cytostatica

Cytostatics are a class of drugs that inhibit cell proliferation. They are used primarily in cancer treatment to slow or stop the growth of malignant cells, but they are also employed in some autoimmune diseases to suppress excessive immune activity and in transplantation to prevent organ rejection. The common feature of cytostatics is their cytotoxic effect on rapidly dividing cells, which can also affect normal tissues such as bone marrow, the gastrointestinal tract, and hair follicles.

Cytostatics work through various mechanisms. Antimetabolites interfere with nucleotide synthesis or function (examples include methotrexate and 5-fluorouracil). Alkylating agents form cross-links in DNA (such as cyclophosphamide and ifosfamide), preventing replication. Mitotic inhibitors disrupt cell division by affecting microtubule function (for example, vincristine and paclitaxel). Topoisomerase inhibitors prevent DNA unwinding or cutting and rejoining (like etoposide and topotecan). Some cytotoxic antibiotics intercalate into DNA or generate free radicals, contributing to cell death (e.g., doxorubicin).

In clinical use, cytostatics are typically given systemically by intravenous infusion or oral administration. Treatment is often delivered in cycles to allow normal tissues to recover between doses and to maximize tumor kill. Regimens commonly combine agents with different mechanisms to enhance effectiveness and reduce resistance.

Adverse effects are a major consideration and are largely dose-dependent. The most important is myelosuppression, which increases infection risk and can cause anemia and bleeding. Other common effects include nausea, vomiting, mucositis, fatigue, and hair loss; organ-specific toxicity may occur with certain drugs. Monitoring of blood counts, organ function, and supportive care are integral to responsible use.

See also: chemotherapy, antineoplastic agents, immunosuppressants.