B. Causes cross-linking in DNA – Explanation
Cytotoxic agents
The table below summarises the mechanism of action and major adverse effects of commonly used
cytotoxic agents
| Cytotoxic | Mechanism of action | Adverse effects |
| Vincristine | Inhibits formation of microtubules | Peripheral neuropathy (reversible) |
| Cisplatin | Causes cross-linking in DNA | Ototoxicity, peripheral neuropathy
hypomagnesaemia |
| Bleomycin | Degrades preformed DNA | Lung fibrosis |
| Doxorubicin | Stabilizes DNA-topoisomerase II complex inhibits
DNA & RNA synthesis |
Cardiomyopathy |
| Methotrexate | Inhibits dihydrofolate reductase and thymidylate
synthesis |
Myelosuppression, mucositis, liver fibrosis |
| Cyclophosphamide | Alkylating agent – causes cross-linking in DNA | Haemorrhagic cystitis, myelosuppression, transitional cell carcinoma |
| Docetaxel | Prevents microtubule depolymerisation &
disassembly, |
Neutropaenia |
| Fluorouracil (5- FU) | Pyrimidine analogue inducing cell cycle arrest and
apoptosis (works during S phase) |
Myelosuppression, mucositis, dermatitis |
