الفهرس | Only 14 pages are availabe for public view |
Abstract Better understanding of the clinical pharmacology of antineoplastic agents will improve the output of cancer chemotherapy. Clinical monitoring and pharmacokinetic data offer the possibility of tailoring drug delivery to particular patients needs. Therefore, the ultimate goal is optimization of the dose which will lead to minimization of side effects and maximum therapeutic effect. Drug concentration measurements are the heart of drug monitoring and pharmacokinetic studies. These measurements can serve as a useful tool which may help in the elucidation of the relationship between drug concentration and pharmacologic or therapeutic effect. Cancer patients may have significant hepatic or renal dysfunction and other abnormalities that may lead to alterations in the pharmacokinetic parameters. Appreciation of inter and intrapatient variabilities is potentially of great importance for optimizing antineoplastic therapy. Therefore, these variabilities should be carefully considered prior to dosing in order to minimize the risk of an undesirable outcome. High dose MTX (Methotrexate) is included in chemotherapy regimens used to treat a number of malignant neoplasms. HD MTX therapy with the addition of leucovorin rescue offer the advantage of minimal bone marrow toxicity. However, HDMTX (regimens) should be instituted only when plasma monitoring is available to determine the adequacy of drug clearance and the risk of serious toxicity (Chu and Allegra, 1996). |