D. Vincristine – Explanation
Vincristine – peripheral neuropathy
Vincristine is associated with peripheral neuropathy. Urinary hesitancy may develop secondary to
bladder atony.
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 |
