Chemotherapy Toxicities - Anti-Metabolites and Anti-Folates
Anti-Metabolites
5-Fluorouracil ...
286
Description

Chemotherapy Toxicities - Anti-Metabolites and Anti-Folates

Anti-Metabolites

5-Fluorouracil 

 • Indications: Breast, colorectal, pancreatic, gastric, esophageal, H&N

 • Toxicities: Coronary vasospasm, acute cerebellar ataxia, hand-foot syndrome, stomatitis, hemorrhage, GI ulcers/bleeding, hiccups, diarrhea, BM↓*

Capecitabine 

 • Indications: Breast, colorectal 

 • Toxicities: Monitor INR (if on Coumadin), hand-foot syndrome, SJS-TEN, N/V/D, cytopenias (worse with stage IV breast CA), liver toxicity

Cytarabine (HiDAC)

 • Indications: AML, ALL, CLL, meningeal leukemia 

 • Toxicities: Acute cerebellar ataxia, PRES, BM↓, chemical conjunctivitis (Rx dexamethasone eye drops), ↑LFTs, cutaneous tox, hand-foot syndrome

Gemcitabine 

 • Indications: Breast, ovarian, NSCLC, pancreas, bladder

 • Toxicities: Capillary leak syndrome, PRES, TMA/HUS, ARDS, ↑LFTs, N/V, hematuria

Mercaptopurine 

 • Indications: ALL (w MTX), CML 

 • Toxicities: Biliary cholestasis & hepatocellular necrosis, BM↓, (Consider TPMT SNP testing if severe BM↓), N/V/D

Fludarabine 

 • Indications: CLL, NHL, AML 

 • Toxicities: BM↓, IS, autoimmune hemolytic anemia, neurotoxicity, fatal pulm toxicity (when used w/ pentostatin for CLL)

Hydroxyurea 

 • Indications: CML, cervical, sickle cell, H&N 

 • Toxicities: BM↓, cutaneous tox, N/V/D, ↑LFTs, ↑Cr, ↑BUN

Anti-Folates

Methotrexate 

 • Indications: ALL, breast, H&N, CTCL, SCLC, NSCLC, NHL, osteosarcoma

 • Toxicities: BM↓, aplastic anemia, AKI, ↑LFTs, hepatic fibrosis/cirrhosis, cutaneous tox, IS (PCP), pneumonitis/PF, teratogenic, ulcerative stomatitis/diarrhea, IF

Pemetrexed 

 • Indications: Mesothelioma, NSCLC 

 • Toxicities: BM↓, desquamating rash, pneumonitis, renal tox



#AntiMetabolites #chemotherapy #Toxicities #SideEffects #pharmacology #antifolates #oncology
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