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Molecules (Basel, Switzerland) Jun 2020The fight against cancer is one of the most challenging tasks currently for lots of researchers in many fields, such as pharmaceuticals, medicine, and chemicals [...].
The fight against cancer is one of the most challenging tasks currently for lots of researchers in many fields, such as pharmaceuticals, medicine, and chemicals [...].
Topics: Antineoplastic Agents; Drug Design; Humans
PubMed: 32570759
DOI: 10.3390/molecules25122808 -
Environmental Science and Pollution... Aug 2016Antineoplastic drugs are important in the treatment of cancer. Some interact directly with the deoxyribonucleic acid (DNA) and are of utmost importance in terms of risk....
Antineoplastic drugs are important in the treatment of cancer. Some interact directly with the deoxyribonucleic acid (DNA) and are of utmost importance in terms of risk. As highly active compounds, antineoplastics and their metabolites are largely excreted into wastewater and are found in the aquatic environment up to the lower μg/L range. Their predicted environmental concentrations are often below the action limit set in the European Medicines Agency (EMA) guideline. An in-depth risk assessment regarding their presence and effects in the aquatic environment is often not performed, and there is a lack of knowledge. This study considered whether there is an underestimation of possible risks associated with the presence of antineoplastic drugs with regard to trigger value stated in the EMA and FDA guidelines. In a balance, we identified a total of 102 active pharmaceutical ingredients of the ATC-group L01 (antineoplastic agents), which are environmentally relevant. In Germany, 20.7 t of antineoplastic agents was consumed in 2012. The share of drugs with DNA-damaging properties increased within the last 6 years from 24 up to 67 %. Solely, capecitabine and 5-fluorouracil amount together 8 t-which corresponds to 39 % of the total antineoplastic consumption. Around 80 % of the total mass consumed could be attributed to prescriptions issued by office-based practitioners and is mostly excreted at home. Based on the different mode of actions, a case-by-case evaluation of the risk connected to their presence in the environment is recommended. DNA-damaging drugs should be assessed independently as no action limit can be assumed.
Topics: Antineoplastic Agents; DNA Damage; Environmental Exposure; Environmental Monitoring; Environmental Pollutants; Germany; Humans; Risk Assessment
PubMed: 25475615
DOI: 10.1007/s11356-014-3902-8 -
Pharmaceutical Nanotechnology 2017
Topics: Antineoplastic Agents; Chemistry, Pharmaceutical; Drug Delivery Systems; Humans; Molecular Targeted Therapy; Nanoparticles; Polymers
PubMed: 28948906
DOI: 10.2174/221173850501170316193147 -
Inorganic Chemistry Jul 2020A sandwiched mixed matrix membrane (MMM) based on a metal-organic framework-hydrogel hybrid exhibits eximious performance in the detection of mitoxantrone. Parts per...
A sandwiched mixed matrix membrane (MMM) based on a metal-organic framework-hydrogel hybrid exhibits eximious performance in the detection of mitoxantrone. Parts per billion-level sensitivity and good selectivity in serum among other analogous antineoplastics have been achieved. This flexible MMM can be used for point-of-care testing drugs in a biological medium.
Topics: Animals; Antineoplastic Agents; Fluorescence Resonance Energy Transfer; Goats; Hydrogels; Limit of Detection; Luminescence; Luminescent Agents; Membranes, Artificial; Metal-Organic Frameworks; Mitoxantrone; Point-of-Care Testing
PubMed: 32613833
DOI: 10.1021/acs.inorgchem.0c01451 -
Molecules (Basel, Switzerland) Feb 2020Cancer is one of the major causes of death worldwide [...].
Cancer is one of the major causes of death worldwide [...].
Topics: Antineoplastic Agents; Biological Products; Humans; Neoplasms
PubMed: 32028725
DOI: 10.3390/molecules25030650 -
Clinical Pharmacokinetics Oct 1987Therapeutic drug monitoring is now widely used in many areas of medicine. With its proliferation has come an understanding of the clinical situations in which it is... (Review)
Review
Therapeutic drug monitoring is now widely used in many areas of medicine. With its proliferation has come an understanding of the clinical situations in which it is likely to be of value. Factors that can limit the usefulness of therapeutic drug monitoring and situations where it is less likely to be of benefit have also been identified. At present, the routine use of therapeutic drug monitoring in antineoplastic therapy is limited to measurement of plasma methotrexate concentrations after high-dose methotrexate therapy. The lack of a more widespread application of therapeutic drug monitoring in oncology has been due to deficiencies in knowledge about the clinical pharmacology of antineoplastic agents and to factors specific to the chemotherapy of neoplasms. These factors include the broad heterogeneity of malignant neoplasms, the complexities of the drug-tumour interaction, difficulties in assessment of this interaction and the use of combinations of antineoplastic agents with cumulative efficacies and toxicities. Despite these problems, there are many areas in antineoplastic therapy where the use of therapeutic drug monitoring could prove of benefit. The prevention of the chronic pulmonary toxicity of bleomycin, the assessment of the bioavailability of oral chemotherapy, and monitoring drug disposition in the presence of hepatic or renal dysfunction are just some of the potential applications. If recent emphasis on dose as a critical factor in the success of cancer chemotherapy is substantiated, then the need to apply therapeutic drug monitoring within oncology will become more pressing.
Topics: Antineoplastic Agents; Humans; Monitoring, Physiologic; Neoplasms
PubMed: 3311530
DOI: 10.2165/00003088-198713040-00001 -
Seminars in Oncology Nursing May 2011The increase in oral anticancer medications with complex regimens creates a need to assure that patients are taking therapeutic dosages as prescribed. This article... (Review)
Review
OBJECTIVES
The increase in oral anticancer medications with complex regimens creates a need to assure that patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents.
DATA SOURCES
Research and journal articles from CINAHL and PubMed.
CONCLUSION
Assessing and measuring adherence to oral antineoplastics should include three dimensions: the percentage of medications taken, the duration, and the timing of taking the medication.
IMPLICATIONS FOR NURSING PRACTICE
Clinicians need to conduct ongoing assessment and measurement of adherence to oral antineoplastic agents. This includes eliciting patient report of adherence, pill counts, drug diaries, and pharmacy or medical record audits.
Topics: Administration, Oral; Antineoplastic Agents; Humans; Neoplasms; Patient Compliance
PubMed: 21514481
DOI: 10.1016/j.soncn.2011.02.004 -
Journal of Oncology Pharmacy Practice :... Jan 2024Extravasation is a potentially severe complication of intravenous administration of antineoplastic drugs. The limited data makes it difficult to develop an optimal...
INTRODUCTION
Extravasation is a potentially severe complication of intravenous administration of antineoplastic drugs. The limited data makes it difficult to develop an optimal management scheme. The objective of this study is to describe the clinical practice in the extravasation management of antineoplastic agents in Spanish centers.
METHODS
An online survey was distributed to oncology pharmacists using the email distribution list of the Spanish Society of Hospital Pharmacists. Respondents were surveyed on the standard operational protocol (SOP) of extravasation, tissue damage risk classification, and specific measures of extravasation management.
RESULTS
A total of 68 surveys were completed. A specific extravasation SOP was available in 82.4% centers. The pharmacist participates in the authorship (100%) and actively collaborates in extravasation management (76.5%). A tissue damage risk classification based on the three categories was mostly adopted (48.2%) and 73.2% applied specific criteria based on concentration and/or extravasated volume. Extravasation management was mainly performed with the application of physical measures and/or antidotes (91.2%). High variability in the choices of pharmacological and/or physical measures recommended is outstanding.
CONCLUSION
The results of this study highlight the involvement of Spanish pharmacists in extravasation management, the application of physical measures and/or pharmacological measures as the method of choice in extravasation management, as well as the existing discrepancies in tissue damage risk classification and management recommendations.
Topics: Humans; Antidotes; Antineoplastic Agents; Extravasation of Diagnostic and Therapeutic Materials; Infusions, Intravenous
PubMed: 37032471
DOI: 10.1177/10781552231167873 -
American Journal of Health-system... Apr 1997The mechanism of action, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of amifostine are reviewed. Amifostine is a prodrug... (Review)
Review
The mechanism of action, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of amifostine are reviewed. Amifostine is a prodrug converted by alkaline phosphatase to the active sulfhydryl compound WR-1065. WR-1065 protects normal cells by scavenging free radicals, donating hydrogen ions to free radicals, depleting oxygen, and binding to active derivatives of antineoplastic agents. The immediate conversion of amifostine to WR-1065, its small volume of distribution, and the limited amount of drug and metabolite recovered in the urine suggest that amifostine is rapidly dephosphorylated and enters cells as its active metabolite. The selectivity of amifostine for normal tissue is hypothesized to be a results of the decreased vascularity of tumors, decreased activity of alkaline phosphatase in tumor cells, and pH dependence of WR-1065 uptake. In clinical studies, amifostine decreased the frequency of cisplatin-induced nephrotoxicity, ototoxicity, neurotoxicity, and myelosuppression. Amifostine has demonstrated an ability to decrease the hematologic toxicity of cyclophosphamide, carboplatin, mitomycin, and antineoplastic drug combinations. Amifostine has FDA-approved labeling for use in reducing cumulative renal toxicity in patients receiving repeat doses of cisplatin for advanced ovarian cancer and non-small-cell lung cancer. The recommended dose in adults is 910 mg/m2 administered as a 15-minute infusion 30 minutes before the start of chemotherapy. The major adverse effects of amifostine include hypotension and emesis. The benefits of amifostine must be weighted against its potential adverse effects, and the drug's impact on the efficacy of antineoplastics should be further investigated. Amifostine has shown promise in protecting non-malignant cells from the toxic effects of antineoplastics, apparently without compromising toxicity against cancer cells.
Topics: Amifostine; Antineoplastic Agents; Clinical Trials as Topic; Hearing; Humans; Kidney; Melanoma; Neoplasms; Nervous System; Prodrugs; Radiation-Protective Agents
PubMed: 9099346
DOI: 10.1093/ajhp/54.7.787 -
Oncology Nursing Forum 1990Despite advances in early diagnosis and treatment of cancer, more than a million new cases of cancer will have been diagnosed in 1990, with an estimated 10% mortality... (Review)
Review
Despite advances in early diagnosis and treatment of cancer, more than a million new cases of cancer will have been diagnosed in 1990, with an estimated 10% mortality within a year of diagnosis. Thus, the search continues for new or improved antineoplastic agents with a wide spectrum of activity and decreased toxicity. The major advances in single-agent antineoplastic drug therapy include the introduction of cisplatin almost 20 years ago and of etoposide (VP-16) in the mid-1980s. However, within the past two years, analogues of existing antineoplastic agents have been purified and marketed. These drugs offer an enhanced therapeutic index when used alone or in combination with other therapies as well as decreased toxicity and, thus, may enhance patient tolerance.
Topics: Alkylating Agents; Antibiotics, Antineoplastic; Antineoplastic Agents; Carboplatin; Drugs, Investigational; Hormones; Humans
PubMed: 2263514
DOI: No ID Found