Cumulative dose

Cardiotoxicity may develop at lower than expected cumulative doses of anthracyclines in patients with risk factors like hypertension, preexisting arrhythmias or valvular disease, advanced age, prior irradiation of the mediastinum. 

QUESTION Is there a decrease in serotonin metabolites, and does it show any relationship to age, cumulative dose, and so forth Did you see anything there You have that one person who had 42 grams. Was he any more or any less affected ... 

Cumulative dosing schedules are useful and have practical application in psychopharmacology (Wenger 1980). The use of the cumulative IV dosing schedule in these studies permitted the full range of activities for each compound to be observed in a group of animals in one test session. 

Wenger, G.R. Cumulative dose-response curves in behavioral pharmacology. Pharmacol Biochem Behav 13 647-651, 1980. 

Concentration (units/mL) Volume (mL) Dose (units) Cumulative Dose (units)... 

Dose Increments (mg) Dose Interval Cumulative Dose (mg)... 

The combination of methotrexate and UVB seems to be synergistic responses may occur with lower cumulative doses of both methotrexate and UVB. However, stopping methotrexate may cause rebound21,33 and there is some concern about photosensitivity.21 Methotrexate and PUVA have been used together in patients refractory to other treatments however, there is additive carcinogenesis (especially increasing the risk of squamous cell cancer) and subacute phototoxicity.21... 

Methotrexate Monitor complete blood cell count and liver function tests at baseline and regularly, and consider liver biopsy prior to treatment and at a cumulative dose of 1.5 g. If available, monitor PIIINP at least three times yearly. 

Isotretinoin Capsules 10, 20, 40 mg 0.5-1 mg/kg/per day in two divided doses Maximum dose 2 mg/kg per day Cumulative dose 120-150 mg/day Dry skin and mucous membranes, muscle and joint pain, elevated liver enzymes and triglycerides, depression, teratogenicity... 

Each category of chemotherapy drugs has similar side effects. Anthracyclines cause cardiac toxicity, which is related to the cumulative dose. Tubulin interactive agents are associated with neuropathy and ileus. Alkylating agents are associated with secondary malignancies. 

Clinicians should play a role in chemotherapy safety, patient education, and monitoring patient response to therapy. For example, cumulative doses of anthracyclines should be monitored along with signs and symptoms of heart failure. Clinicians also should monitor concurrent medications along with chemotherapy for drug interactions. 

Idarubicin inhibits both DNA and RNA polymerase, as well as topoisomerase II. The pharmacokinetics of idarubicin can best be described by a three-compartment model, with an a half-life of 13 minutes, a (3 half-life of 2.4 hours, and a terminal half-life of 16 hours.22 Idarubicin is metabolized to an active metabolite, idarubicinol, which has a half-life of 41 to 69 hours. Idarubicin and idarubicinol are eliminated by the liver and through the bile. Idarubicin has shown clinical activity in the treatment of acute leukemias, chronic myelogenous leukemia, and myelodysplastic syndromes. Idarubicin causes cardiomyopathy at cumulative doses of greater than 150 mg/m2 and produces cumulative cardiotoxic effects with other anthracyclines. Idarubicin is a vesicant and causes red-orange urine, mucositis, mild to moderate nausea and vomiting, and bone marrow suppression. 

This royal-blue-colored drug is an anthracenedione that inhibits DNA topoisomerase II. The pharmacokinetics of mitoxantrone may best be described by a three-compartment model, with an a half-life of 3 to 10 minutes, a 3 half life of 0.3 to 3 hours, and a median terminal half-life of 12 days. Biliary elimination appears to be the primary route of elimination, with less than 10% of the drug eliminated by the kidney.23 Mitoxantrone has shown clinical activity in the treatment of acute leukemias, breast and prostate cancer, and non-Hodgkin s lymphomas. Myelosuppression, mucositis, nausea and vomiting, and cardiac toxicity are side effects of this drug. The total cumulative dose limit is 160 mg/m2 for patients who have not received prior anthracycline or mediastinal radiation. Patients who have received prior doxorubicin or daunorubicin therapy should not receive a cumulative dose greater than 120 mg/m2 of mitoxantrone. Patients should be counseled that their urine will turn a blue-green color. 

Myelosuppression (dose-related) mucositis (worse with continuous infusion) moderate emetogenic potential alopecia vesicant severe extravasation injury cardiac toxicities acute—not related to cumulative dose arrhythmias, pericarditis chronic— cumulative injury to myocardium (total dose greater than 550 mg/m2 lower total cumulative doses cause damage to myocardium in children (e.g., 350 mg/m2)... 

In leukemia, the intensified use of methotrexate and glucocorticoids is responsible for causing an increased frequency of neurotoxicity and, in older children and adults, avascular necrosis of bone. High cumulative doses of anthracyclines can cause cardiomyopathy. Cranial irradiation causes neuropsychologic deficits and endocrine abnormalities that lead to obesity, short stature, precocious puberty, and osteoporosis.3 As newer and more intensive treatments enter clinical trials, close observation for long-term side effects will assume even greater importance.24... 

Doxorubicin (Adriamycin) Myelosuppression, alopecia, cumulative dose-limiting toxicity, myocardium damage Given in combination with vincristine and dexamethasone (VAD)... 

Cumulative Dose (Radiation)—The total dose resulting from repeated or continuous exposures to radiation. 

Many of these reactions are related to the quantity of excipient found in a dosage form. Benzyl alcohol benzalkonium chloride, propylene glycol, lactose, and polysorbates are all associated with dose-related toxic reactions [52-54], Large-volume parenterals containing 1.5% benzyl alcohol as a preservative have caused metabolic acidosis, cardiovascular collapse, and death in low birth weight premature neonates and infants. The cumulative dose of benzyl alcohol ranged from 99 to 234 mg/kg per day in these patients [55,56], Dose-related adverse effects to excipients are of particular concern in the preterm, low birth weight infant because... 

Renal function in workers exposed to lead has also been examined in relation to bone lead, since this measurement of exposure provides a better assessment of cumulative dose of lead to the kidneys than... 

Dibenedetto SP, Guardabasso V, Ragu-sa R et al. 6-Mercaptopurine cumulative dose a critical factor of maintenance therapy in average risk childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol 1994 11 251-258. 

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