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Chemo Drugs - Coggle Diagram
Chemo Drugs
Alkylating Agents
Cyclophosphamide (Cytoxan)
- prevents tumour DNA replication
- used for lymphoma in dogs and cats
- nitrogen mustard derivative
Chlorambucil (Leukeran)
- nitrogen mustard derivative
- use this if patient tried cyclophoshamide and got hemorrhagic cystitis
- treats low grade lymphoma or chronic lymphocytic leukemia
Melphalan (Alkeran)
- Phenylalanine mustard derivative
- used primarily for multiple myeloma in combination with prednisone
- alkylating mustard
Anti-tumour antibiotics
Doxorubicin
- damages DNA helix and impairs DNA, RNa and protein synthesis
- used alone or in combo to treat lymphoma, osteosarcoma, carcinomas and other sarcomas
- eliminated primarily in feces and bile
- dose limiting effect of myelosuppression and cardiotoxicity but cats relatively resistant to cardiotoxicity
- cardiotoxic concerns
Mitoxantrone
- similar to Doxorubicin, but less toxic (however not as efficacious at killing cancer cells)
Dactinomycin
- used as part of a combination treatment for relapsing lymphoma in dogs
- used in dogs who are at risk of cardiotoxicity bc this one is safer
Antimetabolites
Methotrexate & Rheumatrix
- inhibits enzymes needed for folate production
- only used to treat lymphoma
- GI toxicity most common
- Leucovorin is an antidote for methotrexate toxicity
-
Platinums
Cisplatin & Carboplatin
- heavy metal containing agents
- cytotoxic due to DNA alkylation
- carboplatin is less potent than cisplatin
- largely eliminated by kidneys -> highly nephrotoxic (you should fluid load before and after administration)
- cisplatin should NOT be used in cats but carbo can be
- vomiting common with cisplatin
- used to treat solid tumours (osteosarcoma and other carcinomas), sarcoids in the horse (can inject right into the tumour)
- Cisplatin highly nephrotoxic in DOGS
- Cisplatin causes pulmonary complications in the CAT
Mitotic inhibitors
Vincristine & Vinblastine
- inhibits mitotic spindle assembly
- used to treat lymphoma (vincristine first line), lymphoid leukemias, canine VTV
- vinblastine good for canine mast cell tumours
- Best drug to treat TVT in dogs = vincristine
Enzymes
L-Asparaginase
- enzyme derived from e.coli
- some tumour cells rely on asparagine to survive
- used primarily in lymphoma protocol (to reduce remission)
-
Corticosteroids
Predisolone or Dexamethasone
- direct cytotoxicity in lymphoma
- also used in mast cell tumours and leukemias
- anti inflammatory effects reduce inflammation and space occupying tumours
- stimulates appetite and attitude (improves quality of life)