alkylating agents side effects

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Author:
pdnguyen
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81860
Filename:
alkylating agents side effects
Updated:
2011-04-26 12:32:08
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alkylating agents side effects
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alkylating agents side effects
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  1. cyclophosphamide
    • nephrotoxicity
    • urotoxicity
    • full dose in renal dysfunction
  2. ifosfamide
    chloroacetaldehyde increases nephrotoxicity and neurotoxicity
  3. melphalan
    • Varied absoprtion and metabolism
    • Dose carefully adjusted by monitoring WBC's and platelets
  4. Chlorambucil
    • Moderate myelosuppressive: gradual and rapidly reversible
    • OK in renal dysfunction
  5. Carmustine
    • Crosses BBB
    • Need dose adjustments in renal dysfunction
  6. Streptozocin
    No need for dose adjustments in renal dysfunction
  7. Busulfan
    • VOD
    • close TDM and dose adjustments in renal dysfunction
  8. Procarbazine
    Need dose adjustments in renal dysfunction
  9. Dacarbazine
    • Potent vesican --> careful when given IV
    • Need dose re-adjustment in renal/hepatic dysfunction
  10. Temozolomide
    • Crosses BBB
    • No need dose readjustment in renal dysfunction
  11. ThioTEPA
    No need dose readjustment in renal dysfunction
  12. Altretamine
    • Palliative treatment
    • Mild peripheral an dcentral neurotoxicity
  13. Cisplatin
    Need dose adjustments in renal dysfunction
  14. Carboplatin
    • Much less reactive than cisplatin: majority in plasma remains in parent form --> less renal toxicity
    • Need dose adjustments in renal dysfunction
  15. Oxaliplatin
    • Approved with 5-FU
    • Need dose adjustments in renaly dysfunction
  16. methotrexate
    • bone marrow toxicity
    • mucosal toxicity
    • hepatic fibrosis and cirrhosis
    • pneumonitis
  17. 5-FU
    • severe GIT toxicity
    • Bone marrow depression
  18. cytosine arabinoside
    • Severe myelosuppression
    • N/V
    • megaloblastosis
    • leukopenia
    • thrombocytopenia
  19. Gemcitabine
    • myelosuppression
    • N/V/D
  20. 6-thioguanine and 6-mercaptopurine
    mainly bone marrow suppression
  21. Cladribine
    Severe bone marrow suppression
  22. capecitabine
    • myelosuppression
    • N/V
  23. fludarabine
    • myelosuppression
    • neurotoxicity (high doses)
  24. hydroxyurea
    bone marrow depression

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