DR Medhat MRCP

E. Other cytotoxic drugs
Cisplatin
Cytotoxic Mechanism of action Adverse effects
- Causes Cross-linking in DNA
1) Ototoxicity
2) Peripheral neuropathy
3) Hypomagnesaemia
Hydroxyurea
(hydroxycarbamide)
Mycophenolate mofetil
(MMF)
(Cellcept, myfortic)
- Inhibits ribonucleotide
reductase, decreasing DNA
synthesis
- Inhibit inosine monophosphate
dehydrogenase (IMPDH) - -
Purine synthesis (hence DNA)
- - proliferation of B & T cells.
Myelosuppression
1) GIT upset ( diarrhea &
abdominal pain)
2) Myelosuppresion
3) Hyper-glycemia
4) Hyper-kalemia
5) Hyper-cholesterolemia
6) Hypo-magnesemia
7) Hypo-calcemia
Chemotherapy side-effects : nausea and vomiting
- Nausea and vomiting are common side-effects of chemotherapy.
- High risk factors for the development of symptoms include:
Anxiety.
Age less than 50 years old.
Concurrent use of opioids.
The type of chemotherapy used.
• Management :
For patients at low-risk of symptoms : metoclopramide may be used first-line.
For high-risk patients 5HT3 receptor antagonists e.g ondansetron are often
effective, especially if combined with dexamethasone.
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