Cell Cycle
Colchicine also inhibits microtubules
SEs include Bone marrow suppression, hemolysis, pulmonary toxicity, neurotoxicity, leukemogenic
The tables below summarises the mechanism of action and major adverse effects of commonly used cytotoxic agents.
Master mnemonic: “DNA → Tubes → Folate → Free Radicals → Topo → Misc”
| Cytotoxic | Mechanism of action | Adverse effects |
|---|---|---|
| Cyclophosphamide | Alkylating agent - causes cross-linking in DNA | Haemorrhagic cystitis, |
| myelosuppression, transitional cell carcinoma | ||
| Tx - Mesna (traps toxic component acrolein) | ||
| Busulfan | pulmonary fibrosis (“bus‑ulfan = bus‑lungs”) | |
| Melphlan | Alkylating agent - formation of cross-links → prevent DNA replication and transcription |
Cyclophosphamide causes hemorrhagic cystitis and bladder cancer by producing a bladder-toxic metabolite called acrolein.
Procarbazine (alkylating agent) - used in Hodgkin's lymphoma
Nitrosoureas (Lomustine, Carmustine) - cross BBB and good for brain tumors