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- Alkylating agent
- Indications- palliative treatment of chronic lymphocytic leukemia, malignant lymphomas and Hodgkin disease.
- Actions: alkylates cellular DNA, interfering with the replication of susceptible cells.
- Adverse effects: tremors, muscle twitching, confusion, nausea, hepatotoxicity, bone marrow suppression, sterility, cancer.
- treats gestational choriocarcinoma, hydatidiform, meningeal leukemia; symptomatic control of severe psoriasis; rheumatoid arthritis; juvenile rheumatoid arthritis.
- Actions: inhibits folic acid reductase, leading to inhibition of DNA synthesis and inhibition of cellular replication; affects the most rapidly dividing cells.
- Adverse effects: fatigue, malaise, rashes, alopecia, ulcerative stomatitis, hepatic toxicity, severe bone marrow suppression, interstitial pneumonitits, chill, fever, anaphylaxis.
- Antineoplastic antibiotics
- Indications: to produce regression in leukemias, lymphomas, Wilm's tumor, and Kaposi's sarcoma.
- Pharm: IV route, rapid onset, peaks in 2 hours, with a duration of 24-36 hours, metabolized in liver and excreted in bile, feces, and urine.
- Actions: binds to DNA and inhibits DNA synthesis in susceptible cells, causing cell death.
- Adverse effects: cardiac toxicity, alopecia, NV, mucositis, red urine, myelosupression, fever, chills, rash.
- Mitotic inhibitors
- Indications: acute leukemias, Hodgkin's disease, non-Hodgkins lymphoma, rhabdomyosarcoma, neuroblastoma, and Wilm's tumor.
- Actions: interferes with the cells ability to divide.
- Pharm: IV route, has variable onset/peak, 15-30 min. , metabolized in liver and excreted in feces and urine
- Adverse effects: BMS, GI effects, renal/hepatic dysfunction and alopecia
- Hormones and hormone modulators
- Indications: treatment of metastatic breast cancer
- Action: competes with estrogen for binding sites in target tissues, such as the breast: a potent antiestrogenic agent.
- Adverse effects: hot flashes, rash, NV, vaginal bleeding, menstrual irregularities, moodiness, depression, vaginal dryness, edema, pain, cva, pulmonary emboli
- Pharm: oral route