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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Generally, this is not a problem in patients with breast cancer, but clinicians should closely monitor susceptible patients i. Paclitaxel vs epidoxorubicin plus paclitaxel as second-line therapy for platinum-refractory and -resistant ovarian cancer. Once epirubicin enters cardiac cells, it is reduced to an anthracycline free radical that is rapidly oxidized to form the original drug and superoxide anions.
Conjunctivitis and keratitis have been reported with epirubicin chemotherapy. In one case, a woman was 28 weeks pregnant at her diagnosis of breast cancer and was treated with cyclophosphamide and epirubicin every 3 weeks for 3 cycles.
Use care to avoid accidental exposure to epirubicin during preparation, handling, and administration. Due to the risk of long-term cardiotoxicity, it has been recommended that children treated with anthracyclines should undergo screening with ECGs and echocardiograms every 2 years and hour continuous ECGs and radionucleide angiograms every 5 years. Dosage adjustments are required for patients with hepatic or renal dysfunction. Extravasation of epirubicin infusions should be avoided.
The ECF regimen resulted in an increased response and survival benefit for patients with previously untreated gastric cancer or head and neck cancer. Epirubicin-induced cardiomyopathy and congestive heart failure CHF is associated doxorrubidina the cumulative meecanismo of epirubicin.
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. At equimolar doses, epirubicin is less myelotoxic than doxorubicin. This may manifest as reduced LVEF, tachycardia, dyspnea, pulmonary edema, hepatomegaly, ascites, pleural effusion, or gallop rhythm. Long-term survival after epirubicin, cisplatin, and fluorouracil for gastric cancer: A review of its use as a cardioprotective agent in patients receiving anthracycline-based chemotherapy.
Resistance to epirubicin may occur through several mechanisms.
Metabolism of epirubicin occurs through four major routes: Due to the thrombocytopenic effects of epirubicin, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants, Doxprrubicina, platelet inhibitors, including aspirin, strontium chloride, and thrombolytic agents.
Symptoms of extravasation are usually immediate although extravasations into chest wall tissue are less acutely symptomatic. These changes do not necessitate dose modification or discontinuation and are not predictive of delayed cardiotoxicity. As this can be a progressive injury, appropriate long-term follow-up is required. Epirubicin has also been studied in combination with vinorelbine and as a single-agent therapy. La epirubicina tiene un espectro similar de actividad y de toxicidad a los de la doxorrubicina.
Dosage adjustments of antigout agents may be necessary to control hyperuricemia. The severity of the suppression depends on the dose of the drug and the regenerative capacity of the patient’s bone marrow.
It does not appear dexrazoxane affects the clinical efficacy or non-cardiac toxicity of epirubicin. Age does affect the clearance of epirubicin in female patients. J Clin Oncol ; Vaccination during chemotherapy or radiation therapy should be avoided because the antibody response is suboptimal. Serum bilirubin and AST levels should be evaluated before and during treatment with epirubicin.
The French Epirubicin Study Group. Epirubicin is administered intravenously. Clinicians should consult the appropriate references to verify the dose.
The FDA mecanismoo epirubicin for the adjuvant treatment of node-positive breast cancer in September The estimated risk of developing epirubicin-induced CHF is 0. Serum creatinine levels should be assessed before and during epirubicin treatment. A radiation recall reaction can occur after epirubicin administration at the sites of prior radiation.
In the presence of oxygen, the semiquone radical can form a superperoxide that in the presence of hydrogen peroxide forms a hydroxyl radical. It is prudent to closely monitor patients for loss of clinical efficacy of digoxin while receiving antineoplastic therapy. She experienced a spontaneous abortion. Occurrence of secondary malignancy, usually acute myeloid leukemia with or without a preleukemic phase, has been reported following epirubicin.
An increased incidence of ventricular dysfunction and congestive heart failure has been associated with the concurrent use of trastuzumab with anthracyclines e. Epirubicin is a FDA pregnancy category D agent. She received the last dose at 34 weeks of the pregnancy and delivered a healthy baby at 35 weeks. This reaction causes erythema, exfoliative dermatitis, pain, and burning, similar to that experienced with the original radiation therapy.
Other mechanisms of resistance include changes in topoisomerase II and glutathione activity. Prospective and randomized trial of lipiodol-transcatheter arterial chemoembolization treatment of hepatocellular carcinoma: However, later events several months to years after ending treatment have been reported.
It is characterized by facial flushing and delayed erythematous streaking along the vein. 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.
EPIRUBICINA EN VADEMECUM
A second woman with breast cancer metastatic to the liver received fluorouracil, cyclophosphamide and epirubicin but was removed from the trial due to the pregnancy. Anaphylactoid reactions and urticaria may occur following epirubicin administration.
In addition, mecanusmo has a lower incidence of cardiotoxicity; the maximum cumulative dose is almost twice that of doxorubicin. Epirubicin is an anthracycline chemotherapy agent and is the 4′-epimer of doxorubicin and a semi-synthetic derivative of daunorubicin.
Epirubicin is a vesicant, and administration into soft tissue can cause pain, burning, tissue necrosis and accio ulcer. These effects are usually temporary.