tailieunhanh - Chapter 081. Principles of Cancer Treatment (Part 11)

Table 81-2 Commonly Used Cancer Chemotherapy Agents Drug Exam ples of Usual Doses Toxicity Issues Interactions, Direct DNA-Interacting Agents Alkylators Cyclophospha 2000 400– mg/m2 Marrow (relative Liver metabolism required mide IV platelet sparing) to activate to phosphoramide 100 mg/m2 PO qd Common alkylatora Mesna protects Cardiac dose) against Cystitis mustard + acrolein (high "high-dose" bladder damage Mechloretha mine 6 mg/m2 IV day Marrow Topical use in cutaneous lymphoma Vesicant 1 and day 8 Nausea Chlorambucil 1–3 mg/m2 qd PO Marrow Common alkylatora Melphalan 8 mg/m2 qd x 5, nadir) PO Marrow (delayed Decreased renal function delays clearance GI (high dose) Carmustine (BCNU) 200 mg/m2 IV nadir) Marrow (delayed 150 mg/m2 PO dose) GI, liver (high Renal Lomustine (CCNU) 300 PO 100– mg/m2 nadir) Marrow (delayed Ifosfamide g/m2 per day e qd x 5 + Myelosuppressiv Isomeric. | Chapter 081. Principles of Cancer Treatment Part 11 Table 81-2 Commonly Used Cancer Chemotherapy Agents Drug Exam ples of Usual Doses Toxicity Interactions Issues Direct DNA-Interacting Agents Alkylators Cyclophospha 400- 2000 mg m2 Marrow relative Liver metabolism required mide IV 100 mg m2 PO qd platelet sparing Cystitis Common alkylator Cardiac high dose to activate to phosphoramide mustard acrolein Mesna protects against high-dose bladder damage Mechloretha mine 6 mg m2 IV day 1 and day 8 Marrow Vesicant Nausea Topical use in cutaneous lymphoma Chlorambucil 1-3 mg m2 qd PO Marrow Common alkylator Melphalan 8 mg m2 qd x 5 PO Marrow delayed nadir Decreased renal function delays clearance GI high dose Carmustine BCNU 200 mg m2 IV 150 mg m2 PO Marrow delayed nadir GI liver high dose Renal Lomustine CCNU 100- 300 mg m2 PO Marrow delayed nadir Ifosfamide g m2 per day qd x 5 mesna Myelosuppressiv e Bladder Neurologic Metabolic acidosis Isomeric analogue of cyclophosphamide More lipid soluble Greater activity vs .