Which chemotherapy drugs cause hepatotoxicity?
The major chemotherapeutic agents in this group include methotrexate, sorafenib, dactinomycin, ifosfamide, gemcitabine, etoposide, irinotecan, procarbazine, 6-mercaptopurine, cytarabine, crizotinib, and cyclophosphamide.
What is a unique toxicity of oxaliplatin?
Although oxaliplatin by itself has only mild hematologic and gastrointestinal side effects, its clinically dominating toxicity affects the peripheral sensory nervous system in the form of 2 distinct types of neurotoxicity: (1) a unique, frequent, acute sensory neuropathy that is triggered or aggravated by exposure to …
How is drug induced hepatotoxicity treated?
The only specific treatment for most cases of liver damage caused by taking a drug is to stop taking the drug that caused the problem. However, if you took high doses of acetaminophen, you should get treated for liver injury in the emergency department or other acute treatment setting as soon as possible.
What are side effects of oxaliplatin?
Side Effects
- Diarrhea, changes in taste, mouth sores, nosebleeds, tiredness, headache, dizziness, or trouble sleeping may occur.
- Temporary hair loss may rarely occur.
- Oxaliplatin can sometimes affect how your nerves work (peripheral neuropathy).
How is oxaliplatin metabolized?
Platinum is rapidly cleared from plasma by covalent binding to tissues and renal elimination. Urinary excretion (53.8 +/- 9.1%) was the predominant route of platinum elimination, with fecal excretion accounting for only 2.1 +/- 1.9% of the administered dose 5 days postadministration.
Does oxaliplatin cause neurotoxicity?
Neurotoxicity is the most frequent dose-limiting toxicity of oxaliplatin. Acute sensory neurotoxicity manifests as rapid onset of cold-induced distal dysesthesia and/or paresthesia, sometimes accompanied by cold-dependent muscular contractions of the extremities or the jaw.
What is drug induced hepatotoxicity?
Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. It is difficult to diagnose because the presentation is similar to many hepatobiliary disorders. The principle treatment is the removal of the offending agent and close observation for resolution.
How long does drug-induced liver injury last?
Liver abnormalities generally subside within two–five weeks after stopping the drug. In rare cases, cholestasis persists for up to six months. Sulfonamide-induced liver injury occurs within the first month of administering the medication.
How is oxaliplatin extravasation treated?
Recent case reports suggest that oxaliplatin may be better classified as an irritant when extravasated. The optimal management of oxaliplatin extravasation however remains uncertain. Cold compress may cause local vasoconstriction and reduce cellular injury.
How long does it take to lower AST and ALT levels?
With acute Hepatitis, AST levels usually stay high for about 1-2 months but can take as long as 3-6 months to return to normal.
How can I reduce the side effects of oxaliplatin?
Your doctor may prescribe medication to prevent or relieve nausea and vomiting. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
What are the long term side effects of oxaliplatin?
Hand/foot numbness/tingling appeared to be the longest lasting side-effects for those treated with oxaliplatin. The odds of hand numbness/tingling were significantly greater for the FLOX group during therapy and, while no longer significant at 18 months, were significantly greater at the long-term endpoint.
What to do if extravasation occurs?
If extravasation occurs, the injection should be stopped immediately and the IV tubing disconnected. Avoid applying pressure to the site, and do not flush the line. Leave the original catheter in place, and attempt to aspirate as much of the infiltrated drug as possible.
Can oxaliplatin cause liver damage?
Oxaliplatin, a cisplatin derivative, is a major chemotherapeutic agent administered to patients with colorectal cancer. Compared with cisplatin, adverse drug reactions seen in the kidney are rarer after oxaliplatin treatment. However, there is accumulating evidence that oxaliplatin can cause damage to non-tumor-bearing liver ( 1–5 ).
Does oxaliplatin-induced liver injury mimic metastatic carcinoma?
In summary, our experience with this patient indicated that oxaliplatin-induced liver injury can appear as one or more mass-forming lesions and mimic metastatic carcinoma on images.
What is the pathophysiology of hepatotoxicity?
Hepatotoxicity can result from damage to structures such as the liver sinusoids, vasculature, bile ducts, and direct damage to hepatocytes themselves. Additionally, occlusion of vascular and ductal structures, toxic metabolite formation, and inflammatory cell infiltration into the liver parenchyma can induce damage.
Is there a compilation of hepatotoxicity and recommended management of targeted agents?
This work is a compilation of the hepatotoxicity and recommended management of various chemotherapies and targeted agents, with a focus on the newer classes of targeted anticancer agents. Keywords: Hepatotoxicity, liver, chemotherapy, targeted agents Introduction