Classification of anticancer drugs

1. Alkylating agents
Mechanism of action: They transfer alkyl groups to cellular constituents, especially DNA within
the nucleus leading to cell death.
Examples: cyclophosphamide, chlorambucil, mephalan, busulfan

2. Antimetabolites
(a) Methotrexate: it binds to dihydrofolate reductase and inhibits the synthesis of
tetrahydrofolate and ultimately the synthesis of purine nucleotides.

(b) 5-fluorouracil
It inhibits the synthesis of thymidilate leading to inhibiton of synthesis of DNA.
Other examples of antimetabolites include cytarabine, fludarabine and 6-mercaptopurine.

3. Natural products
(a) Vinca alkaloids e.g. vincristine and vinblastine. They inhibit the process of tubulin
polymerisation and disrupt the assembly of microtubules involved in mitotic spindle apparatus.

(b) Taxanes e.g. paclitaxel: it is a mitotic spindle poison.

Other examples of taxanes are docetaxel, cabazitaxel.

(c) Epipodophyltoxin e.g. etoposide: it inhibits topoisomerase II thereby inhibiting DNA synthesis
and function

(d) Campothecins e.g. topotecan and irinotecan. They inhibit topoisomerase I thereby causing
DNA damage.

4. Anticancer antibiotics
(a) anthracyclines e.g. doxorubicin and daunorubicin, epirubicin: They inhibit topoisomerase II.
They block the synthesis of DNA and RNA.
(b) Mitomycin: It generates an alkylating agent that cross links DNA
(c) Bleomycin: It binds to DNA resulting in DNA breakage.

Some cancer drugs and their uses

Bleomycin is used in Hodgkin's lymphoma
Doxorubicin is used in breast cancer
Etoposide is used in lung cancer
Mitomycin is used in breast cancer
Topotecan is used in ovarian cancer
Vinblastine is used in Kaposi's sarcoma
Vincristine is used in neuroblastoma
Irinotecan is used in colorectal cancer.
Classification of drugs used in asthma
1. Bronchodilators
(a) Beta-2 adrenoceptor agonists e.g. albuterol, salmeterol
They cause bronchodilation

(b) Methylxanthines e.g. theophylline

2. Antimuscarinic drugs
They block the bronchoconstrictor effects of acetylcholine. They are effective as bronchodilators.
Examples are ipratopium and tiotropium

3. They inhibit the production of inflammatory cytokines, reduce bronchial hyperreactivity and
redu the frequency of asthma attacks. Examples include beclomethasone and budesonide.

4. Inhibitors of mast cell degranulation e.g. cromolyn sodium

5. Inhibitors of leukotriene synthesis e.g. zileuton and leukotriene receptor antagonists e.g.
zafirlukast and montelukast.

Antitussives
1. Codeine: It suppresses the cough center in the brain and reduces the efferent response to the
afferent cough stimulus originating from the upper respiratory tract.