Alopecia bleomycin

MANAGING ALOPECIA. Alopecia (loss of hair) is a common adverse reaction associated with some of the antineoplastic drugs. Some drugs cause severe hair loss, whereas others cause gradual thinning. Examples of drug commonly associated with severe hair loss are doxorubicin and vinblastine Methotrexate, bleomycin, vincristine, and etoposide are associated with gradual hair loss. 

I 12. The answer is b. (Hardman, pp 1264-1265J Dactinomycin s major toxicities include stomatitis, alopecia, and bone marrow depression. Bleomycin s toxicities include edema of the hands, alopecia, and stomatitis. Mitomycin causes marked bone marrow depression, renal toxicity, and interstitial pneumonitis. Plicamycin causes thrombocytopenia, leukopenia, liver toxicity, and hypocalcemia. The latter may be of use in the treatment of hypercalcemia. Doxorubicin causes cardiotoxicity, as well as alopecia and bone marrow depression. The cardiotoxicity has been linked to a lipid peroxidation within cardiac cells. 

A potentially fatal lung toxicity occurs in 10 to 20% of patients receiving bleomycin. Patients particularly at risk are those who are over 70 years of age and have had radiation therapy to the chest. Rarely, bleomycin also may cause allergic pneumonitis. Bleomycin skin toxicity is manifested by hyperpigmentation, erythematosus rashes, and thickening of the skin over the dorsum of the hands and at dermal pressure points, such as the elbows. Many patients develop a low-grade transient fever within 24 hours of receiving bleomycin. Less common adverse effects include mucositis, alopecia, headache, nausea, and arteritis of the distal extremities. 

Bleomycin Oxygen free radicals bind to DNA causing single- and double-strand DNA breaks Hodgkin s and non-Hodgkin s lymphoma, germ cell cancer, head and neck cancer Allergic reactions, fever, hypotension Skin toxicity, pulmonary fibrosis, mucositis, alopecia... 

Oxidative stress reduces the rate of cell proliferation, and that occurring during chemotherapy may interfere with the cytotoxic effects of antineoplastic drugs, which depend on rapid proliferation of cancer cells for optimal activity. Antioxidants detoxify ROS and may enhance the anticancer effects of chemotherapy. For some supplements, activities beyond their antioxidant properties, such as inhibition of topoisomerase II or protein tyrosine kinases, may also contribute. ROS cause or contribute to certain side effects that are common to many anticancer drugs, such as gastrointestinal toxicity and muagenesis. ROS also contribute to side effects that occur only with individual agents, such as doxorubicin-induced cardiotoxicity, cisplatin-induced nephrotoxicity, and bleomycin-induced pulmonary fibrosis. Antioxidants can reduce or prevent many of these side effects, and for some supplements the protective effect results from activities other than their antioxidant properties. Certain side effects, however, such as alopecia and myelosuppression, are not prevented... 

Adverse effects Pulmonary toxicity is the most serious adverse effect, progressing from rales, cough, and infiltrate to potentially fatal fibrosis. Mucocutaneous reactions and alopecia are common. Hypertrophic skin changes and hyperpigmentation of the hands are prevalent. There is a high incidence of fever and chills and a low incidence of serious anaphylactoid reactions. Bleomycin is unusual in that myelosuppression is rare. 

Cytotoxic antibiotics depress the bone marrow, cause gastrointestinal upsets and stomatitis, alopecia, cardiomyopathy (daunorubicin and doxorubicin) and pulmonary fibrosis and skin rashes (bleomycin). Some of these effects are dose-dependent, for example, doxorubicin-induced cardiomyopathy. Others may be potentiated by concomitant use of radiotherapy. 

Bleomycin Nausea and vomiting fever anaphylaxis and other allergic reactions phlebitis ai in ecuon site Pneumonitis and pulmonary fibrosis rash and hyperpigmenwtion stomatitis alopecia Raynaud s phenomenon cavitating granulomas haemorrhagic cystitis... 

Bleomycin (CCS) Complexes with Fe and 02 —> DNA strand scission (G2 phase) Hodgkin s, testicular, head, neck, skin CA Pneumonitis, pulmonary fibrosis, mucocutaneous reactions (blisters), alopecia, hypersensitivity... 

Toxicity The toxicity profile of bleomycin includes pulmonary dysfunction (pneumonitis, fibrosis), which develops slowly and is dose-limiting. H)q)ersensitivity reactions (chills, fever, anaphylaxis) are common, as are mucocutaneous reactions (alopecia, blister-formation, hyperkeratosis). 

Bleomycin Pneumonitis, pulmonary fibrosis, hyperpigmentation, alopecia, marrow-sparing ... 

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