USMLE

Doxorubicin

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Anti-Neoplastic Drugs
  1. Cyclophosphamide
  2. Methotrexate
  3. Tamoxifen
  4. Cisplatin
  5. Doxorubicin
  6. Imatinib
  7. Paclitaxel
  8. Rituximab
  9. Trastuzumab
  10. Vincristine

Summary

Doxorubicin is a chemotherapy drug used to treat a wide variety of cancers. Like most other chemotherapy drugs, doxorubicin can cause gastrointestinal disturbances and bone marrow suppression in patients. Specific side effects to know about doxorubicin include cardiotoxicity. Doxorubicin may also cause a pinkish red urine discoloration, which is a harmless side effect due to the drug’s red color and excretion into the urine.

Key Points

  • Doxorubicin (Adriamycin)
    • Mechanism
      • Antineoplastic / Immunosuppressant
        • Anthracycline
          • Inhibits DNA and RNA synthesis
    • Clinical Use
      • Cancer / Chemotherapy
        • Breast and ovarian cancer
        • Lung cancer
        • Lymphomas
    • Side Effects and Adverse Reactions
      • Cardiotoxicity
        • Especially dilated cardiomyopathy with systolic dysfunction
        • Doxorubicin is given with the drug dexrazoxane, a chemoprotective drug that helps prevent cardiotoxicity
      • Pink/red urine discoloration
        • A harmless, expected side effect
      • Common chemotherapy side effects
        • Bone marrow suppression
          • Common side effect of many chemotherapeutic drugs due to damage of rapidly-dividing blood cell progenitors
          • Leads to anemia (low red blood cells)
            • Fatigue, dyspnea, pallor
          • Leads to leukopenia (low white blood cells)
            • Increased risk for infection
          • Leads to thrombocytopenia (low platelets)
            • Petechiae, purpura, bleeding
        • GI disturbances
          • Nausea, vomiting, anorexia, diarrhea
          • Common side effect of many chemotherapeutic drugs due to damage of rapidly-dividing gut wall
          • An antiemetic may be ordered prior to chemotherapy
        • Alopecia (hair loss)