medicines

Platinol®-AQ

Generic name: Cisplatin  Trade names: Platinol®, Platinol®-AQ Other names: CDDP

Chemocare.com uses generic names in all descriptions of drugs. Platinol and Platinol-AQ are trade names for Cisplatin. CDDP is another name for Cisplatin. In some cases, health care professionals may use the trade names Platinol and Platinol-AQ or other name CDDP when referring to the generic drug name Cisplatin.

Drug type: Platinol-AQ is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "alkylating agent." (For more detail, see "How this drug works" section below).

What this drug is used for:

. Used to treat testicular, ovarian, bladder, head and neck, esophageal, small and non-small cell lung, breast, cervical, stomach and prostate cancers. Also to treat Hodgkin's and non-Hodgkin's lymphomas, neuroblastoma, sarcomas, multiple myeloma, melanoma, and mesothelioma.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How this drug is given:

. Cisplatin is administered through a vein (intravenously or IV) as an infusion.

. There is no pill form of cisplatin.

. Cisplatin is an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is given.

. If the medication escapes from the vein it can cause tissue damage. The nurse or doctor who gives this medication must be carefully trained. If you experience pain or notice redness or swelling at the IV site while you are receiving cisplatin, alert your health care professional immediately.

. Before and/or after the cisplatin infusion, extra IV fluids are given, care is taken to ensure adequate hydration before, during and after cisplatin, to protect your kidney function.

. Cisplatin also has been used as an infusion into the abdominal cavity (contains the abdominal organs).

. The amount of Cisplatin that you receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer that you have. Your doctor will determine your dose and schedule.

Side effects:  Important things to remember about the side effects of cisplatin:

. Most people do not experience all of the side effects listed.

. Side effects are often predictable in terms of their onset and duration.

. Side effects are almost always reversible and will go away after treatment is complete.

. There are many options to help minimize or prevent side effects.

. There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

. The side effects of cisplatin and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in greater than 30%) for patients receiving cisplatin:

. Nausea and vomiting. Nausea may last up to 1 week after therapy. Anti-nausea medication is given before the infusion, and a prescription is also given for use after.

. Kidney toxicity, effects on kidney function are dose related, observed 10-20 days after therapy, and are generally reversible.

. Blood test abnormalities: (low magnesium, low calcium, low potassium).

. Low white blood cells (this may put you at increased risk for infection).

. Low red blood cells (anemia).

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 10 days Nadir: 14-23 days Recovery: 21-39 days

These are less common side effects (occurring in 10-29%) for patients receiving cisplatin:

. Peripheral neuropathy: Although less common, a serious side effect of decreased sensation and paresthesia (numbness and tingling of the extremities) may be noted. Sensory loss, numbness and tingling, and difficulty in walking may last for at least as long as therapy is continued. These side effects may become progressively more severe with continued treatment, and your doctor may decide to decrease your dose. Neurologic effects may be irreversible.

. High frequency hearing loss. Ringing in the ears.

. Loss of appetite

. Taste changes, metallic taste

. Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. (see liver problems).

. Hair loss

. Your fertility, meaning your ability to conceive or father a child, may be affected by cisplatin. Please discuss this issue with your health care provider.

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.  When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

. Fever of 100.5ºF (38ºC) or higher or chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

. Nausea (unable to drink fluids and unrelieved with prescription medication).

. Vomiting (more than 4-5 times in a 24 hour period).

. No urine output in a 12 hour period.

. Unusual bleeding or bruising.

. Black or tarry stools, or blood in your stools or urine.

. Extreme fatigue (unable to carry on self-care activities).

. Swelling, redness and pain in one leg or arm and not the other.

. Yellowing of the skin or eyes.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

. Before starting cisplatin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.

. Cisplatin may be inadvisable if you have a history of severe allergic reaction to cisplatin, carboplatin, other platinum-containing formulations or mannitol.

. Do not receive any kind of immunization or vaccination without your doctor's approval while taking cisplatin.

. Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (cisplatin may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).

. For both men and women: Do not conceive a child (get pregnant) while taking cisplatin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

. Do not breast feed while taking this medication.

Self-care tips:

. To reduce nausea, take anti-nausea medications as prescribed by your doctor, eat small amounts of food frequently.

. Try dry cereal, toast, crackers especially in the morning to help curb nausea.

. Maintaining a good fluid intake is very important to help to avoid kidney damage. Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.

. You may be at risk of infection so try to avoid crowds or people with colds, and reprt fever or any other signs of infection immediately to your health care provider.

. Wash your hands often.

. To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or salt mixed with 8 ounces of water.

. In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.

. Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.

. Get plenty of rest.

. Maintain good nutrition.

. If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

. You will be checked regularly by your doctor while you are taking cisplatin, to monitor side effects and check your response to therapy. Periodic blood to monitor your complete blood count (CBC), your electrolytes (such as calcium, magnesium, potassium, and sodium levels) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

. Because drug toxicity is seen as numbness and tingling of fingers and toes, a periodic physical examination, which includes a check of your reflexes, is necessary to detect the need for decreased dosages.

. With high dose therapy hearing tests may be ordered as baseline and monitored at times during therapy.

How this drug works:  Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.

Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.

Cisplatin is classified as an alkylating agent. Alkylating agents are most active in the resting phase of the cell. These drugs are cell cycle non-specific. There are several types of alkylating agents.

. Mustard gas derivatives: Mechlorethamine, Cyclophosphamide, Chlorambucil, Melphalan, and Ifosfamide.

. Ethylenimines: Thiotepa and Hexamethylmelamine.

. Alkylsulfonates: Busulfan.

. Hydrazines and Triazines: Procarbazine, Dacarbazine and Temozolomide.

. Nitrosureas: Carmustine, Lomustine and Streptozocin. Nitrosureas are unique because, unlike most chemotherapy, they can cross the blood-brain barrier. They can be useful in treating brain tumors.

. Metal salts: Carboplatin, Cisplatin, and Oxaliplatin.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Fluorouracil

Trade Name: Adrucil ® Other Names: 5-fluorouracil, 5-FU

Drug type:

Fluorouracil is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Fluorouracil is classified as an "antimetabolite." (For more detail, see "How Fluorouracil Works" section below).

What Fluorouracil Is Used For:

. Colon and rectal cancer.

. Breast cancer.

. Gastrointestinal cancers including: anal, esphageal, pancreas and gastric (stomach).

. Head and neck cancer * Hepatoma (liver cancer).

. Ovarian cancer.

. Topical use (cream or solution) in basal cell cancer of the skin and actinic keratoses. -see document Fluorouracil(cream).

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Fluorouracil Is Given:

. As an injection into the vein (intravenous or IV), or as an infusion. The amount of time and schedule of infusion varies depending on a specific protocol, it may be given over several hours to several weeks.

. As a topical ointment, a thin coating is applied to the affected skin lesions twice a day, treatment may continue over several weeks. (see document Fluorouracil(cream).

. The amount of Fluorouracil that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side Effects of Fluorouracil:

Important things to remember about the side effects of Fluorouracil:

. Most people do not experience all of the side effects listed.

. Side effects are often predictable in terms of their onset and duration.

. Side effects are almost always reversible and will go away after treatment is complete.

. There are many options to help minimize or prevent side effects.

. There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

. The side effects of Fluorouracil and their severity depend a variety of factors including dosage, the individual's metabolism, other drugs given as part of a combination therapy, and/or the schedule and duration of treatment.

The following side effects are common (occurring in greater than 30%) for patients taking Fluorouracil:

. Diarrhea

. Nausea and possible occasional vomiting

. Mouth sores

. Poor appetite

. Watery eyes, sensitivity to light (photophobia)

. Taste changes, metallic taste in mouth during infusion

. Discoloration along vein through which the medication is given

. Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 7-10 days Nadir: 9-14 days Recovery: 21-28 days

These side effects are less common side effects (occurring in about 10-29%) of patients receiving Fluorouracil:

. Skin reactions: Dry, cracking, peeling skin. Darkening of the skin (hyperpigmentation), darkening of the skin where previous radiation treatment has been given (radiation recall).

. Hair thinning.

. Nail changes - discoloration, loss of nails (rare)(see skin reactions).

. Hand -foot syndrome (Palmar-plantar erythrodysesthesia or PPE) -skin rash, swelling, redness, pain and/or peeling of the skin on the palms of hands and soles of feet. Usually mild, starting 5-6 weeks after start of treatment. May require reductions in the dose of the medication.

Serious adverse reactions to Fluorouracil are; chest pain, EKG changes and increases in cardiac enzymes - which may indicate problems with the heart. These symptoms are very rare but increased for patients with a prior history of heart disease.

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When To Contact Your Doctor or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

. Fever of 100.5º F (38º C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

. Nausea (interferes with ability to eat and unrelieved with prescribed medication)

. Vomiting (vomiting more than 4-5 times in a 24 hour period)

. Diarrhea (4-6 episodes in a 24-hour period) despite anti-diarrhea medication and diet alterations.

. Unusual bleeding or bruising

. Black or tarry stools, or blood in your stools or urine

. Extreme fatigue (unable to carry on self-care activities)

. Mouth sores (painful redness, swelling or ulcers)

. Tingling or burning, redness, swelling of the palms of the hands or soles of feet

Always inform your health care provider if you experience any unusual symptoms.

Fluorouracil Precautions:

. Before starting Fluorouracil treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.

. Do not receive any kind of immunization or vaccination without your doctor's approval while taking Fluorouracil.

. Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Fluorouracil may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus). For both men and women: Do not conceive a child (get pregnant) while taking Fluorouracil. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

. Do not breast feed while taking Fluorouracil.

Fluorouracil Self Care Tips:

. Use of ice chips in the mouth 10-15minutes before and after IV injections of Fluorouracil may reduce the incidence and severity of mouth sores.

. To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.

. Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.

. Follow regimen of anti-diarrhea medication as prescribed by your health care professional.

. Eat foods that may help reduce diarrhea (see managing side effects - diarrhea).

. You may be at risk of infection so try to avoid crowds or people with colds and/or not feeling well, and report fever or any other signs of infection immediately to your health care provider.

. Wash your hands often.

. To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.

. Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.

. Prevention of hand-foot syndrome. Modification of normal activities of daily living to reduce friction and heat exposure to hands and feet, for about a week after treatment. (for more information see - Managing side effects: hand foot syndrome).

. Keep palms of hands and soles of feet moist using emollients.

. You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.

. In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.

. Get plenty of rest.

. Maintain good nutrition.

Monitoring and Testing While Taking Fluorouracil:   You will be checked regularly by your health care professional while you are taking Fluorouracil, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered.

How Fluorouracil Works:   Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

Fluoruracil belongs to the category of chemotherapy called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere.

. Folic acid antagonist: Methotrexate

. Pyrimidine antagonist: 5-Fluorouracil, Foxuridine, Cytarabine, Capecitabine, and Gemcitabine

. Purine antagonist: 6-Mercaptopurine and 6-Thioguanine

. Adenosine deaminase inhibitor: Cladribine, Fludarabine and Pentostatin

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Docetaxel

(doe-se-TAKS-sel)

Trade name: Taxotere®

Chemocare.com uses generic drug names in all descriptions of drugs. Taxotere is the trade name for docetaxel. In some cases, health care professionals may use the trade name taxotere when referring to the generic drug name docetaxel.

Drug type: Docetaxel is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as a "plant alkaloid," a "taxane" and an "antimicrotubule agent." (For more detail, see "How this drug works" section below).

What this drug is used for:

. Approved in treatment of breast cancer, non-small cell lung cancer, advanced stomach cancer, head and neck cancer and metastatic prostate cancer.

. Also being investigated to treat small cell lung, ovarian, bladder, and pancreatic cancers, soft tissue sarcoma and melanoma.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How this drug is given:

. Docetaxel is given through a vein (intravenously, IV)

. There is no pill form of docetaxel

. Premedication with a corticosteroid pill starting a day prior to docetaxel infusion for 3 days is given to reduce the severity of fluid retention and allergic reactions. Your doctor will prescribe the exact regimen.

. The amount of docetaxel that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated. Your doctor will determine your dose and schedule.

Side effects:  Important things to remember about the side effects of docetaxel:

. Most people do not experience all of the side effects listed

. Side effects are often predictable in terms of their onset and duration

. Side effects are almost always reversible and will go away after treatment is complete

. There are many options to help minimize or prevent side effects

. There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

. The side effects of docetaxel and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects).

The following side effects are common (occurring in greater than 30%) for patients taking docetaxel:

. Low white blood cell count. (This can increase your risk for infection)

. Low red blood cell count (anemia)

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 4-7 days Nadir: 5-9 days Recovery: 21 days

. Fluid retention with weight gain, swelling of the ankles or abdominal area.

. Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. This should be reported to your healthcare provider.

. Nausea

. Diarrhea

. Mouth sores

. Hair loss

. Fatigue and weakness

. Infection

. Nail changes (Color changes to your fingernails or toenails may occur while taking docetaxel. In extreme, but rare, cases nails may fall off. After you have finished docetaxel treatments, your nails will generally grow back) (see skin problems).

These side effects are less common, meaning they occur in 10-29 percent of patients receiving docetaxel:

. Vomiting

. Muscle/bone/joint pain (myalgias and arthralgias)

. Low platelet count (This can increase your risk of bleeding)

. Increases in blood tests measuring liver function. These return to normal once treatment is discontinued. (see liver problems)

Infusion-related side effects (symptoms which may occur during the actual treatment) include:

. Allergic reactions (rash, flushing, fever, lowered blood pressure). Happens rarely, usually occurs in the first or second infusion. Frequency is reduced by premedication with corticosteroid starting one day before infusion. You will be monitored closely during the infusion for any signs of allergic reaction.

. Infusion site reactions (uncommon and generally mild, consist of darkening of the vein, inflammation, redness or dryness of the skin, or swelling of the vein).

When to contact your doctor or health care provider:  Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

. Fever of 100.5º F (38º C) or higher, chills (possible signs of infection)

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

. Nausea (interferes with ability to eat and unrelieved with prescribed medication).

. Vomiting (vomiting more than 4-5 times in a 24 hour period).

. Diarrhea (4-6 episodes in a 24-hour period).

. Unusual bleeding or bruising.

. Black or tarry stools, or blood in your stools or urine.

. Extreme fatigue (unable to carry on self-care activities).

. Mouth sores (painful redness, swelling or ulcers).

. Yellowing of the skin or eyes.

. Swelling of the ankles. Weight gain. Swelling of the stomach.

. Shortness of breath.

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

. Before starting docetaxel treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.

. Do not receive any kind of immunization or vaccination without your doctor's approval while taking docetaxel.

. Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (docetaxel may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).

. For both men and women: Do not conceive a child (get pregnant) while taking docetaxel. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.

. Do not breast feed while taking this medication.

Self-care tips:

. You may be at risk of infection so try to avoid crowds or people with colds or not feeling well, and report fever or any other signs of infection immediately to your health care provider.

. Wash your hands often.

. To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed with 8 ounces of water.

. Use an electric razor and a soft toothbrush to minimize bleeding.

. Avoid contact sports or activities that could cause injury.

. To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.

. Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing. Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.

. In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.

. Get plenty of rest.

. Maintain good nutrition.

Monitoring and testing:   You will be checked regularly by your health care professional while you are taking docetaxel, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.

How this drug works:  Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

Docetaxel belongs to a class of chemotherapy drugs called plant alkaloids. Plant alkaloids are made from plants. The vinca alkaloids are made from the periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as antimicrotubule agents. The podophyllotoxins are derived from the May apple plant. Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata). Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors. The plant alkaloids are cell-cycle specific. This means they attack the cells during various phases of division.

. Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine

. Taxanes: Paclitaxel and Docetaxel

. Podophyllotoxins: Etoposide and Tenisopide

. Camptothecan analogs: Irinotecan and Topotecan

Antimicrotubule agents (such as docetaxel), inhibit the microtubule structures within the cell. Microtubules are part of the cell's apparatus for dividing and replicating itself. Inhibition of these structures ultimately results in cell death.