Nitrogen mustards alkylating agents

Cyclophosphamide, a nitrogen mustard alkylating agent, is a widely used cancer chemotherapeutic drug to treat lymphomas, leukemias, multiple myeloma and a numerous solid tumors. Cyclophosphamide can induce nephrotoxicity characterized as decreased water excretion and an inappropriate concentration of urine. These effects are due to a direct effect of one or more alkylating cyclophosphamide metabolites at distal tubules and collecting ducts. Special caution is warranted to avoid water-induced diuresis or diuretic therapy in these patients as hyponatremia can become a problem. 

Cyclophosphamide is a cytotoxic (cytostatic), cell cycle non-specihc, antiproliferative agent, which is used in such diverse medical problems as neoplasia, tissue transplantation, and inflammatory diseases.Chemically, it is an inert bioprecursor for a potent nitrogen mustard alkylation agent (Figure 36.32). 

The sulfur mustards gave rise to the nitrogen mustards, which are less reactive alkylating agents that are used as anticancer drugs. Nitrogen mustards alkylate DNA, which prevents its reproduction and ultimately kills the cells. 

Alkylating agents were the first drugs to be used to treat highly proliferating cancers. They are mainly of two types the relatively non-specific nitrogen mustards and the even less selective nitrosoureas. 

Alkylating agents Nitrogen mustards (cyclophosphamide) Busulphan Platinum coordination complexes (cisplatin) Nitrosoureas Crosshnks DNA strands... 

Toxicology. Nitrogen mustards are vesicants and alkylating agents that damage the respiratory airways and cause skin and eye burns. 

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