on 29.8.08 with 0 comments

  • methotrexate

    • mechanism: inhibits dihydrofolate reductase (DHFR), so you can’t make purines

    • if overdose occurs, rescue with leucovorin, a tetrahydrofolate

    • resistance: impaired transport, gene amplification or mutation of DHFR

    • toxicities: pulmonary (pneumonitis—looks like pneumonia; rx with steroids), hepatic (cirrhosis)

    • teratogenic

  • Ara-C (cytosine arabinoside)

    • used for all leukemia patients

    • mechanism: incorporated into DNA

    • toxicity: liver and CNS (clinically, check for nystagmus)

  • 5’FU (5’fluorouracil) IV; capecitabine (prodrug) PO

    • if you add leucovorin, this drug becomes more effective

    • toxicities: diarrhea, skin toxicity (hands and feet turn red, swollen, and painful)

  • fludarabine

    • mechanism: adenosine analog

    • toxicities: depletes T cells, leading to opportunistic infections

Category: Pharmacology Notes



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