Etoposide

Etoposide is used to combat several types of tumors, including testicular and small-cell lung cancers, lymphoma, leukemia, and Kaposi s sarcoma. 

Sample preparation 500 jiL Plasma -I- 50 xL 1 xg/mL 17 estradiol -f- 200 xL 200 mM pH 8.0 Na2HP04, extract into ethylene dichloride, centrifuge for 5 min. Remove the organic layer and evaporate it to dryness imder a stream of nitrogen, reconstitute the residue in 200 iL MeCN MeOH water 30 15 55, ipject a 50 p.L aliquot. 

Mobile phase MeCN MeOH water acetic acid 30 15 54.5 0.5, containing 10 mM tetra-methylammonium hydroxide 

Igwemezie, L.N. Kaul, S. Barbhaiya, R.H. Assessment of toxicokinetics and toxicodynamics following intravenous administration of etoposide phosphate in beagle dogs. Pharm.Res., 1995, 12, 117-123 

Column 250 x 4.6 5 pm Spherisorb Phenyl Mobile phase MeOH water acetic acid 45 54 1 Flow rate 1 

6 Aminophenols. - Cu(II) has been used to oxidise o- and p-aminophenol, the former of which is a metaboHte of the earcinogenie aromatie amine o-anisidine. Although a phenoxyl radieal was observed from the p-isomer, no signal was obtained using the o-isomer, whieh was suggested to refleet the lower stability the radical.  

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Epipodophyllotoxins (etoposide, teniposide) are derived from mandrake root (Podophyllum peltatum). They inhibit topoisomerase H thus causing double strand breaks. Cells in S- and G2-phases are most sensitive. Unwanted effects include nausea and vomiting, myelosuppression, and hair loss. 

II cleaves the two complementary strands of DNA four base pairs apart and the resulting 5 -phosphoryl groups become covalently linked to a pair of tyrosine groups, one in each half of the dimeric topoisomerase II enzyme. Several groups of drugs are known that selectively inhibit topoisomerases in bacteria (quino-lones) or mammalian cells (etoposide, tenoposide). Quinolones are used to treat bacterial infections inhibitors of mammalian topoisomerases are cytostatic drugs used for the treatment of cancer. 

When asparaginase is administered to a patient witii diabetes, die risk for hyperglycemia is increased a dosage adjustment of die oral antidiabetic drug may be necessary. Glucocorticoids decrease die effectiveness of aldesleukin. When aldesleukin is administered witii antihypertensive drugs, tiiere is an additive hypotensive effect Etoposide may decrease the immune response to live viral vaccines. 

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. 

DOX, doxorubicine TAX, taxol MTX, methotrexate DDPt, cisplatin 5PU, flurouracil ETO, etoposide. 

D Etomedac (medac) Etoposide Pierre Fabre J Lastet (Nippon Kayaku ... 

HASHIMOTO S, XU M, MASUDA Y, AIUCHI T, NAKAJO S, CAO J, MIYAKOSHI M, IDA Y and NAKAYA K (1999) Beta-hydroxyisovalerylshikonin inhibits the cell growth of various cancer cell lines and induces apoptosis in leukemia HL-60 cells through a mechanism different from those of Fas and etoposide , J Biochem (Tokyo), 125 17-23. 

Etoposide (XV) is a semisynthetic gylcoside derivative of podophyllotoxin, which is one of the most extensively used anticancer drugs in the treatment of various types of tumors [64,65]. The anticancer activity of this drug is mainly due to its ability to inhibit an ubiquitous and essential enzyme human DNA topo II [66,67]. Despite its extensive use in the treatment of cancers, it has several limitations, such as poor water solubility, drug resistance, metabolic inactivation, myelosuppression, and toxicity [68]. In order to overcome these... 

Etoposide causes multiple DNA double-strand breaks by inhibiting topoisomerase II. The pharmacokinetics of etoposide are described by a two-compartment model, with an a half-life of 0.5 to 1 hour and a (5 half-life of 3.4 to 8.3 hours. Approximately 30% of the dose is excreted unchanged by the kidney.16 Etoposide has shown activity in the treatment of several types of lymphoma, testicular and lung cancer, retinoblastoma, and carcinoma of unknown primary. The intravenous preparation has limited stability, so final concentrations should be 0.4 mg/mL. Intravenous administration needs to be slow to prevent hypotension. Oral bioavailability is approximately 50%, so oral dosages are approximate two times those of intravenous doses however, relatively low oral daily dosages are used for 1 to 2 weeks. Side effects include mucositis, myelosuppression, alopecia, phlebitis, hypersensitivity reactions, and secondary leukemias. 

JP is receiving a highly myelosuppressive chemotherapy regimen for the next 3 days for his lymphoma. The chemotherapy orders specify ifosfamide, carboplatin, and etoposide. The goal of this cycle of chemotherapy is to put the cancer into remission so that his lymphoma can be cured with a bone marrow transplant. 

The rapidly proliferating cells of the GI tract make them susceptible to the effects of chemotherapy. Mucositis is the inflamed, ulcerated mucosa of the mouth, esophagus, and lower GI tract that may result in infection and pain with subsequent decreased fluid and nutritional intake. Methotrexate, 5-FU, etoposide, and doxorubicin are the chemotherapy agents most commonly associated with mucositis. Patients should be instructed on good oral mouth care and use saline rinses several... 

CAV, cyclophosphamide, doxorubicin, vincristine EC, etoposide carboplatin EP, etoposide cisplatin IC, irinotecan, cisplatin. See Table 87M for doses and schedules. 

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