Antineoplastics #1

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mp
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215146
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Antineoplastics #1
Updated:
2013-04-22 23:58:44
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Med Chem III Antineoplastics
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Antineoplastics #1
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  1. Alkylating Agents -- Nitrogen Mustards moa
    generates highly reactive aziridinium ions that act like alkylating agents to cross link DNA
  2. Alkylating Agents -- Nitrogen Mustards (7)
    • chlorambucil -- Leukeran
    • bendamustine -- Treanda
    • estermustine -- Emcyt
    • cyclophosphamide -- Cytoxan
    • ifosfamide -- Ifex
    • mechlorethamine -- Mustargen
    • melphalan -- Alkeran
  3. chlorambucil -- Leukeran
    • Nitrogen Mustard -- least toxic
    • Bifunctional
    • USE contraception
  4. bendamustine -- Treanda
    • Aziridinium ion based alkylation
    • Cell cycle non-specific
  5. estermustine -- Emcyt
    • Nitrogen Mustard
    • 17 beta-estradiol with phosphate group
    • Prostate Cancer
  6. cyclophosphamide -- Cytoxan
    • Nitrogen Mustard
    • Prodrug -- requires CYP450 for activation
    • kidney and bladder toxic (acrolein)
  7. ifosfamide -- Ifex
    • Nitrogen Mustard
    • Prodrug -- requires CYP450 for activation
    • kidney and bladder toxic
  8. Mesna sodium-thiol
    • cytoprotective agent -- cyclophosphamide and ifosfamide
    • scavenges acrolein
  9. mechlorethamine -- Mustargen
    • Nitrogen Mustard
    • Extravasation problem
  10. Extravasation tx
    • 0.16 M Sodium thiosulfate and ice packs
    • scavenges azridinium ions
  11. Alkylating Agents -- Nitrosoureas moa
    • alkylation of DNA and RNA
    • also reacts with protein and enzyme biochemical processes
  12. melphalan -- Alkeran
    • Nitrogen mustard
    • causes chromosome abnormalities
  13. Alkylating Agents -- Nitrosoureas (3)
    • carmustine -- BiCNU
    • lomustine -- CeeNu
    • streptozocin -- Zanosar
  14. carmustine -- BiCNU
    • Nitrosourea
    • injection or wafers
    • reactive intermediates are azridines and ethene cation
  15. lomustine -- CeeNu
    • Nitrosourea
    • reactive intermediate is ethene cation
    • monoalkylation -- no cross linking
  16. streptozocin -- Zanosar
    • Nitrosourea
    • highly renal toxic
    • natural product -- no antidote
  17. Other Alkylating Agents (4)
    • dacarbazine -- DTIC-Dome
    • busulfan -- Myleran
    • altretamine -- Hexalen
    • thiotepa
  18. dacarbazine -- DTIC-Dome
    • alkylating agent
    • cell cycle non-specific with some G2 phase activity
  19. busulfan -- Myleran
    • severe myelosuppression
    • used for bone marrow ablation prior to bone marrow transplant
    • can cause hyperuricemia
  20. altretamine -- Hexalen
    alkylating agent
  21. Thiotepa
    • alkylating species is ethyleneimine radical
    • disrupts DNA causing chain scission
    • monitor blood counts

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