites or nucleic acids necessary for RNA and DNA synthesis

Cell cyclespecific (s phase)

Nausea,vomiting, diarrhea, bone marrow suppression,proctitis, stomatitis,renal toxicity(methotrexate), hepatotoxicity

NITROSUREAS Carmustine(BCNU), Lomustine(CCNU), Semustine(methyl CCNU),Streptozocin TOPOISOMERASE I INHIBITORS Irinotican,tropotecan

ANTIMETABOLITES 5-Azacytadine, cytarabine,fludarabine, 5-flourouracil(5-FU), FUDR, gemcitabine,hydroxyurea, leustatin,6-mercaptopurine,metho trexate,pentostatin,6-thioguanine

ANTITUMOR ANTIBIOTICS Bleomycin,dactinomycin, Daunorubicin,doxorubicin, (adriamycin),idarubicin, mitomycin,mitoxantrone, plicamycin

Interfere with DNA synthesis By binding DNA;prevent RNA synthesis

Cell cyclenonspecific

Bone marrow suppression, nausea,vomiting,alopecia, anorexia,cardiac toxicity (daunorubicin,doxorubicin)

Arrest metaphase by inhibiting mitotic tubular formation(spindle); Inhibit DNA and protein synthesis

Cell cyclespecific (M phase)

Bone marrow suppression(mild with VCR),neuropathies(VCR), Stomatitis

Arrest metaphase by inhibiting tubulin depolymerization

Cell cyclespcific (M phase)

Bradycardia, hypersensitivity reactions,bone marrow suppression,alopecia, neuropathies

Bind to hormone receptor sites that alter cellular growth;block binding of estrogens o receptor sites(antiestrogens); Inhibit RNA synthesis;suppress aromatase of P450 system,which decreases estrogen level

Cell cyclenonspecific

Hypercalcemia,jaundice, increased appetite, Masculinization, feminization,sodium and fluid retention,nausea, vomiting,hot flashes, vaginal dryness

Unknown or too complex to categorize

Varies

Anorexia,nausea,vomiting, Bone marrow suppression, Hepatotoxicity,altered Glucose metabolism

MITOTIC SPINDLE POISONS Plant alkaloids:etoposide, teniposide,vinblastine, Vincristine(VCR),vindesine, Vinorelbine,

Taxanes:paclitaxel,docetaxel HORMONAL AGENTS Androgens and antiandrogens,estrogens an antiestrogens,progestines and antiprogestines,aromatase inhibitors,luteinizing hormonereleasing hormone analogs,steroids

MISCELLANEOUS AGENTS Asparaginase,procarbazine