taxanes

primary treatment of advanced ovarian cancer and metastatic ovarian cancer

metastatic CA of breast

lung, esophageal, bladder, head and neck

hypersensitivity reactions

reversible neutropenia

cardiac conduction defects

alopecia

peripheral neuropathy

muscle pain

used with cisplatin - clearance reduced

inhibits microtubule disassembly and microtubular plates accumulate in cells causing abnormal and dysfunctional spindles

selective estrogen receptor modulator

breast cancer treatment and prophylaxis

gynecomastia

infertility

blocks binding of estrogen to estrogen receptors

has other actions - agonist in bone

nausea, vomiting, hot flashes, vaginal bleeding, hypercalcemia, ocular dysfunction, peripheral edema

aromatase inhibitor

prevents estrogen synthesis by inhibiting aromatase which converts androstenedione to estradiol

not used in pre-menopausal women, very useful in post-menopausal patients

slowly replacing tamoxifen

Other

converts asparagine to aspartic acid and ammonia

exogenously decreases available asparagine for cancer cell, thus inducing apoptosis

IV

hypersensitivity reactions

high doses its toxic to CNS

Antibody

aka Herceptin

immunoglobulin antibody binds with high affinity and specificity to her-2 receptor inhibiting growth of tumor

used alone or in combo with paclitaxel

nausea, vomiting, chills, fevers, headaches, ventricular dysfunction and heart failure

platinum coordination complex

urogenital cancers

testicular, ovarian, bladder cancer

enters cells by diffusion

reacts with DNA leading to breaks and miscoding causing inhibition of replication and transcription

IV

cannot be given with any needle that has aluminum

nephrotoxicity

electrolyte disturbances

hypomagnesemia

hypocalcemia

hypokalemia

hypophosphatemia

phototoxicity

nausea, vomiting

Cisplatin: Antidote

amifostine

generates theol metabolites which scavenge free radicals

given as pre-treatment with hydration

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