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Mechanism of Action

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Mechanism of Action
Dose Modifications (Renal)
Dose Modifications (hepatic)
MDR

Drug--->Mechanism of Action
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1. CISPLATIN/CARBOPLATIN---->cross-links DNA, interstrand or intrastrand
2. TAXOL/TAXOTERE--> enhances tubulin polymerization (high affinity binding for microtubules)
3. VINCA ALKALOIDS (VINCRISTINE; VINBLASTINE; VINORELBINE)--> binds to specific sites on tubulin & prevents polymerization of tubulin dimers & inhibits microtubule formation. Note that vinorelbine does not affect neural microtubules as much as the other vinca alkaloids (less neurotoxicity).
4. ANTHRACYCLINES--> Free radical formation; topoisomerase II-mediated DNA damage; direct intercalation into DNA
5. EPIPODOPHYLLOTOXINS (VP-16; VM-26)-->inhibits the function of topoisomerase II. Results in single strand DNA breasks
6. CAMPTOTHECIN (Irinotecan; topotecan)--> Interact non-covalently with topoisomerase I & inhibit the religation step.
7. ALKYLATING AGENTS
8. BLEOMYCIN-->produces single/double stranded DNA breaks. Requires activation by oxidized iron.