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Oncology Drugs

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generic name
MOA
Important information
Uses:
Toxicites
show Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific   CNS toxicites caused by chloroacetaldehyde metabolite-D/C therapy   sarcomas, lymphoma, testicular, bladder, head and neck, cervical and lung cancers   Myelosuppresion(DLT), N/V, alopecia, Amenorrhea, infertility, Hemorrhagic cystist(must use MESNA), nephrotoxicity, cardiotoxicity, CNS toxicites  
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oxaliplatin   Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific   show colorectal and esophageal cancers   mild myelosuppression, N/V, diarrhea, neuropathy(DLT)(can't feel breathing and intolerant to cold), nephrotoxicity uncommon  
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Cisplatin   Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific   have to give plenty of fluids + mannitol and antiemetics   lung, ovarian, testis, bladder, head and neck, lymphomas, and esophageal cancers   show
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show Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific   use calvert equation to dose=AUC x (GFR + 25)   lung, ovarian, testes, bladder, breat, endometrial, relapse leukemias, and head and neck cancers.   more myelosuppresion(DLT) (thrombocytopenia), less nephrotoxicity, neuropathy, ototoxicity, and N/V  
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Methotrexate   Antifolate Antimetabolite agent-inhibit dihydrofolate reductaseactive in S phase   hydration w/ urinary alkalinization, antiemeticsLeucovorin is a rescue when a high dose is given.   show myelosuppresion, mucositis, N/V/D, hepatotoxicity, nephrotoxicity  
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Pemetrexed   Antifolate Antimetabolite agents-inhibits dihydrofolate reductase and thymidylate synthase   must be given w/ folic acid and Vit. B12 to reduce myelosuppression   show myelosuppression(DLT), N/V, mucositis, skin rash  
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5-Fluorouracil   show Continous-D/mucositis, Hand/Foot, Vasospastic anginabolus-BM suppresion, metallic tasteleucovorin enhances the drug.   breast, colorectal, gastric, pancreatic, ovarain, head and neck and basal cell skin(topical)   N/V, excessive lacrimation, somnolence, photosensitiviy, dry skin  
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Capecitabine   5-Fluoropyrimidine Antimetabolite agent-incorporated into DNA as a false base pair. Inhibits TS which results in thymidylate deficiency. Prevents DNA repair and synthesis   oral prodrug of 5-FU, 3 step enzymatic process that occurs only in tumorblack box: with warfarin   show N/V, mucositis, Diarrhea, HAND AND FOOT SYNDROME  
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show Cytidine Antimetabolite agent-ARa-C is triphosphorylated to ara-CTp which is incorporated into the DNA and halts strand elongation/repair   high-dose: Cerebellar toxicity(ataxia, nystagmus, slurred speech, tremor)5 days after tx and chemical conjunctivitishand and foot rare   acute & chronic leukemia, NHL, leptomeningeal carcinomatosis   depends on dose and schedule: myelosuppression, N/V, Diarrhea, Mucositis, hepatic dysfunction  
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Gemcitabine   Cytidine Antimetabolite agent-ARa-C is triphosphorylated to ara-CTp which is incorporated into the DNA and halts strand elongation/repair   show soft tissue sarcomas, pancreatic, lung, breast, ovarian, and bladder cancers   myelosuppression(DLT), flu-like, asthenia, increased transaminases  
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vincristine   vinca alkaloids-bind to tubulin, which inhibits polymerization,which is needed to form mitotic spindle. M phase specific   dose empirically capped at 2mg due to neurotoxicity Vesicant   leukemia, lymphoma, Wilm's tumor, neuroblastoma, brain, sarcoma   show
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vinblastine   vinca alkaloids-bind to tubulin, which inhibits polymerizationwhich is needed to form mitotic spindle,. M phase specific   show testicular cancer, lymphoma, kaposi's sarcoma, neuroblastoma   myelosuppression(DLT), neuropathy, constipation, SIADH, mucositis  
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Vinorelbine   show Vesicant   NSCLC, breast   More myelosuppresion than Vinblastine(DLT), neuropathy, SIADH, mucositis  
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show Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation   extravasation(vesicant)   breast, lung, gastric, bladder, thyroid, and ovarain cancers, leukemia, lymphoma, multiple myeloma, neuroblastoma, and soft tissue sarcoma   myelosuppression(DLT),N/V, mucositis & diarrhea, alopecia, hyperpigmentation of nails, rare skin rash, urticaria, cardiotoxicity, red/orange urine  
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Daunorubicin   Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation   drug is a red/orange colorvesicant   acute myeloid leukemia, acute lymphoid leukemia   show
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idarubicin   Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation   show acute myeloid leukemia   myelosuppression(DLT),N/V, mucositis & diarrhea, alopecia, hyperpigmentation of nails, rare skin rash, urticaria, cardiotoxicity, red/orange urine  
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liposomal doxorubicin   Anthracycline agent-Topoisomerase II inhibitor, DNA intercalation, inhibits DNA dependent Rna polymerase, free radical generation   drug is an irritant   show myelosuppression, N/V, mucositis, hand-foot, infusion related reactions  
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show Inhibit topoisomerase I which results in DNA single stranded breaks-S phase specific   acute and delayed diarrhea   colorectal, lung cancer   myelosuppression(DLT), N/V mucositis, alopecia, Diarrhea(DLT), cholinergic syndrome  
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show Topoisomerase II inhibitor by forming ternary complexes w/ it which results in Double stranded DNA breaks-G2 phase specific     lymphoma, ovarian, cervical, testicular, gastric, and lung cancers   myelosuppression(DLT), mucositis, Diarrhea(mild), elevated transaminases  
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etoposide Vp-16   show 50mg capsules are available-bio availability is 50%   testicular cancer, acute leukemia, lymphoma, lung cancer, ovarian cancer   myelosuppression(DLT), N/V, alopecia, mucositis, secondary AML, infusion related reactions  
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Paclitaxel   show Give dexamethasone, H1 and H2 antagonist to treat hypersensitivities   breast, ovarian, lung,bladder,prostate, esophageal, head and neck disorders, Kaposi's sarcoma   myelosuppresion(DLT), mucositis, alopecia, hypersensitivity reactions(cremophor), neuropathy, myalgias, arthralgias, hepatotoxicity, EKG abnormalities  
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Docetaxel   Taxane agent-bind tubulin creating dysfunctional microtubules resistant to depolymerization. M phase specific   given w/ 3 days of dexamethasone for prophylaxis of edema & prevent infusion reactions   show myelosuppression, mucositis, alopecia, neuropathy, peripheral edema, myalgias, fatigue, hepatoxicity, infusion related reactions  
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show Taxane agent-bind tubulin creating dysfunctional microtubules resistant to depolymerization. M phase specific   no El Cremophor, decreased risk of reactions. NO need for traditional premedications produced via nanotechnology   breast cancer   myelosuppression, alopecia, neuropathy, myalgias, hepatoxicity, EKG abnormalities  
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Ixabepilone   show pre-meds H1 and H2 antagonist   metastatic breast cancer who have progressed on anthracyclines and taxanes    
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Bevacizumab   HUMANIZED-monoclonal antibody-vascular endothelial growth factor, which initiates angiogenesis(forms new blood vessels)   documented improvement in survival w/ chemo in metastatic colon and breast cancers   show bleeding, thrombosis, HTN, infusion reactions, nephrotic syndrome, impaired wound healing, Gi perforations  
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traztuzumab   HUMANIZED-monoclonal antibody-her-2-neu, which is expressed on breast carcinomas   benefit as a single agent and in combination w/ chemo   show infusion reactions, cardiomyopathy(w/ anthracyclines), diarrhea  
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Rituximab   CHIMERIC-monoclonal antibody-B-cell surface marker CD20, which is against lymphoma cells   active in both indolent and agressive NHL, start infusion slow and then increase   show infusion reactions, mild myelosuppression  
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Cetuximab   show used as single or combo therapy w/ irinotecan in colorectal cancer   colorectal, head and neck   infusion reactions, aceneform rash, diarrhea, asthenia, paronychia, hypmagnesemia  
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show FULLY HUMAN-monoclonal antibody--directed against Epidermal growth factor receptor   used only as a single agent   colorectal cancer   decreased infusion reactions, acneform rash, diarrhea, asthenia, paronychia, hypomagnesemia  
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Imatinib   Tyrosine Kinase Inhibitor-inhibits Bcr-Abl tyrosine kinase,which is product of philadelphia chromosome in CML   many drug interaction-CYP3A4   CML, ALL(Ph+), GIST   show
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show Tyrosine Kinase Inhibitor-epidermal growth factor receptor such as in lung cancer   mild benefit in patients who have failed standard treatment   lung cancer   fatigue, diarrhea, acneform rash, nausea  
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Lapatinib   Tyrosine Kinase Inhibitor-Inhibits epidermal growth factor receptor (HER1 and HER2/neu-breast carcinomas   many drug interactions-CYP3A4   show fatigue, diarrhea, rash, nausea, hepatotoxicity  
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Bortezomib   show promotes apoptosis   relapsed multiple myeloma and relapsed or refractory mantle cell lymphoma   thrombocytopenia, fatigue, peripheral neuropathy, neutorpenia, diarrhea  
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show not fully understood, Immune modulation??   must register in STEPS program-contraceptions, filled w/in 7 days, 4 weeks at a time   multiple myeloma   teratogenic, DVT, somnolence, rash, neuropathy, constipation, and dizziness/hypotension  
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Cyclophosphamide   Akylating agent-Form covalent bond w/ cancer DNA, which prevents unwinding and replication of DNA. Cell cycle non-specific   metabolized to active species. drug increases anticoagulation effect and decreases digoxin plasma levels. Phenobarbital and phenytoin increase rate of drug metabolism to toxic metabolites   leukemia, lymphoma, multiple myeloma, sarcomas, bone, breast and ovarian cancers   show
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