Topoisomerase I inhibitor

Prevents religation of single-strand DNA breaks
Diarrhea and myelosuppression

Drugs with this mechanism (2)

Irinotecan — Two diarrheas: early cholinergic, late secretory. UGT1A1 matters.
Topotecan — Topoisomerase-I inhibitor used as salvage chemotherapy; marrow suppression dominates.

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