amifostine

[am″ĭ-fos´tēn] a chemoprotectant used to prevent renal toxicity in cisplatin chemotherapy and to reduce esophagitis, xerostomia, and loss of taste in patients receiving therapy" >radiation therapy for head, neck, or lung cancer.

amifostine

Ethyol

Pharmacologic class: Organic thiophosphate cytoprotective drug

Therapeutic class: Cytoprotectant

Pregnancy risk category C

Action

Undergoes conversion to free thiol, an active metabolite that reduces toxic effects of cisplatin on renal tissue

Availability

Powder for injection: 500-mg anhydrous base and 500 mg mannitol in 10-ml vials

Indications and dosages

➣ To reduce cumulative renal toxicity of cisplatin therapy in patients with ovarian cancer or non-small-cell lung

Adults: 910 mg/m² I.V. daily as a 15-minute infusion, starting 30 minutes before chemotherapy

➣ To reduce moderate to severe xerostomia in patients undergoing postoperative radiation treatment for head or neck cancer

Adults: 200 mg/m² I.V. daily as a 3-minute infusion, starting 15 to 30 minutes before standard fraction radiation therapy

Off-label uses

• Protection against cisplatin- and paclitaxel-induced neurotoxicity

Contraindications

• Hypersensitivity to drug

• Hypotension

Precautions

Use cautiously in:

• arrhythmias, heart failure, ischemic heart disease, renal impairment, hearing impairment, hypocalcemia, myasthenia gravis, nausea, vomiting, hypotension, obesity

• history of cerebrovascular accident or transient ischemic attacks

• concurrent antihypertensive therapy that can't be discontinued for 24 hours before amifostine therapy (not recommended)

• definitive radiotherapy (not recommended)

• elderly patients

• pregnant patients (safety and efficacy not established)

• breastfeeding patients

• children (safety and efficacy not established).

Administration

• Ensure that patient is adequately hydrated before starting drug.

• Give antiemetics before and during therapy.

• Reconstitute single-dose vial with 9.7 ml of sterile normal saline injection. May be further diluted with normal saline solution up to a concentration of 40 mg/ml.

• Don't mix with other drugs or solutions.

• Know that drug also can be prepared in polyvinyl chloride bags.

• Don't infuse longer than 15 minutes; doing so increases risk of adverse reactions.

See Keep patient supine during administration.

Adverse reactions

CNS: dizziness, drowsiness, rigors

CV: hypotension

GI: nausea, vomiting

Metabolic: hypocalcemia

Respiratory: dyspnea, sneezing

Skin: flushing, rash, urticaria, erythema multiforme

Other: chills, warm sensation, hiccups, allergic reactions

Interactions

Drug-drug. Antihypertensives: increased risk of hypotension

Drug-diagnostic tests. Calcium: decreased level

Patient monitoring

• Monitor blood pressure every 5 minutes during infusion and immediately after infusion as clinically indicated.

• Assess for severe nausea and vomiting.

• Monitor fluid intake and output.

• Monitor blood calcium level. Give calcium supplements as ordered.

Patient teaching

• Emphasize importance of remaining supine during drug administration to prevent hypotension.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

• Provide dietary counseling. Refer patient to dietitian if adverse GI effects significantly limit food intake.

• Inform patient that sneezing is a normal effect of drug.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

amifostine

A drug used to reduce the side effects of anticancer treatments, especially the dangers of infection and of damage to the kidneys. A brand name is Ethyol.

单词	amifostine
释义	amifostine amifostine [am″ĭ-fos´tēn] a chemoprotectant used to prevent renal toxicity in cisplatin chemotherapy and to reduce esophagitis, xerostomia, and loss of taste in patients receiving therapy" >radiation therapy for head, neck, or lung cancer. amifostine Ethyol *Pharmacologic class:* Organic thiophosphate cytoprotective drug *Therapeutic class:* Cytoprotectant *Pregnancy risk category C* Action Undergoes conversion to free thiol, an active metabolite that reduces toxic effects of cisplatin on renal tissue Availability Powder for injection: 500-mg anhydrous base and 500 mg mannitol in 10-ml vials Indications and dosages ➣ To reduce cumulative renal toxicity of cisplatin therapy in patients with ovarian cancer or non-small-cell lung Adults: 910 mg/m² I.V. daily as a 15-minute infusion, starting 30 minutes before chemotherapy ➣ To reduce moderate to severe xerostomia in patients undergoing postoperative radiation treatment for head or neck cancer Adults: 200 mg/m² I.V. daily as a 3-minute infusion, starting 15 to 30 minutes before standard fraction radiation therapy Off-label uses • Protection against cisplatin- and paclitaxel-induced neurotoxicity Contraindications • Hypersensitivity to drug • Hypotension Precautions Use cautiously in: • arrhythmias, heart failure, ischemic heart disease, renal impairment, hearing impairment, hypocalcemia, myasthenia gravis, nausea, vomiting, hypotension, obesity • history of cerebrovascular accident or transient ischemic attacks • concurrent antihypertensive therapy that can't be discontinued for 24 hours before amifostine therapy (not recommended) • definitive radiotherapy (not recommended) • elderly patients • pregnant patients (safety and efficacy not established) • breastfeeding patients • children (safety and efficacy not established). Administration • Ensure that patient is adequately hydrated before starting drug. • Give antiemetics before and during therapy. • Reconstitute single-dose vial with 9.7 ml of sterile normal saline injection. May be further diluted with normal saline solution up to a concentration of 40 mg/ml. • Don't mix with other drugs or solutions. • Know that drug also can be prepared in polyvinyl chloride bags. • Don't infuse longer than 15 minutes; doing so increases risk of adverse reactions. See Keep patient supine during administration. Adverse reactions CNS: dizziness, drowsiness, rigors CV: hypotension GI: nausea, vomiting Metabolic: hypocalcemia Respiratory: dyspnea, sneezing Skin: flushing, rash, urticaria, erythema multiforme Other: chills, warm sensation, hiccups, allergic reactions Interactions Drug-drug. Antihypertensives: increased risk of hypotension Drug-diagnostic tests. Calcium: decreased level Patient monitoring • Monitor blood pressure every 5 minutes during infusion and immediately after infusion as clinically indicated. • Assess for severe nausea and vomiting. • Monitor fluid intake and output. • Monitor blood calcium level. Give calcium supplements as ordered. Patient teaching • Emphasize importance of remaining supine during drug administration to prevent hypotension. • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness. • Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids. • Provide dietary counseling. Refer patient to dietitian if adverse GI effects significantly limit food intake. • Inform patient that sneezing is a normal effect of drug. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above. amifostine A drug used to reduce the side effects of anticancer treatments, especially the dangers of infection and of damage to the kidneys. A brand name is Ethyol.
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