CHEMO
AGENTS
CHEMOTHERAPEUTIC DRUGS
Chemotherapeutic Drugs: classified by their action on the cell or their source.
ALKYLATING AGENTS:not cell cycle specific but rather work throughout the cycle, they bond with nucleic acids, thereby interfering with their action. Associated with an increased risk of acute myelogenous leukemia and is related to the total drug dose.
- Side Effects Include: bone marrow depression, amenorrhea in women and azoospermia in men, and carcinogenesis.
Busulfan: nausea and vomiting, diarrhea, pulmonary fibrosis, bone marrow suppression, impotence, amenorrhea, and skin hyperpigmentation
Carboplatin: nausea and vomiting, bone marrow suppression, ototoxicity, neurotoxicity, and hyperuricemia
Chlorambucil: myelosuppression and interstitial pneumonia-pulmonary fibrosis
Cisplatin: neurotoxicity, myelosuppression, nephrotoxicity, nausea and vomiting, hyperkalemia, and hypomagnesemia
Cyclophosphamide: myelosuppression, anorexia, stomatitis, alopecia, gonadal suppression, nail hyperpigmentation, nausea and vomiting, diarrhea, and hemorrhagic cystitis
Dacarbazine: nausea and vomiting, anorexia, vein irritation, alopecia, myelosuppression, facial flushing, and radiation recall
Hexamethylmelamine: nausea and vomiting, diarrhea, abdominal cramps, alopecia, myelosuppression, and neuropathy
Melphalan: hypersensitivity, nausea, myelosuppression, amenorrhea, pulmonary infiltrates, and sterility
Nitrogen mustard: nausea and vomiting, fever, chills, anorexia, vesication, gonadal suppression, myelosuppression, hyperpigmentation and alopecia
Thiotepa: nausea and vomiting, bone marrow suppression, mucositis, and gonadal dysfunction
ANTIMETABOLITES: act by interfering with the synthesis of new nucleic acids, cell cycle specific, much more toxic to proliferating cells, but not associated with delayed bone marrow suppression or carcinogenesis, often used with intrathecal administration and 5-fluorouracil.
- Side Effects Include:gastrointestinal toxicity and acute bone marrow suppression
Cytarabone: myelosuppression, diarrhea, nausea and vomiting, alopecia, rash, fever, conjunctivitis, neurotoxicity, hepatotoxicity, pulmonary edema, and skin desquamation of the palms and soles of the feet
Floxuridine: nausea and vomiting, diarrhea, oral and gastrointestinal ulcers, bone marrow suppression, alopecia, and hepatotoxicity
Fludarabine: chills, fever, hyperuricemia, nausea and vomiting, bone marrow suppression, neurotoxicity, and pulmonary toxicity
Fluorouracil (5-FU): oral and gastrointestinal ulcers, nausea and vomiting, diarrhea, alopecia, vein hyperpigmentation, and radiation recall
6-Mercaptopurine: nausea and vomiting, anorexia, myelosuppression, diarrhea, hepatotoxicity, and hyperpugmentation
6-Thioguanine: anorexia, stomatitis, rash, vein irritation, hepatotoxicity, myelosuppression, and nausea and vomiting.
ANTITUMOR ANTIBIOTICS: derived from microbial fermentation, act on the DNA to disrupt DNA and RNA transcription, not cell cycle specific, though the effects of the antibiotics are more pronounced in the S or G2 phase
Side Effects Include:cardiac toxicity, skin ulceration with extravasation, pulmonary toxicities, bone marrow suppression and increased effects of radiation therapy.
Bleomycin: anaphylaxis, pneumonitis, pulmonary fibrosis, alopecia, stomatitis, anorexia, radiation recall, skin hyperpigmentation, fever, chills, and nausea and vomiting
Dactinomycin (actinomycin D): nausea and vomiting, stomatitis, vesication, alopecia, radiation recall, myelosuppression, and diarrhea
Daunorubicin:myelosuppression, vesication, cardiotoxicity, stomatitis, radiation recall, nausea and vomiting, alopecia, and facial flushing
Doxorubicin (Adriamycin): myelosuppression, vesication, cardiotoxicity, stomatitis, alopecia, nausea and vomiting, radiation recall, and diarrhea
Idarubicin: myelosuppression, alopecia, stomatitis, cardiotoxicity, nausea and vomiting, and vesication
Mithramycin: myelosuppression, hepatotoxicity, hyperpugmentation, nausea and vomiting, facial flushing, and nephrotoxicity
Mitomycin: myelosuppression, vesication, nausea and vomiting, alopecia, pulmonary fibrosis, hepatotoxicity, stomatitis, and hyperuricemia
HORMONAL AGENTS: act to eliminate or displace natural hormones, used to clinically manipulate cells by binding to specific intracellular receptors and interacting with DNA to change cellular function, the most common use is in the treatment of breast cancer when the tumor is positive for estrogen and progesterone receptors,
- Side Effects Include: hot flashes, depression, loss of libido, and an increase in endometrial cancers
Corticosteroids (Dexamethasone, Hydrocortisone, Prednisone, Solu-Cortef): nausea, suppression of immune function, weight gain, hyperglycemia, increased appetite, cataracts, impaired wound healing, menstrual irregularity, and interruption in sleep and rest patterns
Antiandrogen (Flutamide): impotence and gynecomastia
Antiestrogen (Tamoxifen, Zoladex): nausea and vomiting, hot flashes, fluid retention, changes in menstrual pattern, increase in bone pain, and hypercalcemia
Gonadotropin-releasing hormone (Leuprolide): impotence, decreased libido, increase in bone and tumor pain, genital atrophy and gynecomastia
NITROSOUREAS: not cell cycle specific, but they are lipid soluble and able to cross the blood brain barrier, interfere with DNA synthesis
- Side Effects Include:delayed myelosuppression, gastrointestinal toxicity, and delayed nephrotoxicity
Carmustine (BCNU): nausea and vomiting, vein irritation, myelosuppression, stomatitis, nephrotoxicity, and pulmonary fibrosis
Lomustine: nausea and vomiting, stomatitis, anorexia, myelosuppression, pulmonary fibrosis, and nephrotoxicity
Semustine: myelosuppression, nausea and vomiting, hepatotoxicity, nephrotoxicity, and pulmonary fibrosis
Streptozocin: nausea and vomiting, fever, chills, nephrotoxicity, diarrhea, myelosuppression, and hypoglycemia
PLANT (VINCA) ALKALOID: derived from the periwinkle plant, by binding to a substance that is needed for mitosis and solute transport, the vinca alkaloids stop cell replication in metaphase.
- Side Effects Include:neurotoxicity, severe ulceration of the skin if extravasation occurs, and myelosuppression
Etoposide: nausea and vomiting, diarrhea, stomatitis, parotitis, anaphylaxis, hypotension, myelosuppression, radiation recall, hepatotoxicity, and alopecia
Taxol: anaphylaxis, hypotension, nausea and vomiting, cardiotoxicity, myelosuppression, neurotoxicity, alopecia, stomatitis, and diarrhea
Teniposide: nausea and vomiting, hypertension, anaphylaxis, myelosuppression, neuropathy, alopecia, and phlebitis
Vinblastine: neurotoxicity, anorexia, myelosuppression, stomatitis, alopecia, gonadal suppression, peripheral neuropathy, and vesication
Vincristine: neurotoxicity, constipation, myelosuppression, alopecia, vesication, peripheral neuropathy, and paralytic ileus
Vindestine: nausea and vomiting, jaw pain, myelosuppression, paresthesia, alopecia, paralytic ileus, and stomatitis
MISCELLANEOUS AGENTS:
Asparaginase: anaphylaxis, nausea and vomiting, fever, chills, myelosuppression, hyperglycemia, abdominal pain, diarrhea, pancreatitis, and anorexia
Hydroxyurea: nausea and vomiting, alopecia, myelosuppression, allergic reactions, radiation recall, rash, azotemia, and dysuria
Pentostatin: nausea and vomiting, rash, myelosuppression, vein irritation, nephrotoxicity, and hyperuricemia
Procarbazine: nausea and vomiting, stomatitis, peripheral neuropathy, and severe gastrointestinal and central nervous system effects if taken with foods containing tyramine, alcohol, and monoamine oxidase inhibitor medications
Tototecan: diarrhea, nausea and vomiting, myelosuppression, anorexia, and influenza like symptoms