Tamoxifen Cyclophosphamide

I 10. The answer is a. (Hardman, p 1302J Cyclophosphamide is classified as a poly functional alkylating drug that transfers its alkyl groups to cellular components. The cytotoxic effect of this agent is directly associated with the alkylation of components of DNA. Methotrexate and 5-FU are classified as anti metabolites that block intermediary metabolism to inhibit cell proliferation. Tamoxifen is an antiestrogen compound. Doxorubicin is classified as an antibiotic chemotherapeutic agent. 

Chemotherapy Cyclophosphamide, erlotlnlb, ifos-famide, paclitaxel, tamoxifen, vinblastine, vincristine HIV protease inhibitors Amprenavir, atazanavir, indinavir, nelfinavir, ritonavir, saquinavir HMG-CoA reductase inhibitors Atorvastatin, lovastatin, simvastatin... 

Although the endometrial cancers associated with tamoxifen are usually pure adenocarcinomas, other types of rare tumors have also been reported. A pure uterine rhabdomyosarcoma has been reported (99), and a mesodermal mixed tumor of the endometrium occurred 5 years after 5 years of tamoxifen therapy (100). The tumor responded only to combined treatment with doxorubicin, cyclophosphamide, 5-fluorouracil, and carbopla-tin. It is possible that this type of tumor arises later than adenocarcinomas and should be looked for during longterm use of tamoxifen. 

Distante V, Bolognesi A, Aldrighetti D, Farris A. Cyclophosphamide, methotrexate, and fluorouracil versus tamoxifen plus ovarian suppression as adjuvant treatment of estrogen receptor-positive pre-/perimenopausal breast cancer patients results of the Italian Breast Cancer Adjuvant Study Group 02 randomized trial. J Clin Oncol 2000 18(14) 2718-27. 

Carcinoma of breast (1) Adjuvant chemotherapy or tamoxifen after primary breast surgery Cyclophosphamide, doxorubicin, vincristine, methotrexate, fluorouracil, paclitaxel, mitoxantrone, prednisone, megestrol, androgens,1 aminoglutethimide, trastuzumab... 

The correct choice = B. Tamoxifen binds to the estrogen receptor and acts as an antagonist. Doxorubicin intercalates in DNA and thus interferes in transcription. Cyclophosphamide, mechlorethamine and cisplatin can cross-link with DNA strands to inhibit its function. 

High-dose therapy with certain chemotherapeutic agents, including cytosine arabinoside, cyclophosphamide, methotrexate, and 5-fluorouracil, has been implicated in conjunctivitis. However, it appears that low-dose therapy with the anticancer agent tamoxifen is infrequently associated with anterior segment toxicity. 

The calcium channel blocker mibefradil (Posicor ) was removed from the market in 1998. The headline for the Pink Sheets article describing this action was "Posicor Withdrawal Reflects Complexity of Interaction Profile" (59). Products identified as potentially dangerous in combination with mibefradil included cardiac drugs, such as amiodarone, flecainide, and propafenone oncologic products, such as tamoxifen, cyclophosphamide, etoposide, ifosfamide, and vinblastine and the immunosuppressant medications cyclosporine and tacrolimus. The sponsor s decision to withdraw mibefradil was based on the complexity of the drug interaction information that would have to be communicated to ensure safe usage. 

Jakesz R, Hausmaninger H, Kubista E, et al. Randomized adjuvant trial of tamoxifen and gosereUn versus cyclophosphamide, mefiiotrexate, and fluorouracil Evidence for file superiority of treatment wifii endocrine blockade in premenopausal patients with hormone-responsive breast cancer— Austrian Breast and Colorectal Cancer Study Group Trial 5. J ain Oncol 2002 20 4621 627. 

Acetaminophen, aldrin, alfentanil, amiodarone, aminopyrine, amitriptyline, amprenavir, androstenedione,antipyrine, astemizole, benzphetamine, budesonide, carbamazepine, celecoxib, chlorpromazine, chlorzoxazone, cisapride, clarithromycin, clozapine, cocaine, codeine, cortisol, cyclophosphamide,cyclosporin, dapsone, delavirdine, dextromethorphan, digitoxin, diltiazem, diazepam, erythromycin, 17j3-estradiol, ethinylestradiol, etoposide, felbamate, fentanyl, flutamide, hydroxyarginine, ifosphamide, imipramine, indinavir, ketoconazole, lansoprazole, loratidine, losartan, lovastatin, (iS)"mephen3d in, methadone, mianserin, miconazole, mifepristone, nelfinavir, nevirapine, nicardipine, nifedipine, odansetron, omeprazole, orphenadrine, proguanil, propafenone, quinidine, quinine, rapamycin, retinoic acid, ritonavir, saquinavir, selegiline, serindole, sufentanil, sulfinpyrazone, tacrolimus, tamoxifen, tamsulosin, taxol, teniposide, terfenadine, tetrahydrocannabinol, theophylline, toremifene, triazolam, trimethadone, trimethoprim, troleandomycin, verapamil, warfarin, zatosetron, Zolpidem, zonisamide... 

Hormonal therapy and chemotherapy versus chemotherapy alone as adjuvant treatment in breast cancer was studied in 236 patients (H8). All presented axillary node involvement and had ERP levels greater than or equal to 10 fmol/mg protein and/or PRP levels greater than or equal to 15 ftnol/mg protein. They were randomized to receive either chemotherapy alone, with 9 courses of cyclophosphamide, methotrexate, and 5-fluorouracil over 6 months, or chemotherapy plus hormonal therapy, with tamoxifen for 2 years. The two groups of patients were comparable except for the mean number of axillary nodes involved (3.4 for the chemotherapy... 

CYP2B6 <5 1-2 Bupropion Carbamazepi ne Cyclophosphamide Selegiline Flunitrazepam Meperidine Bupropion Selegiline Ethinylestradiol Phencyclidine Tamoxifen Ticlopidine Clotrimazole Carbamazepine Phenobarbital Phenytoin Pioglitazone Rifampin Troglitazone Valproic acid Ritonavir... 

Breast carcinoma (stages 1 and II) CMP regimen Cyclophosphamide plus methotrexate and fluorouracil, or doxorubicin for methotrexate (CAP regimen) tamoxifen if hormone receptor-positive... 

Breast carcinoma Postoperative chemotherapy commonly involves use of the CMF regimen (cyclophosphamide, methotrexate, and fluorouracil) with or without tamoxifen, or the CAP regimen in which doxorubicin (Adriamycin) replaces methotrexate. Tamoxifen (or toremifene) is added to such regimens for receptor-positive cancers, and trastuzumab may be included if tumors overexpress HER2 protein. 

Items 1-3 A 32-year-old woman underwent segmental mastectomy for a breast tumor of 3 cm diameter. Lymph node sampling revealed two involved nodes. Since chemotherapy is of established value in her situation, she underwent postoperative treatment with antineoplastic dmgs. The FAC-V regimen was employed, consisting of fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide, plus vincristine. Six cycles 1 month apart of this chemotherapy regimen were planned. Adjunctive drugs included tamoxifen, since the tumor cells were hormone receptorpositive. 

Then five years ago in her late forties while going through a divorce, Susan discovered she had breast cancer. It was stage i with no lymph node involvement. She had a lumpectomy, radiation, and four rounds of combination chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) plus antihormonal treatments of tamoxifen. 

Barbara, unemployed, formerly worked with the developmentally and mentally impaired. Breast cancer, stage 2, diagnosed in 2005 at age fifty. (Treatment mastectomy. Chemo doxorubicin, cyclophosphamide, pacli-taxel. Targeted therapy trastuzumab [Herceptin], Anti-hormonals tamoxifen, then anastrozole.)... 

A pharmacokinetic study in patients with non-Hodgkin s lymphoma receiving CHOP (cyclophosphamide, vincristine, prednisone and doxorubicin 37.5 to 50 mg/m ) found that the addition of tamoxifen 480 mg daily for 5 days had no significant effect on the AUC or total clearance of doxorubicin. For the possible additive thromboembolic effect of doxorubicin and tamoxifen, see Antineoplastics + Tamoxifen , p.616. 

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