cytotoxic drugs

细胞毒性药物
  • 文章类型: Case Reports
    背景:以铂类为基础的联合化疗,包括顺铂和卡铂,是重要的细胞毒性抗癌剂,其广泛用于治疗各种实体瘤。卡铂对小细胞肺癌的生存有类似的影响,但与顺铂相比,通常毒性较轻。两者都可能导致中度或重度神经毒性,但很少报道卡铂的眼部神经毒性。病例介绍:一名79岁的男性接受了静脉化疗(阿特珠单抗,依托泊苷,和卡铂)用于小细胞肺癌。第二个周期化疗后一周,他报告双侧视力丧失为双眼的手部运动。眼底扩张检查显示视网膜动脉狭窄,无出血,在光学相干断层扫描扫描中观察到弥漫性脉络膜和视网膜变薄。荧光素血管造影显示明显延迟的循环,没有阻塞性病变的证据。30-闪烁视网膜电图测试显示双眼完全没有视锥反应。患者的视力加重到双眼没有光感知,即使在化疗停止后。结论:以治疗剂量给予卡铂联合化疗可导致不可逆的视力丧失,一个没有被广泛承认的副作用。使用卡铂时,医生应该意识到其潜在的眼部毒性.
    Background: Platinum-based combination chemotherapy, including cisplatin and carboplatin, are important cytotoxic anti-cancer agents that are widely used to treat various solid tumors. Carboplatin has a similar effect on survival in small cell lung cancer, but generally has a milder toxicity profile when compared with cisplatin. Both may cause moderate or severe neurotoxicity, but ocular neurotoxicity from carboplatin is rarely reported. Case presentation: A 79-year-old man underwent intravenous polychemotherapy (atezolizumab, etoposide, and carboplatin) for small cell lung cancer. One week after the second cycle of chemotherapy, he reported bilateral visual loss as hand motion in both eyes. Dilated fundus examination showed retinal arterial narrowing without hemorrhage, and diffuse choroidal and retinal thinning was observed in an optical coherence tomography scan. Fluorescein angiography revealed significantly delayed circulation without evidence of obstructive lesions. 30-Flicker electroretinogram testing showed a complete absence of cone response in both eyes. The patient\'s visual acuity aggravated to no light perception in both eyes, even after the cessation of chemotherapy. Conclusions: Carboplatin combination chemotherapy administered at therapeutic doses can result in irreversible visual loss, a side effect that is not widely acknowledged. When using carboplatin, physicians should be aware of its potential ocular toxicity.
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  • 文章类型: Case Reports
    肠气(PI)是指肠壁内存在空气。它可能与许多原因有关,包括化疗。我们报告了一例70岁的男性转移性舌鳞状细胞癌(SCC),其住院过程因腹泻和PI的发展而复杂化,这是由于5-氟尿嘧啶(5-FU)化疗后,全面的诊断检查和令人放心的体格检查。患者接受抗生素和肠道休息保守治疗。出院前进行的重复成像显示出稳定的发现。患者出院后无并发症发生。我们强调了在确保体检和诊断检查的患者中认识到5-FU是PI的原因的重要性。此外,我们强调,通过保守的措施,它仍然可能得到成功的管理。
    Pneumatosis intestinalis (PI) refers to the presence of air within the bowel wall. It can be associated with many causes including chemotherapy. We report a case of a 70-year-old male with metastatic tongue squamous cell carcinoma (SCC), whose hospital course was complicated by diarrhea and the development of PI, which was attributed to 5-fluorouracil (5-FU) chemotherapy after a comprehensive diagnostic workup and reassuring physical examination. The patient was treated conservatively with antibiotics and a bowel rest. A repeat imaging done before discharge showed stable findings. The patient was discharged afterward without complications. We highlight the importance of recognizing 5-FU as a cause for PI among patients with reassuring physical examination and diagnostic workup. Furthermore, we highlight that it may still be successfully managed with conservative measures.
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  • 文章类型: Journal Article
    背景:卫生保健专业人员有可能在日常工作中接触细胞毒性药物。该研究旨在评估卫生专业人员在冈达尔大学专科医院护理细胞毒性药物和相关因素的实践。
    方法:采用横断面研究设计。EPIInfo7用于数据输入,然后导出到SPSS20中进行统计分析。计算具有标准偏差的频率和平均值。已进行Logistic回归以找出相关因素。进行了95%不确定区间的粗略和调整后的赔率比。p<0.05的变量被宣布为细胞毒性药物处理实践的重要因素。
    结果:该研究使用了四百零十二名卫生专业人员,以97.4%的反应率参加了该研究。研究参与者的平均年龄为29.9岁,范围为20-60岁,20名(53.4%)参与者为男性。一百五十五(37.6%)卫生专业人员具有良好的细胞毒性药物处理实践。平均每天参加4-9例患者(AOR=2.12,95%CI:1.05,4.22),中等工作应力(AOR=2.01,95%CI:1.04,3.90),细胞毒性药物处理手册的可用性(AOR=2.51:95%CI:1.22,5.12),良好的知识(AOR=4.09,95%CI:2.35,7.11)与细胞毒性药物处理实践显着相关。
    结论:细胞毒性药物处理护理的实践较低。它要求卫生部门的参与,以避免这种不充分的做法,并且必须专注于为细胞毒性药物处理的实践提供知识和后勤。
    BACKGROUND: Health care professionals are potential to be in contact with cytotoxic drugs during their daily work activ-ities. The study aimed to assess the practice of health professionals to care for cytotoxic drugs and associated factors in the University of Gondar Specialized Hospital.
    METHODS: Cross-sectional study design was employed. EPI Info 7 was used for data entry and then exported into SPSS 20 for statistical analysis. Frequencies and mean with standard deviation were computed. Logistic regression had been performed to find out associated factors. Crude\' and adjusted Odds\' ratio with 95% uncertainty interval was done. Variables with a p < 0.05 were declared as significant factors for practice of cytotoxic drug handling.
    RESULTS: The study used four-hundred and twelve health professionals took part in the study with 97.4% response rate. The mean age of study participants was 29.9 years ranging from 20-60 years and twenty (53.4%) participants were males. One hundred and fifty-five (37.6%) health professionals had good cytotoxic drug handling practice. Attending an average of 4-9 patients per day (AOR = 2.12, 95% CI: 1.05, 4.22), Medium work stress (AOR = 2.01, 95% CI: 1.04, 3.90), availability of cytotoxic drug handling manual (AOR = 2.51: 95% CI: 1.22, 5.12), and good knowledge (AOR = 4.09, 95% CI: 2.35, 7.11) were significantly associated with cytotoxic drug handling practice.
    CONCLUSIONS: The practice of cytotoxic drug handling care was low. It demands the engagement of the health sector to avert such inadequate practice and has to focus on delivering knowledge and logistics for the practice of cytotoxic drug handling.
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  • 文章类型: Case Reports
    Paclitaxel (PTX) and/or cisplatin (CDDP), as important cytotoxic anti-cancer agents, are widely used to treat various solid tumors. Both may cause moderate or severe neurotoxicity, but ocular neurotoxicity is also occasionally reported. A patient diagnosed with nasopharyngeal cancer suffering acute ocular neurotoxicity 10 days after paclitaxel and CDDP administration at the recommended dose is described in the present case report, and PTX- and/or CDDP-induced ocular neurotoxicity are summarized according to previous reports. Possible mechanisms and the potential diagnostic, therapeutic and predictive strategies of PTX- and/or CDDP-induced ocular neurotoxicity are reviewed, to help the oncologist to take the infrequent toxicity of cytotoxic drugs into account and improve patient safety during anti-cancer therapy.
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