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Chemotherapy Drug Classification Overview

The document provides a comprehensive classification of chemotherapy agents, detailing their mechanisms, key toxicities, dose modifications, and indications. It covers various drug categories including alkylating agents, antimetabolites, antimicrotubule agents, topoisomerase inhibitors, anthracyclines, platinum compounds, anti-tumor antibiotics, epipodophyllotoxins, and miscellaneous cytotoxics. Each category includes specific drugs, their side effects, and clinical applications in treating different cancers.

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Anindya Mukherjee
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22 views3 pages

Chemotherapy Drug Classification Overview

The document provides a comprehensive classification of chemotherapy agents, detailing their mechanisms, key toxicities, dose modifications, and indications. It covers various drug categories including alkylating agents, antimetabolites, antimicrotubule agents, topoisomerase inhibitors, anthracyclines, platinum compounds, anti-tumor antibiotics, epipodophyllotoxins, and miscellaneous cytotoxics. Each category includes specific drugs, their side effects, and clinical applications in treating different cancers.

Uploaded by

Anindya Mukherjee
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

CHEMOTHERAPY CLASSIFICATION AND DRUG-WISE SUMMARY

1. ALKYLATING AGENTS

Mechanism: DNA cross-linking, non–cell-cycle-specific.

Drugs: Cyclophosphamide, Ifosfamide, Melphalan, Chlorambucil, Busulfan, Dacarbazine,


Temozolomide, Procarbazine, Bendamustine.

Key Toxicities: Myelosuppression, hemorrhagic cystitis, neurotoxicity (ifos), gonadal failure,


secondary malignancies, busulfan lung fibrosis.

Dose Modifications: Renal/hepatic impairment, cytopenias.

Indications: Lymphoma, breast, sarcoma, myeloma, brain tumors, transplant regimens.

2. ANTIMETABOLITES

S-phase specific; inhibit DNA/RNA synthesis.

2A. Folate Antagonists

Methotrexate: DHFR inhibitor; mucositis, renal toxicity; leucovorin rescue; renal dose mod; ALL,
lymphomas, osteosarcoma.

Pemetrexed: Multi-target antifolate; myelosuppression, rash; needs folate/B12/steroids; NSCLC,


mesothelioma.

2B. Purine Analogues

6-MP/6-TG: TPMT metabolism; hepatotoxic; ALL maintenance.

Fludarabine/Cladribine: Profound immunosuppression; needs PJP prophylaxis; CLL, indolent


lymphomas.

2C. Pyrimidine Analogues

5-FU: TS inhibitor; HFS, mucositis, diarrhea; DPD deficiency risk; GI cancers.

Capecitabine: Oral 5-FU; HFS; renal reduction.

Cytarabine: CNS toxicity (high-dose), conjunctivitis; AML.

Gemcitabine: Myelosuppression, flu-like symptoms; pancreas, lung, bladder.

3. ANTIMICROTUBULE AGENTS

3A. Vinca Alkaloids

Vincristine: Neurotoxicity, constipation; non-myelosuppressive; fatal intrathecal.

Vinblastine: Myelosuppression.
Vinorelbine: Lung/breast; neutropenia.

3B. Taxanes

Paclitaxel, Docetaxel, Nab-paclitaxel.

Toxicities: Neuropathy, myelosuppression, hypersensitivity (Cremophor), fluid retention.

Indications: Breast, lung, ovary, GI, sarcoma.

Dose Mod: Neuropathy, hepatic dysfunction, ANC thresholds.

4. TOPOISOMERASE INHIBITORS

4A. Topo I (Irinotecan, Topotecan)

Irinotecan: Acute diarrhea (atropine), delayed diarrhea (loperamide); UGT1A1*28 toxicity;


colorectal.

Topotecan: Myelosuppression; SCLC, ovarian.

4B. Topo II (Etoposide)

Myelosuppression, secondary AML; SCLC, germ cell tumors, lymphomas.

5. ANTHRACYCLINES

Doxorubicin, Epirubicin, Daunorubicin, Idarubicin.

Mechanism: Intercalation, Topo II block, free radicals.

Toxicities: Cardiomyopathy, myelosuppression, mucositis, vesicant.

Monitoring: ECHO; dexrazoxane.

Indications: Breast, lymphoma, sarcoma, leukemia.

6. PLATINUM COMPOUNDS

Cisplatin: N/V, nephrotoxicity, ototoxicity, neuropathy, Mg/K wasting.

Carboplatin: Myelosuppression; AUC-based dosing; less renal toxicity.

Oxaliplatin: Cold neuropathy; colorectal.

Dose Mod: Renal function, neuropathy.

7. ANTI-TUMOR ANTIBIOTICS (Non-anthracycline)

Bleomycin: Pulmonary fibrosis; HL and germ cell.

Mitomycin-C: HUS; GI, bladder.


8. EPIPODOPHYLLOTOXINS

Etoposide: (covered above).

9. MISCELLANEOUS CYTOTOXICS

Mitoxantrone: Less cardiotoxic; prostate, AML.

L-Asparaginase: Pancreatitis, thrombosis, allergy; ALL.

Hydroxyurea: Myelosuppression; CML, leukostasis.

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