Chapter 17: specific side effects of chemotherapeutics
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| what is the most widely used alkylating agent? | cyclophosphamide.
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| what is the MOA of cyclophosphamide? side effects? | it becomes active only after biotransformation by P450. it, like all alkylating agents, destroys DNA. its ADRs include alopecia, BMD, leukocytosis, amenorrhea, sterility, and most importantly, hemorrhagic cystitis, which can progress to bladder fibrosis
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| this drug is famous for its ability to cause pulmonary fibrosis (resulting in restrictive pulmonary disease). | bleomycin
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| platinum compound that is extremely toxic. causes intra and interstrand cross linking between nucleotides, effectively ceasing RNA and DNA synthesis. | Cisplastin: "CEASES" all DNA and RNA synthesis. primary indication is for solid tumors such as metastatic testicular cancer, ovarian cancer, and bladder ancer.
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| ADRs of cisplastin? | persistent, intractable vomitting, nephrotoxicity, ototoxicity, and peripheral neuropathy
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| this causes aspargine to convert to aspartic acid. some neoplastic cells need an external source of aspargine, so this drug deprives them of any formerly available asparagine. | L asparginase
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| what is the primary indication for aspargine? | ALL
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| ADRs for aspargine? | hypersensitivities, as well as decreased clotting factors, liver problems, pancreatitis, seizures, coma.
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