Anesthetic-antineoplastic drug interactions Journal Article
| Author: | Desiderio, D. P. |
| Article Title: | Anesthetic-antineoplastic drug interactions |
| Abstract: | The treatment of a patient with cancer requiring antineoplastic drugs, either as first line or as adjuvant therapy to surgery or radiation, can be quite challenging for the anesthesiologist as well as the oncologist. As discussed, the majority of chemotherapy agents have some type of toxic effects along with their antineoplastic effects. These side effects can have an immediate and delayed onset. The immediate effects occur during therapy and usually resolve with its discontinuation. These patients will present to the anesthesiologist for emergency surgery, as elective surgery is routinely delayed for 4 to 6 weeks after chemotherapy treatment. The immediate effects include nausea and vomiting, requiring a rapid sequence induction, and tissue necrosis, leading to an increase in potassium and uric acid. Succinylcholine may need to be avoided, and aggressive diuresis is important in avoiding renal failure. Hypersensitivity is common, and any skin rash should be noted preoperatively so as not to be confused with an anesthetic drug reaction or a blood reaction intraoperatively. Hypocalcemia may require treatment preoperatively, and hyperthermia should be monitored. More common to the anesthesiologist's practice are the delayed side effects as discussed for each individual agent. As one can see, it is very important for the anesthesiologist to be aware of these toxic effects prior to the induction of anesthesia because the anesthetic management may well be altered. |
| Keywords: | cancer chemotherapy; busulfan; review; cisplatin; fluorouracil; interferon; cytarabine; methotrexate; neurotoxicity; antineoplastic agent; interleukin 2; liver toxicity; lung toxicity; nephrotoxicity; granulocyte macrophage colony stimulating factor; alkylating agent; cyclophosphamide; melphalan; antineoplastic activity; carmustine; chlormethine; ifosfamide; lomustine; gastrointestinal toxicity; vincristine sulfate; cardiotoxicity; general anesthesia; mitomycin c; nitrosourea; anthracycline; vinblastine sulfate; growth factor; granulocyte colony stimulating factor; chlorambucil; antimetabolite; bone marrow toxicity; drug indication; anesthetic agent; alkaloid; human; priority journal |
| Journal Title: | Seminars in Anesthesia |
| Volume: | 12 |
| Issue: | 2 |
| ISSN: | 0277-0326 |
| Publisher: | W. B. Saunders Company |
| Date Published: | 1993-06-01 |
| Start Page: | 68 |
| End Page: | 73 |
| Language: | English |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 March 2019 -- Source: Scopus |
MSK Authors
-
30Desiderio
Related MSK Work