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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Medicamentos de quimioterapia
doxorrubiciina The overall survival following both regimens was not superior to other treatments. Administration of epirubicin destroys any GP activity present in cardiac cells.
Studies examining the use of the r-isomer of verapamil to block MDR, which has less cardiac effects, are underway. For the adjuvant treatment of breast cancer: With the addition of colony-stimulating factors, dose-intensive regimens have been developed to take advantage of the dose-response relationship of epirubicin and the lower incidence of myleotoxicity and cardiotoxicity.
Epirubicin should not be administered during pregnancy because of the possibility of teratogenic effects. Epirubicin has been designated an orphan drug by the FDA for this indication.
It is prudent to closely monitor patients for loss of clinical efficacy of digoxin while receiving antineoplastic therapy. Adverse Reactions Bone marrow suppression is the acute dose-limiting toxicity of epirubicin.
However, later events several months to years after ending treatment have been reported. A radiation recall reaction can occur after epirubicin administration at the sites of prior radiation. Following intravenous administration, epirubicin is widely distributed into tissues. The dose of epirubicin should be adjusted for elevations in the total bilirubin or AST because these patients will have a decreased clearance of epirubicin with an increase in overall toxicity see Dosage.
La epirubicina tiene un espectro similar de actividad y de toxicidad a los de la doxorrubicina. Serum bilirubin and AST levels should be evaluated before and during treatment with epirubicin. Valspodar is an investigational cyclosporine analog with less renal and immunosuppressive effects than cyclosporine while retaining effects on MDR.
The coadministration of paclitaxel or docetaxel did not affect the pharmacokinetics of epirubicin when epirubicin was given immediately following the taxane. It is characterized by facial flushing and delayed erythematous streaking along the vein.
This may manifest as reduced LVEF, acicon, dyspnea, pulmonary edema, hepatomegaly, ascites, pleural effusion, or gallop rhythm. Cimetidine therapy should be stopped during epirubicin therapy. Epirubicin has a triphasic clearance with half-lives for the alpha, beta, and terminal phases of 3 minutes, 1 hour, and 30 hours, respectively. 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.
The ECF regimen resulted in an increased response and survival benefit for patients with previously untreated gastric cancer or head and neck cancer. Occurrence of secondary malignancy, usually acute myeloid leukemia with or without a preleukemic phase, has been doxorrubician following epirubicin.
Once epirubicin enters cardiac cells, it is reduced to an anthracycline free radical mecanismi is rapidly oxidized to form the original drug and superoxide anions. These reactions are associated with excessively rapid administration and do not contraindicate further use. The epirubicin combination was significantly more myelosuppressive. The red urine should not be confused with hematuria. As this can be a progressive injury, appropriate long-term follow-up is required. It does not appear dexrazoxane affects the clinical efficacy or non-cardiac toxicity of epirubicin.
Patients should be closely monitored during IV infusions for signs and symptoms of extravasation such as poor blood return, burning, stinging, and swelling at the injection site.
J Clin Oncol ; Despite these dose increases, the immune response may still be suboptimal. Men may experience spermatogenesis inhibition. Patients who have had previous radiation therapy may experience radiation recall reactions during epirubicin therapy. The correct dose of epirubicin will vary from protocol to protocol.
Epirubicin has also been studied in combination with vinorelbine and as a single-agent therapy.
EPIRUBICINA EN VADEMECUM
The severity of the suppression depends on the dose of the drug and the regenerative capacity of the patient’s bone marrow. Epirubicin and etoposide combination chemotherapy to treat hepatocellular carcinoma patients: Epirubicin is a FDA pregnancy category D agent. Women of childbearing potential should be warned against getting pregnant. 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.
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Age does acion the clearance of epirubicin in female patients. In the presence of oxygen, the semiquone radical can form a superperoxide that in the presence re hydrogen peroxide forms a hydroxyl radical. Multicenter randomized clinical trial on high-dose epirubicin plus cis-platinum versus vinorelbine plus cis-platinum in advanced non-small cell lung cancer.
These changes do not necessitate dose modification or discontinuation and are not predictive of delayed cardiotoxicity. Generally, this is not a problem in patients with breast cancer, but clinicians should closely monitor susceptible patients i.
Alopecia occurs in almost all patients receiving epirubicin therapy. When exposed to a vaccine-preventable disease such as measles, severely immunocompromised children should be considered susceptible regardless of their vaccination history.
The resulting hyperuricemia could aggravate gout or urate mecaanismo. Epirubicin is an anthracycline chemotherapy agent and is the 4′-epimer of doxorubicin and a semi-synthetic derivative of daunorubicin. Some antineoplastic agents have been reported to decrease the absorption of digoxin tablets due to their doxorrubicija effects on the GI mucosa; no significant change was seen with digoxin capsules, and the effect on digoxin liquid is not known.
These complexes have high association constants and may contribute to epirubicin-induced cardiotoxicity by enhancing redox cycling to produce membrane and mitochondria damage. Administration of epirubicin to patients who have received the maximum cumulative dose of other anthracycline agents dde. If possible, avoid veins over joints or in extremities with compromised venous or lymphatic drainage.