Drug interactions in cancer treatment

It also significantly increased morbidity and mortality. But using docetaxel before cisplatin applications can improve the therapeutic index. The index is highest in intervals of 48 hours. In clinical trial of cisplatin before docetaxel, cisplatin affect the CYP enzymes involved in docetaxel metabolism, resulting in reducing the clearance of paclitaxel by 25%. So there is more obvious bone marrow suppression. In the study of patients with advanced breast cancer, sequential administration of doxorubicin and docetaxel cost has an impact on metabolism. If docetaxel is prior, doxorubicin’s plasma concentration improves and accompanied by significant hematological and mucosal toxicity. It is suggested that doxorubicin should be the first in sequential administration.

Interaction of is pharmacodynamic level often similar. Because the action mechanism of two drugs or a drug-induced electrolyte changes affect other drugs, so synergistic, additive, or antagonistic pharmacodynamic interaction (toxic or anti-tumor effect). Observed in non-small cell lung cancer cells in the Department of cisplatin and gemcitabine he coast of the synergistic anti-tumor role, while the four variable thyroid cancer, Department, gemcitabine and cisplatin before application of the two showed a synergistic effect, while cisplatin in gemcitabine application before the two were antagonistic.

When the cumulative dose of cisplatin or docetaxel 200 mg/m2, 75% of the two drugs in patients with neurotoxicity, increases in both incidence and severity compared with separate applications. In the application of cisplatin, doxorubicin treatment in patients with no cardiac symptoms can be induced by repeated reversible precordial pain, chest tightness, and electrocardiogram ischemia performance. Cancer therapy, drug interactions mechanism has not yet been fully elucidated, the increase in the number of drug applications and new combination drug interactions become more complex. Often not only contain a chemotherapy drugs, as well as other adjuvant that may exist between the pharmacy, pharmacokinetics, pharmacodynamics, various forms of drug interactions.

In addition, the risk of non-prescription drugs combined with chemotherapy can not be ignored, lack of knowledge often may lead to doctors and patients facing sudden, unexpected serious side effects. For example, large doses of vitamin C acidified urine, in combination with high dose MTX, MTX metabolites of 7-hydroxy-MTX non-water soluble, low pH precipitation in the renal tubules, which may lead to acute renal failure. Again, the side effects of MTX and nonsteroidal anti-inflammatory drug (NSAID) in combination significantly increased, the exact mechanism is unclear, excretion, change may be to compete in the tubular secretion of MTX metabolism, competitive protein binding is related, it is suggested that after the application of large doses of MTX, they should not use NSAID in 10 days.

In order to maximize the treatment effect, pharmaceutical raw materials suppliers need to collect more drug interaction and clinical data, and rational use synergy in the drugs to avoid antagonism. In this regard, the new technology has played a huge role, such as the interaction among the human drug metabolizing enzymes in transgenic mice models, quantitative computer-aided analysis and qualitative expected drug interaction. In clinicals, it must be regularly checked with the patient about drug use and particular emphasis on the application of anti-cancer therapy. The patients taking warfarin, rifampicin, anticonvulsants, antidepressants, antihypertensive drugs need special attention about drug interactions.Source:http://www.cospcn.com