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Anti-Proliferative Agents (Methotrexate (Use (cancer, RA, Psoriasis,…
Anti-Proliferative Agents
Cyclophosphamide
MOA
Alkylates DNA
Affects B cells > T cells
SE
Haemorrhagic cystits
Alopecia
Sterility: esp. males
BM suppression
Use
SLE
Systemic sclerosis
Wegener’s
Cancer
RA
Give mesna to prevent
haemorrhagic cystitis
Activated by P450
Methotrexate
MOA
Dihydrofolate reductase inhibitor
SE
Pulmonary fibrosis
Hepatotoxic
Mucositis
BM suppression
Interactions
↑ toxicity with
NSAIDs
ciclosporin
steroids
Use
cancer
RA
Psoriasis
Crohn's
CI
R+L
Give folinic acid to ↓
risk of myelosuppression
Monitor U+E, FBC, LFT
Cisplatin
MOA
Alkylates DNA
SE
BM suppression
Severe n/v
Nephrotoxic
Ototoxic
Peripheral neuropathy
Use
Cancer
ovarian
SCLC
Testicular
Carboplatin a/w less severe SEs
Requires pre-admin hydration
Mycophenolate
mofetil
MOA
Blocks de novo nucleotide
synthesis
Affects T cells > B cells
SE
BM suppression
GI upset
Skin malignancy
Use
Prevent Tx rejection
AI disease
Azathioprine
MOA
Blocks de novo purine synthesis
Affects T cells > B cells
Active metabolite is 6-mercaptopurine
SE
BM suppression
Hepatotoxicity
n / v / d
Arthralgia
interaction
Allopurinol → ↑ toxicity
use
Prevent Tx rejection
Steroid-sparing agent
IBD
SLE
RA
Do TPMT assay before use
50% of pts intolerant of
azathioprine tolerate 6-MP
Chlorambucil
MOA
Alkylates DNA
SE
EM → SJS
BM suppression
Use
Cancer: e.g. CLL