Myocardial toxicity

Myocardial toxicity, manifested in its most severe form by potentially fatal CHF, may occur either during therapy with mitoxantrone or months to years after termination of therapy. Mitoxantrone use has been associated with cardiotoxicity this risk increases with cumulative dose. In cancer patients, the risk of symptomatic CHF was estimated to be 2.6% for patients receiving up to a cumulative dose of 140 mg/m. For this reason, monitor patients for evidence of cardiac toxicity and question them about symptoms of heart failure prior to initiation of treatment. Monitor patients with multiple sclerosis (MS) who reach a cumulative dose of 100 mg/m for evidence of cardiac toxicity prior to each subsequent dose. Ordinarily, patients with MS should not receive a cumulative dose greater than 140 mg/m. Active or dormant cardiovascular disease, prior or concomitant radiotherapy to the mediastinal/pericardial area, previous therapy with other anthracyclines or anthracenediones, or concomitant use of other cardiotoxic drugs may increase the risk of cardiac toxicity. Cardiac toxicity with mitoxantrone may occur at lower cumulative doses whether or not cardiac risk factors are present (see Warnings and Administration.and.Dosage). 

When used for spinal anaesthesia, 0.75% ropivacaine produces less intense sensory and motor block than 0.5% bupivacaine. It is suitable for regional, spinal and epidural block but not for regional intravenous anaesthesia. The addition of adrenaline (epinephrine) does not prolong the duration of anaesthesia in brachial plexus or epidural block. Ropivacaine is indistinguishable from bupivacaine when used in obstetric anaesthesia. Its direct myocardial toxicity is somewhat less than that of bupivacaine. 

Idarubicin Nausea and vomicing cissue damage on extravasation Bone marrow depression alopecia stomatitis myocardial toxicity diarrhoea... 

Trehu EG, Isner JM, Mier JW, Karp DD, Atkins MB. Possible myocardial toxicity associated with interleukin-4 therapy. J Immunother 1993 14(4) 348-51. 

Fever fluid retention hypotension respiratory distress rash anemia thrombocytopenia nausea and vomiting diarrhea capillary leak syndrome nephrotoxicity myocardial toxicity hepatotoxicity erythema nodosum neutrophil chemotactic defects... 

Pescatore SL +, Expert Opin Pharmacother 1(3), 537 Myocardial infarction (2006) Prescrire Int 15(83), 83 Myocardial toxicity... 

Simpson C +, Clin] Oncol Nurs 8(5), 497 Myocardial toxicity... 

Erol MK+, South Med J 96(1), 99 (with cisplatin) Myocardial toxicity... 

Murray TJ, Expert Opin Drug Saf 5(2), 265 Congestive heart failure (2006) Murray TJ, Expert Opin Drug Saf 5(2), 265 (2004) Libersa C +, Therapie 59(1), I 27 Myocardial toxicity... 

Hill RE, Heard K, Bogdan GM, Cairns CB, Dart RC (2001) Attenuation of verapamil-induced myocardial toxicity in an ex-vivo rat model using a verapamil-specific ovine immunoglobin. Acad Emerg Med 8(10) 950-955... 

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