complicado mecanismo de acción antitumoral como con sus efectos .. inhibidores de la topoisomerasa II (doxorrubicina, etopósido. mecanismo de acción de antineoplasicos. AV Doxorrubicina (antraciclina). – Lesión del ADN. –Inhibición topoisomerasa II. –Vía intravenosa. Abraxane (nombre genérico: paclitaxel unido a albúmina (nab-paclitaxel)) · Adriamicina (nombre genérico: doxorrubicina) · Carboplatino.
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The common dose for bladder cancer prophylaxis following TUR is epirubicin 50 mg in 50 ml sterile normal saline instilled into the bladder once weekly for 4 weeks then maintenance treatement of the same dose monthly for 11 months. The resulting hyperuricemia could aggravate gout or urate ds. Patients who have received adjuvant epirubicin in clinical trials show a cumulative risk of secondary acute myelogenous leukemia of about 0.
Medicamentos de quimioterapia
It is characterized by facial flushing and delayed erythematous streaking along the vein. Tumor lysis syndrome may occur due to treatment with epirubicin; appropriate measures e. Signs and symptoms of anaphylactic reactions include skin rash unspecifiedpruritus, fever, chills and anaphylactic shock.
Live virus vaccines are contraindicated during therapy with antineoplastic agents due to the potentiation of virus replication, adverse reactions to the virus, and the immunocompromised status of the patient. Passive immunoprophylaxis with immune globulins may be indicated for immunocompromised persons instead of, or in addition to, vaccination.
Patients who have received prior mitoxantrone therapy may also experience increased cardiotoxicity. Epirubicin was granted orphan drug status for the treatment of breast cancer prior to approval in the United States.
J Clin Oncol ; Men may experience spermatogenesis inhibition. These reactions may lead to phlebitis. These agents could enhance epirubicin’s activity. Dexrazoxane does appear to limit epirubicin-induced cardiotoxicity.
Epirubicin and its major metabolites are excreted through biliary excretion and to a lesser extent urinary excretion.
Because antineoplastic agents exert their toxic effects against rapidly growing cells, such as hematopoietic progenitor cells, sargramostim, GM-CSF, and filgrastim, G-CSF, are contraindicated for use in patients within 24 hours of treatment with antineoplastic agents.
Overall, recurrence rates with epirubicin or intravesical BCG are similar except in patients with poorly differentiated tumors G3 or tumor restricted to the lamina propria of the bladder T1 where epirubicin is associated with a higher recurrance rate.
Conjunctivitis and keratitis have been reported with epirubicin chemotherapy. Cyclosporine, valspodar PSCtrifluoperazine, tamoxifen, toremifene, and verapamil all block the multidrug resistance MDR glycoprotein, which is a mechanism of resistance to naturally occurring non-synthetic chemotherapy agents.
A review of its use as a cardioprotective agent in patients receiving anthracycline-based chemotherapy. Epirubicin and other anthracyclines induce cytotoxicity through several different mechanisms.
A radiation recall reaction can occur after epirubicin administration at the sites of prior radiation. When exposed to a vaccine-preventable disease such as measles, severely immunocompromised children should be considered susceptible regardless of their vaccination history. Females and children may be more sensitive to the cardiotoxic effects of anthracyclines.
Stomatitis and esophagitis can occur in 2 to 3 days following initiation of chemotherapy and is characterized by oral bleeding, burning, erythema, infections, and oral ulceration. Resistance to epirubicin may occur through several mechanisms.
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The hair loss can be sudden and total. Anaphylactoid reactions and urticaria may occur following epirubicin administration. Those undergoing antineoplastic therapy should not be exposed to others who have recently received the oral poliovirus vaccine OPV.
Women of childbearing potential should be warned against getting pregnant. Treatment required colony stimulating factor support. Administration of epirubicin destroys any GP activity present in cardiac cells.
Two pregnancies have been reported in women receiving epirubicin. Cimetidine therapy should be stopped during epirubicin therapy. In addition, epirubicin has a lower incidence of cardiotoxicity; the maximum cumulative dose is almost twice that of doxorubicin. Dosage adjustments of antigout agents may be necessary to control hyperuricemia. This simple act of changing the conformation of DNA can interfere with strand elongation by inhibiting DNA polymerase and can inhibit protein synthesis due to effects on RNA polymerase.
Epirubicin has a similar spectrum of activity and toxicity as doxorubicin. Epirubicin is a FDA pregnancy category D agent. This reaction causes erythema, exfoliative dermatitis, pain, and burning, similar to that experienced with the original radiation therapy.
Generally, this is not a problem in patients with breast cancer, but clinicians should closely monitor susceptible patients i.
Following intravenous administration, epirubicin is widely distributed into tissues. Both cardiac and malignant cells are rich in mitochondria. The majority of patients were then able to undergo surgical resection.
Symptoms may last up to an hour and may be treated with steroids, antihistamines and ice packs. In the presence of oxygen, the semiquone radical can form a superperoxide that in the presence of hydrogen peroxide forms a hydroxyl radical. Phase III randomized study of fluorouracil, epirubicin and cyclophosphamide v fluorouracil, doxorubicin, and cyclophosphamide in advanced breast cancer: Epirubicin has similar response rates to doxorubicin in non-small cell and small cell lung cancer, non-Hodgkin’s lymphoma, ovarian cancer, gastric cancer and hepatocellular carcinoma.
Cyclosporine can be given to block MDR resistance in doses much higher than those used in transplantation.