NITROSOUREAS TOXICITY

Course overview

NITROSOUREAS ARE MEDICATIONS USED TO MANAGE AND TREAT HIGH-GRADE GLIOMAS AND GLIOBLASTOMAS, AS WELL AS SOME LUNG TUMORS, PANCREATIC ISLET CELL TUMORS, HODGKIN'S DISEASE, NON-HODGKIN'S LYMPHOMAS, AND MELANOMAS. THEY ARE CLASSIFIED AS ALKYLATING AGENTS WITH HIGH LIPOPHILICITY, AND THEY TREAT BRAIN CANCERS EFFECTIVELY. THERE IS NO KNOWN ANTIDOTE FOR NITROSOUREA TOXICITY, AND TREATMENT INVOLVES DRUG CESSATION, SUPPORTIVE CARE, AND, WHEN INDICATED TRANSFUSIONS. CLOSE MONITORING FOR TOXICITY IS NECESSARY FOR PATIENTS ON NITROSOUREA THERAPY.THIS COURSE REVIEWS THE ACUTE AND SUBACUTE TOXICITY OF SOME OF THE MOST COMMONLY USED NITROSOUREAS. NITROSOUREAS HAVE A SEVERE AND EXTENSIVE SIDE EFFECT PROFILE THAT CAN CAUSE CONSIDERABLE TOXICITY IN THERAPEUTIC DOSES. SOME OF THE KNOWN SIDE EFFECTS OF NITROSOUREA TOXICITY ARE PULMONARY FIBROSIS LEADING TO HYPOXIA AND DOSE-DEPENDENT MYELOSUPPRESSION. APPARENT HISTOPATHOLOGICAL FEATURES NARROW THE DIFFERENTIAL DIAGNOSIS CONSIDERABLY, THOUGH TOXIC EFFECTS ARE EXERTED ON SEVERAL ORGAN SYSTEMS. PARTICIPATING CLINICIANS WILL LEARN HOW TO WORK WITHIN AN INTERDISCIPLINARY TEAM IN IDENTIFYING, EVALUATING, AND TREATING PATIENTS WITH NITROSOUREA TOXICITY. IN PARTICULAR, THE APPROACH TO IDENTIFYING THE TOXIC SIGNS OF AN EMERGENCY VERSUS LONG-TERM EXPOSURE IS REVIEWED.