Chemotherapy drug chart.cd - OHSU Books
Chemotherapy drug chart.cd - OHSU Books
Chemotherapy drug chart.cd - OHSU Books
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Class of <strong>drug</strong> Drug examples Mechanism Specific uses Notes<br />
Anthracyclines Daunorubicin, inhibits<br />
Leukemia, Lymphomas<br />
Doxorubicin, topoisomerase II,<br />
cardiomyopathy, CHF<br />
Mitoxantrone,<br />
Idarubicin<br />
R.O.S. generation<br />
Alkylating agents Cyclophosphamide Alkylates and Lymphoma, Myeloma hemorrhagic cystitis<br />
Melphalan<br />
Chlorambucil<br />
Dacarbazine(DTIC)<br />
damages DNA<br />
Busulfan<br />
CML, SCTs<br />
Platinums<br />
ototoxicity (cisplatin)<br />
Hydroxyurea inhibits<br />
acute stage of leukemia<br />
ribonucleotide (initial therapy @<br />
reductase<br />
presentation w/ ↑WBC)<br />
Purine analogs Fludarabine Makes bad DNA -‐ CLL<br />
severe immune<br />
Clofarabine<br />
-‐ AML, ALL<br />
suppression (CD4 < 200<br />
*Pentostatin<br />
= ADA inhibitor<br />
(too toxic for CLL) after 6 mos.)<br />
Pyrimidine Cytosine<br />
inhibits pyrimidine AML cerebellar dysfunction<br />
antagonist arabinoside<br />
(cytarabine)<br />
synthesis<br />
Hypomethylators azacitidine, inhibit DMT ⇒<br />
decitabine allow transc’n of<br />
tumor suppressor<br />
histone deacetylase vorinostat,<br />
cut. T cell lymphoma<br />
inhibitor<br />
romadepsin<br />
Proteosome Bortezomib Impairs DNA Multiple Myeloma<br />
Inhibitors<br />
replications<br />
Antimetabolite Methotrexate blocks DHF<br />
reductase<br />
Intrathecal Tx in ALL *antidote = leucovorin
Targeted Therapy<br />
(bcr-‐abl)<br />
Immune<br />
Suppression<br />
Imatinib<br />
dasatanib<br />
nilotinib<br />
Thalidomide,<br />
Lenolidomide,<br />
IFN<br />
Inhibits mutated<br />
enzyme<br />
Immune<br />
suppression<br />
CML (c-‐kit, PDGF, SCF)<br />
(src-‐kit, EPHA2)<br />
Multiple Myeloma,<br />
myelodysplasia,<br />
CLL<br />
ALL<br />
inc. activity/binding<br />
Teratogenic!<br />
Enzyme L-‐Asparaginase Impairs leukemia<br />
(asparagine→asp) cell growth<br />
Vinca alkaloids Vincristine, Microtubule Lymphoma, ALL peripheral neuropathy<br />
Vinblastine inhibition<br />
taxanes,<br />
Microtubule<br />
epothilones promotion<br />
Antibiotic Bleomycin DNA breaks, blocks Hodgkin’s Lymphoma lung damage<br />
thymidine<br />
(dose>400 units,<br />
incorporation,<br />
age>70)<br />
makes R.O.S.<br />
∴ avoid high O2 %!<br />
Differentiating All-‐trans-‐retinoic Induced<br />
M3 (AML) ATA syndrome<br />
Agent<br />
acid<br />
differentiation of<br />
= fluid retention<br />
leukemia cells<br />
= fever/wgt gain/SOB<br />
Monoclonal Rituximab Binds & kills cells CLL, NHL<br />
antibodies = anti-‐CD20<br />
alemtuzumab<br />
= anti-‐CD52<br />
Immunosuppression<br />
Topoisomerase Etoposide (II) Interferes with ALL consolidation<br />
inhibitors<br />
Teniposide (II)<br />
Topotecan (I)<br />
DNA repair<br />
Glucocorticosteroid Prednisone,<br />
dexamethasone<br />
Kills lymphocytes ALL, NHL
targeting linked molecules<br />
gemtuzumab ozogamicin = anti-‐CD33+calicheamicin (AML)<br />
denileukin difitox = Diphtheria toxin + IL-‐2 (T cell NHL)<br />
radioimmunoconjugates (anti-‐CD20 ⇒ lymphoma): Tositumomab = iodine131<br />
Ibritumomab tiuxetan = ytrium90<br />
Disease Common Standard Therapy<br />
Acute Myelogenous Leukemia 3+7 (anthracycline/cytarabine)<br />
Hodgkin’s Disease ABVD<br />
Non-‐Hodgkin’s Disease CVP, R-‐CHOP<br />
Chronic Myelogenous Leukemia Imatinib (or dasatanib, nilotinib)<br />
Chronic Lymphocytic Leukemia FCR / PCR<br />
Myelodysplasia lenolidomide, hypomethylator<br />
Myeloma DVD, CYBOR-‐D<br />
Acute Lymphocyte Leukemia Induction: DVPA<br />
Consolidation: DVPA + teniposide, cytarabine, methotrexate<br />
Maintenance: MTX, 6MP<br />
Regimen Components<br />
3+7 3 d. Anthracycline, 7 d. Cytarabine<br />
CHOP Cyclophosphomide, Doxorubicin, Vincristine, Prednisone<br />
ABVD Adriamycin, Bleomycin, Vincristine, DTIC<br />
FCR Fludarabine, Cyclophosphamide, Rituxan<br />
PCR Pentostatin, Cyclophosphamide, Rituxan<br />
DVD Doxorubicin, Vincristine, Dexamethasone<br />
CYBOR-‐D Cyclophosphomide, Bortezomib, Dexamethasone<br />
DVPA Daunorubicin, Vincristine, Prednisone, Asparaginase
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