Cancer Drugs

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DNA Synthesis Inhibitors

Methotrexate
Permetrexed
Cytarabine
Fluorouracil
Gemcitabine

Methotrexate

MOA: Inhibits dihydrofolate reductase (DHFR)
A/E: Myelosuppression, Stomatitis, Renal and GI toxicity

Permetrexed

MOA: Inhibits DHFR, TS, GART
A/E: Myelosuppression, Hepatoxicity, GI toxicity

Cytarabine

MOA: Inhibition of DNA polymerase and incorparted into developing DNA
A/E: Nausea + Vomiting, Myelosuppression, Oral +GI ulceration

Fluorouracil

MOA: Converts to: d-UMP - inhibits thymidylate synthetase and prevents synthesis of thymidyline; 5-dUTP - interferes with RNA polymerase
A/E: Nausea + Vomiting, Myelosuppression, Oral + GI ulceration

Gemcitabine

MOA: S-phase specific inhibitor of DNA synthesis
A/E: Myelosuppression, Alopecia, Various GI disturbances

DNA Alkylating Drugs

Cyclophosphamide
Cisplatin

Cyclophosphamide

MOA: Cross-links DNA strands by forming covalent bonds betwwen alkyl groups of the drug and guanine bases of DNA
A/E: Myelosuppression, Alopecia, Hemorrhagic cystitis, Nausea + Vomiting

Cisplatin

MOA: Forms intrastrand and interstrand covalent bonds with DNA bases
A/E: Myelosuppression, Severe nausea + vomiting, Nephrotoxicity

Intercalating Drugs

Doxorubicin

Doxorubicin

MOA: Intercation of DNA but may also inhibit topoisomerase, and form of free radicals
A/E: Myelosuppression, Cardiac damage, Dose-dependent nausea + vomiting, mucosa ulceration

Mitotic Inhibitors

Vincristine
Vinblastine
Paclitaxel

Vincristine and Vinblastine

MOA: Block microtubule aassembly and interferes with mitosis
A/E: Vincristine - neurotoxicity, Vinblastine - myelosuppression

Paclitaxel

MOA: Block microtubule disassembly and interferes with mitosis
A/E: Neurotoxicity, Myelosuppression, Alopecia

Topoisomerase Inhibitors

Etoposide
Irinotecan

Etoposide

MOA: Inhibits topoisomerase II and prevents DNA replication
A/E: Myelosuppression, Nausea + Vomiting, Alopecia

Irinotecan

MOA: Converted to active metabolite SN38 which inhibits topoisomerase I and prevents DNA replication
A/E: Myelosuppression, Nausea + Vomiting

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