alkylating agents side effects

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cyclophosphamide
- nephrotoxicity
- urotoxicity
- full dose in renal dysfunction
ifosfamide

chloroacetaldehyde increases nephrotoxicity and neurotoxicity
melphalan
- Varied absoprtion and metabolism
- Dose carefully adjusted by monitoring WBC's and platelets
Chlorambucil
- Moderate myelosuppressive: gradual and rapidly reversible
- OK in renal dysfunction
Carmustine
- Crosses BBB
- Need dose adjustments in renal dysfunction
Streptozocin

No need for dose adjustments in renal dysfunction
Busulfan
- VOD
- close TDM and dose adjustments in renal dysfunction
Procarbazine

Need dose adjustments in renal dysfunction
Dacarbazine
- Potent vesican --> careful when given IV
- Need dose re-adjustment in renal/hepatic dysfunction
Temozolomide
- Crosses BBB
- No need dose readjustment in renal dysfunction
ThioTEPA

No need dose readjustment in renal dysfunction
Altretamine
- Palliative treatment
- Mild peripheral an dcentral neurotoxicity
Cisplatin

Need dose adjustments in renal dysfunction
Carboplatin
- Much less reactive than cisplatin: majority in plasma remains in parent form --> less renal toxicity
- Need dose adjustments in renal dysfunction
Oxaliplatin
- Approved with 5-FU
- Need dose adjustments in renaly dysfunction
methotrexate
- bone marrow toxicity
- mucosal toxicity
- hepatic fibrosis and cirrhosis
- pneumonitis
5-FU
- severe GIT toxicity
- Bone marrow depression
cytosine arabinoside
- Severe myelosuppression
- N/V
- megaloblastosis
- leukopenia
- thrombocytopenia
Gemcitabine
- myelosuppression
- N/V/D
6-thioguanine and 6-mercaptopurine

mainly bone marrow suppression
Cladribine

Severe bone marrow suppression
capecitabine
- myelosuppression
- N/V
fludarabine
- myelosuppression
- neurotoxicity (high doses)
hydroxyurea

bone marrow depression

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pdnguyen

81860

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alkylating agents side effects

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alkylating agents side effects

Updated

2011-04-26T16:32:08Z

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