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藥理:抗癌用藥(chemotherapy) (cell cycle non-specific (alkylating agent…
藥理:抗癌用藥(chemotherapy)
cell cycle non-specific
alkylating agent
introduction
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廣效性抗癌藥
對proliferative, non-proliferative cell都會作用
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其重要adverse effect
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共同副作用
Obvious BM suppression, alopecia, pulmonary fibrosis, gonadal dysfunction
mechlorethamine
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臨床應用
治療Hodgkin's, non-Hodgkin's lymphoma
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cyclophosphamide (C)
臨床應用
Hodgkin's (BEACOPP), non-Hodgkin's lymphoma (R-CHOP)、neuroblastoma、乳癌、卵巢癌, lupus nephritis, multiple myeloma (CM)
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adverse effect
掉髮、出血性膀胱炎(bladder fibrosis, 以Mesna治療), infertility (woman > 24y/o; man > 18y/o), N/V, cardiotoxicity, hypoNa
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carmustine, lomustine
其脂溶性高
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臨床應用
Brain tumor, anaplastic oligodendroglioma (PCV)
procarbazine, dacarbazine, temozolomide
屬於非典型alkylating agent,dacarbazine屬於ABVD之一(Hodgkin lymphoma), 注意勿與酒精共用,會導致 disulfiram like syndrome
Procarbazine
HD (ChlVPP, BEACOPP), anaplastic oligodendroglioma (PCV)
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Temozolomide
High grade glioma (GBM, 2nd line for anaplastic astrocytoma), melanoma, malignant prolactinoma
Ifosfamide
不等於 fosfomycin
臨床應用
Sarcoma, osteosarcoma (+ etoposide)
Side effect
神經毒性、出血性膀胱炎、Fanconi-like syndrome, encephalopathy
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platinum analog
cisplatin, carboplatin, oxaplatin
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adverse effect
Strong N/V, hypoMg, hypoCa, hypoNa (renal salt wasting syndrome)
Cisplatin
臨床應用
Ovarian CA, genital organ CA, lung CA, bladder CA, head and neck, GI CA
Side effect
Nephrotoxicity, ototoxicity, peripheral neurotoxicity, N/V, relatively no BM suppression
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anthracyclines
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doxorubicin (A or H)
臨床應用
治療sarcoma、breast, endometrial CA, Hodgkin's (ABVD, BEACOPP), non-Hodgkin's lymphoma (R-CHOP)
daunorubicin (D)
僅用於leukemia治療 (ALL, AML) —> OPDL
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adverse effect
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心肌受損
heart failure, arrhythmia(delayed toxicity)
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L-asparaginase
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adverse effect
Coagulopathy, hypofibrinogen, liver toxicity, renal toxicity, bronchospasm, respiratory failure, 胰臟炎
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steroid
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用於ALL、Hodgkin's, non-Hodgkin's lymphoma
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target therapy
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藥物
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針對tumor marker
Rituximab
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adverse effect
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tumor lysis syndrome
hyperuricemia, hypocalcemia
protein kinase inhibitor
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Imatinib, Dasatinib, Nilotinib
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adverse effect
GI distress, fluid retention, edema, thrombocytopenia, neutropenia
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