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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Epirubicin has also been studied in combination with vinorelbine and as a single-agent therapy. Patients who have already received the maximum cumulative dosage of anthracyclines should not receive intravesicle epirubicin. Dosage adjustments of antigout agents may be necessary to control hyperuricemia.
In addition, there was a high incidence of secondary malignancies. The majority of patients were then able to undergo surgical resection. Epirubicin has a similar spectrum of activity and toxicity as doxorubicin. Treatment required colony stimulating factor support. The decreased incidence of clinically significant cardiac toxicity associated with epirubicin as compared to doxorubicin is due to the more rapid clearance of epirubicin and possibly, glucuronidation of epirubicin.
Dosage For the adjuvant treatment of breast cancer: Some antineoplastic agents have been reported to decrease the absorption of digoxin tablets due to their adverse effects on the GI mucosa; no significant change was seen with digoxin capsules, and the effect on digoxin liquid is not known.
Most patients recover by the third week of therapy. In one case, a woman was 28 weeks pregnant at her diagnosis of breast cancer and was treated with cyclophosphamide and epirubicin every 3 weeks for 3 cycles. First-line chemotherapy with epirubicin, paclitaxel, and carboplatin for advanced ovarian cancer: Generally, this is not a problem in patients with breast cancer, but clinicians should closely monitor susceptible patients i.
Due to the thrombocytopenic effects of epirubicin, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants, NSAIDs, platelet inhibitors, including aspirin, strontium chloride, and thrombolytic agents. Regrowth of hair usually resumes 3 weeks after therapy has been discontinued. Application of ice packs has been shown to be effective in reducing skin lesions associated with anthracycline extravasation.
All surviving patients improved or maintained their prior responses following high-dose therapy. The esophagus can be especially sensitive. Epirubicin is a severe vesicant. Anaphylactoid reactions and urticaria may occur following epirubicin administration. The addition of cyclosporine or valspodar to epirubicin therapy may result in increases in AUC for both epirubicin and epirubicinol possibly due to a decrease in clearance of parent drug, a decrease in metabolism of epirubicinol, or an increase in intracellular epirubicin concentrations.
Patients with hepatic impairment: La epirubicina tiene un espectro similar de actividad y de toxicidad a los de la doxorrubicina.
Due to rapid lysis of chemosensitive cells by epirubicin, serum uric acid levels may increase. Those undergoing antineoplastic therapy should not be exposed to others who have recently received the oral poliovirus vaccine OPV. An increased incidence of ventricular dysfunction and congestive heart failure has been associated with the concurrent use of trastuzumab with anthracyclines e.
She experienced a spontaneous abortion. These reactions may lead to phlebitis. Following intravenous administration, epirubicin is widely distributed into tissues. Patients who have had previous radiation therapy may experience radiation recall reactions during epirubicin therapy. Epirubicin is a radiation sensitizer and should be used with caution in patients receiving concurrent radiation therapy; although in some cases this may be a benefit.
It is thought that myocardial damage and ventricular dysfunction progress and lead to late-onset cardiac dysfunction following treatment with anthracyclines.
Epirubicin was granted orphan drug status for the treatment of breast cancer prior to approval in the United States. Epirubicinol has the one-tenth the cytotoxic activity of epirubicin and is not doxorrubicinx to contribute to the overall cytotoxic activity of doxorrubkcina.
Intramuscular injections should not be administered to patients with platelet counts 60 years. Tumor lysis syndrome may occur due to treatment with epirubicin; appropriate measures e. The FDA approved epirubicin for the adjuvant treatment of node-positive breast cancer in September Cyclosporine can be given to block MDR resistance in doses much higher than those used in transplantation.
In the presence of oxygen, the semiquone radical can form a superperoxide that in the presence of hydrogen peroxide forms a hydroxyl radical.
A radiation recall reaction can occur after epirubicin administration at dde sites of prior radiation. Both cardiac and malignant cells are rich in mitochondria. Serum creatinine levels should be assessed before and during epirubicin treatment. Previous irradiation to the left chest is associated with an increased risk of developing CHF and an accelerated mortality.
It is not known if epirubicin is excreted in human breast milk but has been detected in breast milk of animals. The immune response of mecanisom immunocompromised patient to vaccines is decreased and higher doses or more frequent boosters may be required.
These changes do not necessitate dose modification or discontinuation and are not predictive of delayed cardiotoxicity. Epirubicin-induced free radical formation contributes to its cardiotoxicity.
Medicamentos de quimioterapia
J Clin Oncol ; Once epirubicin enters cardiac cells, it is reduced to an anthracycline free radical that is rapidly oxidized mecanizmo form the original drug and superoxide anions. Concurrent use of epirubicin with other agents that cause bone marrow or immune suppression such as other antineoplastic agents or immunosuppressives may result in additive effects. Epirubicin is a vesicant, and administration into soft tissue can cause pain, burning, tissue necrosis and skin ulcer.
Valspodar is an investigational cyclosporine analog with less renal and immunosuppressive effects than cyclosporine while retaining effects on MDR.
The severity of the suppression depends on the dose of the drug and the regenerative capacity of the dr bone marrow. Estimates for postponing vaccination vary from 3 months to 1 year following discontinuation of treatment depending of the type of antineoplastic agent used and the disease state of the patient. Despite these dose increases, the immune response may still be suboptimal. Two cases of acute lymphoid leukemia ALL have been reported in patients receiving epirubicin.