TAILIEUCHUNG - Chapter 081. Principles of Cancer Treatment (Part 13)

Cisplatin was discovered fortuitously by observing that bacteria present in electrolysis solutions could not divide. Only the cis diamine configuration is active as an antitumor agent. It is hypothesized that in the intracellular environment, a chloride is lost from each position, being replaced by a water molecule. The resulting positively charged species is an efficient bifunctional interactor with DNA, forming Pt-based cross-links. Cisplatin requires administration with adequate hydration, including forced diuresis with mannitol to prevent kidney damage; even with the use of hydration, gradual decrease in kidney function is common, along with noteworthy anemia. Hypomagnesemia frequently attends cisplatin use. | Chapter 081. Principles of Cancer Treatment Part 13 Cisplatin was discovered fortuitously by observing that bacteria present in electrolysis solutions could not divide. Only the cis diamine configuration is active as an antitumor agent. It is hypothesized that in the intracellular environment a chloride is lost from each position being replaced by a water molecule. The resulting positively charged species is an efficient bifunctional interactor with DNA forming Pt-based cross-links. Cisplatin requires administration with adequate hydration including forced diuresis with mannitol to prevent kidney damage even with the use of hydration gradual decrease in kidney function is common along with noteworthy anemia. Hypomagnesemia frequently attends cisplatin use and can lead to hypocalcemia and tetany. Other common toxicities include neurotoxocity with stocking-and-glove sensorimotor neuropathy. Hearing loss occurs in 50 of patients treated with conventional doses. Cisplatin is intensely emetogenic requiring prophylactic antiemetics. Myelosuppression is less evident than with other alkylating agents. Chronic vascular toxicity Raynaud s phenomenon coronary artery disease is a more unusual toxicity. Carboplatin displays less nephro- oto- and neurotoxicity. However myelosuppression is more frequent and as the drug is exclusively cleared through the kidney adjustment of dose for creatinine clearance must be accomplished through use of various dosing nomograms. Oxaliplatin is a platinum analog with noteworthy activity in colon cancers refractory to other treatments. It is prominently neurotoxic. newpage Antitumor Antibiotics and Topoisomerase Poisons Antitumor antibiotics are substances produced by bacteria that in nature appear to provide a chemical defense against other hostile microorganisms. As a class they bind to DNA directly and can frequently undergo electron transfer reactions to generate free radicals in close proximity to DNA leading to DNA damage in the form of .

• Y học thường thức
• Principles of Cancer Treatment
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine