Name the class of drug and some toxicities

Cyclophosphamide

Ifosfamide

Chlorambucil

These 3 are all Nitrogen Mustard Alkylating agents

Cyclophosphamide/Ifosfamide- hemorrhagic cystitis, myo-pericarditis, pleuritis, sterilitity

Chlorambucil- amenorrhea, male sterility

Name the class and some toxicities

Busulfan

Alkyl sulfonate alkylating agent

toxicities: pulmonary fibrosis, hepatic/pulmonary veno-occulsive disease

Name the class and toxicities

Cisplatin

Carboplatin

Platinum compounds, alkylating agents

Cisplatin- nephrotoxicity, ototoxicity, emetogenesis, myelosuppresive, alopecia

carboplatin-myelosuppression, peripheral neuropathy

Name the class of these drugs and toxicities

doxorubicin, danurubicind, idarubicin, mitoxantrone, mitomycin C, bleomycin, dactinomycin

Antineoplastic antibiotics

derivced from Streptomyces

toxicities: cardiotoxicity, alopecia, myelosuppression

Bleomycin --> pulmonary toxicity

Name the class and toxicity

Vincristine

Vinblastine

Plant alkaloid (from periwinkle)

inhibit microtubules

toxicities: neurotoxicity

Name class and toxicity

Etoposide

Teniposide

Epipodophyllotoxins

attack topoisomerases

toxicities: leukomogenesis of Chr. 11 --> acute leukemia

Name class and toxicities

Paclitaxel (Taxol)

Docetaxel (Taxotere)

Taxanes and Camptothecins

toxicities: neurological, arthralgias

Name class and toxicities

Topotecan

irinotecan

Camptopothecins

topoisomerase inhibitors

toxicities: myelosuppresion, cholergic reaction

Name the mechanism, toxicties

Methotrexate

DHFR inhibitor which inhbitis purine and thymidylate synthesis so it can be rescued by leucovorin (reduced, methylated folate) if there's an OD

toxicities: pulmonary, hepatic, mucous membrane, bone marrow

Name mechanism and toxicities

5-fluorouracil

inhibits thymidylate synthetase, used for GI maliginancies

toxicities: GI, mucosal, hand-foot syndrome

Name the class and mechanism

Fludarabine

pentostatin

Cladribine

purine nucleoside analogues

work on ribonucleotide reductase and adenosine deaminase to suppress the marrow

used for: low grade lymphomas, hairy cell leukemia

Name the class and mechanism

Tamoxifen

Megestrol acetate

leuprolide/goserelin

armidex

hormonal agents

cause receptor transformation/activation --> intracellular cascade of events --> apoptosis

can act via paracrine/autocrine mechanisms

Name class and toxicities

Prednisone

Dexamethasone

Corticosteroids

toxicities: glucose intolerance, osteoporosis, opportunistic infection, fluid retentation, fat redistribution, psychiatric

Name class

Flutamide/bicalutamide

Leuprolide/goserelin

Anti-androgens

flutamide/bicalutamide- acts directly on tissue

leuprolide/goserelin- LNRH/GnRH agonists, indirectly decrease FSH/LH levels

Name Class and use

Aminoglutethimide

Armidex

Name use/mechanism

All-trans retinoic acid

used for acute promyelocytic leukemia t(15;17) which produces PML-RAR-alpha transgene

binds to RAR-alpha --> degradation of abnormal receptor inducing differentiation

Name use and mechanism

Imatinib (Gleevec)

used for chronic myelogenous leukemia t(9;22) --> Bcr-abl transgene which is a tyrosine kinase

inhibits the tyrosin kinase and prevents substrate phosphorylation

Name use/mechanism

Rituximab

monoclonal antibody to CD20 antigen on surface of B cells so it is used for B-cell lymphomas

binds to CD20 and blocks B-cell differentiation/division --> tumor cell lysis by compleement and antibody-dependent cytotoxicity

Name use/mechanism

Trastuzumab (Herceptin)

used for breast cancer

antibody to HER2/neu receptor

Name use/mechanism

Gemtuzumab

used for AML

is an anti-CD33 monoclonal antibody attached to calicheamicin (DNA intercalating antibiotic)

Name use/mechanism

Tositumomab

Ibritumomab tiuxetan

used for lymphomas

radioimmunoconjugates (antibody+radioactivity)