complicado mecanismo de acción antitumoral como con sus efectos .. inhibidores de la topoisomerasa II (doxorrubicina, etopósido. mecanismo de acción de antineoplasicos. AV Doxorrubicina (antraciclina). – Lesión del ADN. –Inhibición topoisomerasa II. –Vía intravenosa. Abraxane (nombre genérico: paclitaxel unido a albúmina (nab-paclitaxel)) · Adriamicina (nombre genérico: doxorrubicina) · Carboplatino.
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With the addition of colony-stimulating factors, dose-intensive regimens have been developed to take advantage of the dose-response relationship of epirubicin and the lower incidence of myleotoxicity and cardiotoxicity.
These reactions may lead to phlebitis. Acute cardiotoxicity can occur during administration of epirubicin; a cumulative, dose-dependent cardiomyopathy may also occur. For the treatment of bladder cancer, epirubicin 50 mg in 50 ml is instilled once weekly for 8 weeks; the dose may be increased to 80 mg in 50 ml in patients with carcinoma in situ, depending on individual tolerability.
Administration of epirubicin destroys any GP activity present doxorrubicinx cardiac cells.
If possible, avoid veins over joints or in extremities with compromised venous or lymphatic drainage. Epirubicin is a radiation sensitizer and should be used with caution in patients receiving concurrent radiation therapy; although in some cases this may be a benefit. These reactions are associated with excessively xccion administration and do not contraindicate further use.
Medicamentos de quimioterapia
Epirubicin may contribute to gonadal suppression seen during cancer chemotherapy. Intramuscular administration and subcutaneous administration of epirubicin are contraindicated due to severe skin and tissue necrosis.
Females and children may be more sensitive to the cardiotoxic effects of anthracyclines. Patients with a doxorrubiicina of varicella zoster, other herpes infections e.
Medicamentos de quimioterapia
Phase III randomized study of fluorouracil, epirubicin and cyclophosphamide v fluorouracil, doxorubicin, and cyclophosphamide in advanced breast cancer: Prospective and randomized trial of lipiodol-transcatheter arterial chemoembolization treatment of hepatocellular carcinoma: Dose-intensive chemotherapy with ifosfamide, epirubicin, and filgrastim for adult patients with metastatic or locally advanced soft tissue sarcoma: Oncology Huntingt ;12 1 Suppl 1: The dose of epirubicin should be adjusted for elevations in the total bilirubin or AST because these patients will have a decreased clearance of epirubicin with an increase in overall toxicity see Dosage.
Generally, this is not a problem in patients with breast cancer, but clinicians should closely monitor susceptible patients i. Epirubicin is a vesicant, and administration into soft tissue can cause pain, burning, tissue necrosis and skin ulcer.
These agents could enhance epirubicin’s activity. Cyclosporine, valspodar PSCtrifluoperazine, tamoxifen, toremifene, and verapamil acicon block the multidrug resistance MDR glycoprotein, which is a mechanism of resistance to naturally occurring non-synthetic chemotherapy agents.
Epirubicin-induced free radical formation contributes to its cardiotoxicity. This simple act of changing the conformation of DNA can interfere with strand elongation by inhibiting DNA polymerase and jecanismo inhibit protein synthesis due to effects on RNA polymerase. If extravasation occurs, stop the infusion and remove the tubing.
The estimated risk of developing epirubicin-induced CHF is 0. Epirubicin has a similar spectrum of activity and toxicity as doxorubicin.
Stomatitis and esophagitis can occur in 2 to 3 days following initiation of chemotherapy and is characterized by oral bleeding, burning, erythema, infections, and oral ulceration.
A venous flare reaction has been noted in patients who receive epirubicin. In addition, epirubicin has a lower incidence of cardiotoxicity; the maximum cumulative dose is almost twice that of doxorubicin. The addition of cyclosporine or valspodar to epirubicin therapy may result in increases in AUC for both epirubicin and epirubicinol possibly due to a decrease in clearance of parent drug, a decrease in metabolism of epirubicinol, or an increase in intracellular epirubicin concentrations.
Surgical follow-up is indicated if pain and swelling at the site continues 2 weeks after the extravasation. Two cases of acute lymphoid leukemia ALL have been reported in patients receiving epirubicin. Women may experience irreversible amenorrhea, premature menopause, and decreased fertility. The immune response of the immunocompromised patient to vaccines is decreased and higher doses or more frequent boosters may be required.
It is not known if epirubicin is excreted in human breast milk but has been detected in breast milk of animals. A prospective randomized phase III trial comparing combination chemotherapy with cyclophosphamide, fluorouracil, and either doxorubicin or epirubicin. In two European phase III trials comparing epirubicin FEC and doxorubicin CAF in combination with cyclophosphamide and fluorouracil for the treatment of breast cancer, the patients treated with epirubicin had similar response and survival rates as patients treated with doxorubicin.
The epirubicin combination was significantly more myelosuppressive.
As this can be a progressive injury, appropriate long-term follow-up is required. A review of its use as a cardioprotective agent in patients receiving anthracycline-based chemotherapy.
Measles-mumps-rubella MMR vaccination is not contraindicated for the close contacts, including health care professionals, of immunocompromised patients.
Resistance to epirubicin may occur through several mechanisms. Epirubicin is administered intravenously. Concurrent use of epirubicin with other agents that cause bone marrow or immune suppression such as other antineoplastic agents or immunosuppressives may result in additive effects.