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PCT4--Chemo Drugs

Drugs, class, side effect

Drug/ClassMain side effects
Fluorouracil Pyrimidine analog Diarrhea, Hand-Foot syndrome
Capecitabine (Xeloda) Pyrimidine analog Hand-Foot syndrome (dose-limiting toxicity) USE: Colon, breast cancers
Cytarabine (Ara-C) Pyrimidine analog Neurotoxicity (cerebellar syndrome,), conjuctivitis (use prophylactic steroid eye drops)
Gemcitabine (Gemzar) Pyrimidine analog Myelosuppression (affects all 3 lineages, neutropenia prominent); transient rashes (topical/systemic corticosteroids or antihistamines)
Azacytidine (Vidaza) Pyrimidine analog Myelosuppression
Fludarabine (FAMP, Fludara) Purine analog Myelosuppression (also T-cell depleting, increased risk for opportunistic infection, consider adding prophylactic antibiotics)
Cladribine (Leustatin) Purine analog Immunosuppressive (at risk for opportunistic infections)
6-Mercaptopurine (Purinethol) Dry rash, hepatotoxicity (may be dose-limiting)
Methotrexate (Folex) Folate antagonist Myelosuppression (also T-cell depleting, increased risk for opportunistic infection, consider adding prophylactic antibiotics), CNS toxicity possible, dose-related hearing loss, mucositis!
Alimta (Pemetrexed) Folate antagonist Myelosuppression (decreased by folic acid and B12 supplements)
Vincristine (Oncovin) Vinblastine (Velban) Vinorelbine (Navelbine) Vinca alkaloids Extravastation, myelosuppression, neurotoxic(esp. Vincristine, dose-limiting), alopecia, FATAL if given intrathecally DOSE: Vincristine max is 2 mg
Paclitaxel (Taxol) Docetaxel (Taxotere) Taxanes Hypersensitivity reactions (premedicate with steroid, H1 and H2 antagonists, reaction caused by excipients), alopecia, fluid retention
Cabazitaxel (Jevtana) Taxane High cross-reactivity with other taxanes, myelosuppression (requires growth factor support), hypersensitivity (must premedicate)
Etoposide (VePesid) Topoisomerase II inhibitor Hypotension (infuse slowly--over 1 hour)
Ixabepilone (Ixempra) Epothilone Hypersensitivity (premedicate), caution if patient has cardiac disease (esp. if using with capecitabine) USE: metastatic breast cancer (with capecitabine)
Topotecan (Hycamtin) Irinotecan (Camptosar) Topoisomerase I inhibitors Diarrhea (esp. irinotecan--"I run to the can"), use loperamide (4 mg at first sign, 2 mg Q2 hours until diarrhea-free for 12 hours)
Doxorubicin (Adriamycin) Daunorubicin (Cerubidine) Idarubicin (Idamycin) Anthracyclines Major nausea and vomiting, myelosuppression, and alopecia! Cardiotoxic! Max lifetime doses: Doxorubicin: 550 mg/m2; Daunorubicin: 900-1000 mg/m2 Extravasation (use DMSO to treat) Dexrazoxane (Zinecard)--cardioprotectant
Epirubicin (Ellence) Anthracycline Cardiotoxic (max lifetime dose: 900 mg/m2), less toxic than doxorubicin because of decreased free radical formation
Mitoxantrone (Novatrone) Anthracenedione Similar to anthracyclines, less extravasation, nausea/vomiting, alopecia, cardiotoxicity compared to anthracyclines
Cyclophosphamide (Cytoxan) Ifosfamide (Ifex) Alkylating agents Myelosuppression, ifosfamide dose-limiting side effect is hemorrhagic cystitis (less in cyclophosphamide), nephrotoxicity Mesna--prevents hemorrhagic cystitis by increasing acrolein excretion
Cisplatin (Platinol) Carboplatin (Paraplatin) Oxaliplatin (Eloxatin) Platinums Cisplatin--worst for nephrotoxicity (1-2L NS pre- and post-dose), nausea/vomiting (esp. dose > 60mg/m2), neuropathy (also bad with oxaliplatin, may be exacerbated by cold), ototoxicity, potassium and magnesium wasting; carboplatin suppresses platelets
Bleomycin (Blenoxane) Antitumor antibiotic "Blow-mycin", "anti-Lance Armstrong drug", because causes pulmonary toxicity
Asparaginase Pegaspargase Erwinia asparaginase Antitumor enzyme Lower risk of hypersensitivity with pegylated, pancreatitis, monitor clotting function
Trastuzumab (Herceptin) MAB USE: Breast cancer Cardiomyopathy (must evaluate left ventricular function pre- and during treatment), infusion-related reactions (pre-treat with APAP and Benadryl)
Alemtuzumab (Campath) MAB USE: B-cell CLL Inusion-related reactions (premedicate), prolonged myelosuppression (need prophylaxis up to 6 months afterwards)
Cetuximab (Erbitux) MAB USE: Colorectal, head and neck cancer Acne-form rash (signature!) on face and torso, reversible
Bevacizumab (Avastin) MAB USE: Colorectal, lung cancer Most serious side effect is GI perforation/bleeding (only ~2%), severe hypertension (caution in patients with PMH, treat with antihypertensives)
Panitumumab (Vectibix) MAB USE: Colorectal cancer Rash (sunscreen and moisturizers), infusion reactions not as common, electrolyte abnormalities (monitor)
Gemtuzumab (Mylotarg) MAB USE: CD33 and AML Severe mylosuppression (all 3 cell lines), hypersensitivity and infusion-related reactions (pretreat with APAP/Benadryl), hepatotoxic, pulmonary toxicity
Rituximab (Rituxan) MAB USE: lymphoma, rheumatoid arthritis, leukemia Hypersensitivity reactions (do not re-try agent if these occur, stop infusion and give epinephrine, antihistamines, corticosteroids), infuse slowly, tumor lysis syndrome
Created by: 100000197460889