cytotoxic agents

see also:

• neoplasia / cancer / tumours
• immunosuppressants

• cytotoxics are those medications and substances which kill cells - especially rapidly dividing cells such as epithelial, gastro-intestinal, haemopoietic and many cancer cells
• hence they are commonly used in chemotherapy for cancers as well as in auto-immune diseases

• alopecia
• gastrointestinal effects such as diarrhoea
• immunocompromise with infection risk
  • see also the immunocompromised patient in the ED, febrile neutropenia
• Acute tumour lysis syndrome
• long term DNA mutations in normal cells / premature aging of cells
  • see Nature 2025: The long-term effects of chemotherapy on normal blood cells

• alkylating agents (damage DNA classically by adding an alkyl group):
  • nitrogen mustards such as:
    • cyclophosphamide
    • melphalan
    • chlorambucil
    • ifosfamide
    • bendamustine
      • introduced Aust. PBS 2014 for Rx CLL and non-Hodgkin lymphoma
  • nitrosoureas such as:
    • carmustine
    • lomustine
    • streptozocin
  • alkyl sulfonates such as:
    • busulfan
  • platinum agents such as:
    • cisplatin

• azathrioprine - prodrug for mercaptopurine
• methotrexate
• cyclosporin
• cytarabine - a pyrimidine analogue used to Rx AML
• bleomycin
• dactinomycin / actinomycin D
• mitomycin
• hydroxyurea
• mercaptopurine
• thioguanine

• doxorubicin
• epirubicin
• mitozantrone
• idarubicin

• etoposide

• vinorelbine