Lange Smart Charts: Pharmacology, 2e >Oncologic Drugs

Catherine E. Pelletier-Dattu+

Drug Pharmacokinetics Mechanism of Action Clinical Uses and General Information Side Effects

•Bone marrow suppression

•A: IV or intracavitary •Lymphoma (Hodgkin's and non- •Headache
•M: Rapid hydrolysis and •Inhibition of DNA and RNA action by Hodgkin's) •Injection site reaction
Mechlorethamine (Mustargen) demethylation in plasma various mechanisms resulting in the •Malignant effusions •Nausea
•E: Parent drug and metabolites cross linking of DNA •More stable and easier to use than •Vomiting
excreted in urine nitrogen mustard •Sterility
•Ototoxicity

•Bone marrow suppression

•Breast CA
•Nausea
•Lymphoma (Hodgkin's and non-
•A: PO and IV •Vomiting
Hodgkin's)
•M: Hepatic (P450) to active •Hemorrhagic cystitis
•Multiple myeloma
Cyclophosphamide (Cytoxan) metabolites •Bladder fibrosis/carcinoma
•Neuroblastoma
•E: Parent drug and metabolites •Sterility
•Ovarian adenocarcinoma
excreted in urine •Alopecia
•Longer acting and more stable
•Inhibits P450 enzymes
analogues of nitrogen mustard
•Induces P450 enzymes

•Alopecia
•Encephalopathy
•A: IV
•Hemorrhagic cystitis
•M: Hepatic (P450)
Ifosfamide (IFEX) •Testicular germ cell tumors •Nephrotoxicity
•E: Parent drug and metabolites
•Bone marrow suppression
excreted in urine
•Inhibits P450 enzymes
•Induces P450 enzymes

•Allergic reactions (urticaria to

•A: PO
•Chronic lymphocytic leukemia hypersensitivity)
•M: Hepatic
Chlorambucil (Leukeran) •Lymphoma (Hodgkin's and non- •Sterility
•E: Parent drug and metabolites
Hodgkin's) •Bone marrow suppression
excreted in urine
•GI distress

•A: PO and IV
•M: Hepatic
•Multiple myeloma (palliative)
Melphalan (Alkeran) •E: Majority of parent drug and
•Ovarian CA
metabolites excreted in feces;
remainder in urine

•Chronic myelogenous leukemia

•A: PO and IV •Bone marrow suppression
(palliative)
Busulfan (Myleran, Busulfex) •M: Hepatic •GI distress
•Myeloablation prior to stem cell
•E: Metabolites excreted in urine •Pulmonary fibrosis
transplant

•Bone marrow suppression

•A: PO •GI distress
•M: Hepatic (P450 minor) •Brain tumors •Hepatotoxicity
Lomustine (CeeNU)
•E: Majority of metabolites excreted in •Hodgkin's lymphoma •Pulmonary fibrosis
urine •Neurotoxicity
•Inhibits P450 enzymes
 •Bone marrow suppression
•A: IV and intracranial wafer •Brain tumors
•GI distress
•M: Hepatic •Lymphoma (Hodgkin's and non-
Carmustine (BiCNU, Gliadel) •Hepatotoxicity
•E: Majority of metabolites excreted in Hodgkin's)
•Pulmonary fibrosis
urine •Multiple myeloma
•Nephrotoxicity

•A: IV
•M: Hepatic
Streptozocin (Zanosar) •Pancreatic CA
•E: Parent drug and metabolites
excreted in urine

•Bone marrow suppression

•A: IV •GI distress
•M: Nonenzymatic conversion to •Bladder CA (advanced) •Anaphylaxis
Cisplatin (Platinol) inactive metabolites •Ovarian CA (metastatic) •Hepatotoxicity
•E: Majority of metabolites excreted in •Testicular CA (metastatic) •Nephrotoxicity
urine •Neurotoxicity
•Ototoxicity

•Bone marrow suppression

•Anaphylaxis
•A: IV
•Neurotoxicity
Carboplatin (Paraplatin) •M: Hepatic (minor) •Ovarian CA (advanced)
•Vision loss
•E: Metabolites excreted in urine
•Ototoxicity
•Vomiting

•A: IV
•Bone marrow suppression
•M: Hepatic (P450) •Malignant melanoma
Dacarbazine (Dtic-Dome) •Hepatotoxicity
•E: Parent drug and metabolites •Hodgkin's lymphoma
•GI distress
excreted in urine

•A: IV, intravesicular, intracavitary •Ovarian CA

•GI distress
•M: Hepatic •Breast CA
Thiotepa •Infertility
•E: Metabolites and parent drug •Bladder CA
•Inhibits P450 enzymes
excreted in urine •Malignant effusions

•A: PO, IV
•Peripheral edema
•M: Hydrolyzed in peripheral tissues
Temozolomide (Temodar) •Brain tumors (astrocytoma, GBM) •GI distress
•E: Majority excreted as metabolites in
•Bone marrow suppression
urine

•A: IV
•CLL
Bendamustine (Treanda) •M: Hepatic (P450 minor)
•NHL
•E: Metabolites excreted in urine

•A: PO •Bone marrow suppression

•M: Hepatic metabolism •GI distress
Procarbazine (Matulane, Natulan) •Hodgkin's lymphoma
•E: Majority of metabolites excreted in •Hepatotoxicity
urine •Neurotoxicity

•A: PO •GI distress

Altretamine (Hexalen) •M: Hepatic •Ovarian CA (palliative) •Hepatotoxicity
•E: Metabolites excreted in urine •Neurotoxicity

Date of download: 06/23/22 from AccessPharmacy: accesspharmacy.mhmedical.com, Copyright © McGraw Hill. All rights reserved.