Cytotoxic Agents

Key points

• Summary of mechanism of action and major adverse effects of commonly used cytotoxic agents
• Cyclophosphamide: alkylating agent — adverse effects include haemorrhagic cystitis, myelosuppression, transitional cell carcinoma
• Methotrexate: antimetabolite (inhibits dihydrofolate reductase) — adverse effects include myelosuppression, mucositis, liver and lung fibrosis
• Fluorouracil (5-FU): antimetabolite (pyrimidine analogue) — adverse effects include myelosuppression, mucositis, dermatitis
• Vincristine/vinblastine: vinca alkaloids (inhibit microtubule formation) — vincristine causes peripheral neuropathy, vinblastine causes myelosuppression
• Doxorubicin: anthracycline (stabilises the DNA-topoisomerase II complex) — adverse effect: cardiomyopathy
• Bleomycin: degrades preformed DNA — adverse effect: lung fibrosis