Anticancer drugs adverse effects

The same is true with cytotoxic (anticancer) drugs, which have many adverse effects. Many neoplastic diseases (leukemia, breast cancer, etc.) show definite rhythms in presenting their symptoms. Thus, if the therapy is tuned according to these rhythms, not only is the disease better treated, but the patient also is protected from side effects. Thus the drug delivery should be programmed according to the disease condition. 

Aspirin, paracetamol, and hydrocortisone are used to control febrile reactions of amphotericin. Patients with a history of adverse effects with amphotericin should be prophylactically treated with antipyretics and hydrocortisone. Antiemetics and pethidine also are used for the treatment of adverse effects of amphotericin. With sodium supplements and hydration therapy, damage to the kidney can be reduced. If conventional amphotericin is not well tolerated by the patient, colloidal carriers can be used as alternative options. Administration of amphotericin with a nephrotoxic drug, such as cyclosporin, may further increase toxicity. Diuretics and anticancer drugs should be avoided with amphotericin. 

Supportive care, administration of antiemetics, corticosteroids, and nutritional supplements may be used to treat the adverse effects of anticancer drugs. Scalp... 

Adverse effects and precautions commonly observed with anticancer drugs... 

BUPROPION 1. ANTICANCER DRUGS - thiotepa 2. ANTIDEPRESSANTS-fluoxetine, fluvoxamine, paroxetine, sertraline 3. ANTIVIRALS - efavirenz, protease inhibitors t plasma concentrations of bupropion and risk of adverse effects Inhibition of CYP2B6 Warn patients about adverse effects and use alternatives when possible. Avoid co-administration of bupropion with protease inhibitors. Co-adminis-ter efavirenz and bupropion with caution. A retrospective study showed that two patients received a combination without reported adverse effects. Potential T risk of seizures... 

CHLORAMPHENICOL ANTICANCER AND IMMUNOMODULATING DRUGS-TACROLIMUS Toxic blood levels of tacrolimus, usually on the second day of starting chloramphenicol Attributed to impaired clearance of tacrolimus by chloramphenicol 1 dose of nearly 80% of tacrolimus may be required to prevent toxicity. Watch for adverse effects (see below). Monitor tacrolimus plasma concentrations... 

PHOSPHODIESTERASE TYPE 5 INHIBITORS -SILDENAFIL ANTICANCER AND IMMUNOMODULATING DRUGS-CICLOSPORIN T plasma concentrations of cidosporin, with risk of adverse effects Competitive inhibition of CYP3A4-mediated metabolism of cidosporin Be aware. Sildenafil is taken intermittently and is unlikely to be of clinical significance unless concomitant therapy is long term... 

Use of suboptimal doses of drugs in serious disease, sacrificing efficacy for avoidance of serious adverse effects, has been documented. It particularly affects drugs of low therapeutic index (see Index), i.e. where the effective and toxic dose ranges are close, or even overlap, e.g. heparin, anticancer drugs, aminoglycoside antimicrobials. In these cases dose adjustment to obtain maximum benefit with minimum risk requires both knowledge and attentiveness. 

Dose-limiting effects are in bold type. Cutaneous reactions (sometimes severe), hyperpigmentation, and ocular toxicity have been reported with virtually all nonhormonal anticancer drugs. For adverse interactions with other drugs, see The Medical Letter Handbook of Adverse Drug Interactions, 2003. 

Rapidly proliferating normal cells are more sensitive to cytotoxic drugs. Bone marrow suppression [ often determines the upper limit of tolerable chemotherapy. Table Vll-l-l lists mechanisms of action, selected clinical uses, and adverse effects of major anticancer drugs. Table VIII-l-2 shows the dose- j limiting and distinctive toxidties of anticancer drugs. j... 

The success of chemotherapy depends on the drugs being relatively more toxic to the infecting organism than to the cells of the human host. This is known as selective toxicity. Chemotherapy also applies to treatment of cancers. Cancer cells are similar to normal cells and most anticancer drugs show little selective toxicity and therefore produce serious adverse effects. (See Chapter 10.)... 

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