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Answer 56 =  = CYTOSAR (ARA C) = Cytarabine
Source = Deoxycytidine analog originally isolated from the sponge Cryptotethya crypta.
Mechanism = Incorporation of ara-CTP into DNA resulting in chain termination and inhibition of DNA synthesis and function. Cell cycle–specific with activity in the S-phase.
Myelosuppression is dose-limiting.
Neurotoxicity = Cerebellar ataxia, lethargy, and confusion. Neurotoxicity develops in up to 10% of patients. Onset usually 5 days after drug treatment and lasts up to 1 week. In most cases, CNS toxicities are mild and reversible. Risk factors for neurotoxicity include high-dose therapy, age older than 40, and abnormal renal and/or liver function.