ATC Group: L01AA Nitrogen mustard analogues

The World Health Organization's ATC classification organizes medical drugs based on therapeutic properties, chemical composition, and anatomy. It helps make essential medicines readily available globally and is widely used in the pharmaceutical industry.

Position of L01AA in the ATC hierarchy

Level Code Title
1 L Antineoplastic and immunomodulating agents
2 L01 Antineoplastic agents
3 L01A Alkylating agents
4 L01AA Nitrogen mustard analogues

Group L01AA contents

Code Title
L01AA01 Cyclophosphamide
L01AA02 Chlorambucil
L01AA03 Melphalan
L01AA05 Chlormethine
L01AA06 Ifosfamide
L01AA07 Trofosfamide
L01AA08 Prednimustine
L01AA09 Bendamustine
L01AA10

Active ingredients in L01AA

Active Ingredient Description
Bendamustine

Bendamustine is an alkylating antitumour agent with unique activity. The antineoplastic and cytocidal effect of bendamustine is based essentially on a cross-linking of DNA single and double strands by alkylation. As a result, DNA matrix functions and DNA synthesis and repair are impaired.

Chlorambucil

Chlorambucil is an aromatic nitrogen mustard derivative which acts as a bifunctional alkylating agent. In addition to interference with DNA replication, chlorambucil induces cellular apoptosis via the accumulation of cytosolic p53 and subsequent activation of an apoptosis promoter.

Chlormethine

Chlormethine is a bifunctional alkylating agent that inhibits rapidly proliferating cells. It works by binding to DNA, crosslinking two strands and preventing cell duplication. It binds to the N7 nitrogen on the DNA base guanine. It has been derivatized into the estrogen analogue estramustine phosphate, used to treat prostate cancer.

Cyclophosphamide

Cyclophosphamide has been demonstrated to have a cytostatic effect in many tumour types. The active metabolites of cyclophosphamide are alkylating agents which transfer alkyl groups to DNA during the process of cell division, thus preventing normal synthesis of DNA.

Ifosfamide

Ifosfamide is an antineoplastic, a cytotoxic alkylating agent. It is a prodrug and shows no in vitro cytotoxic activity until activated by microsomal enzymes. The cytotoxic activity of ifosfamide (alkylation of the nucleophilic centres in the cells) is associated with the activated oxazaphosphorine ring hydroxylated at the C4 atom which interacts with DNA-DNA cross linking. This activity manifests itself by blocking the late S and early G2 phases of the cell cycle.

Melphalan

Melphalan is a bifunctional alkylating agent. Formation of carbonium intermediates from each of the two bis-2-chloroethyl groups enables alkylation through covalent binding with the 7-nitrogen of guanine on DNA, cross-linking the two DNA strands and thereby preventing cell replication.

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