What is ifosfamide toxicity?
Central nervous system (CNS) toxicity has been reported in approximately 10%–30% of patients receiving intravenous infusions of ifosfamide. Encephalopathy is a rare but serious CNS adverse reaction in these patients, and although usually transient and reversible, may cause persistent neurological dysfunction or death.
What is ifosfamide-induced encephalopathy?
Encephalopathy is a potentially fatal toxicity of ifosfamide. Clinical manifestations of encephalopathy range from fatigue and confusion to coma and death. Early identification of this toxicity and prompt cessation of ifosfamide are the essential elements in the management of ifosfamide encephalopathy.
Why is mesna given ifosfamide?
The chemotherapy drugs ifosfamide and cyclophosphamide can sometimes irritate the lining of the bladder. This can cause bleeding from the bladder and may show up as blood in your urine (pee). This is called haematuria. Mesna helps protect your bladder to prevent irritation and bleeding.
How does methylene blue work for ifosfamide toxicity?
Methylene blue is thought to help in cases of ifosfamide neurotoxicity due to its inhibition of monoamine oxidase (MAO). This enzyme is responsible for producing chloroacetaldehyde, the neurotoxic metabolite of ifosfamide.
What drug should always be given with ifosfamide?
Ifosfamide injection is indicated for use in combination with certain other approved antineoplastic agents for third-line chemotherapy of germ cell testicular cancer. It should be used in combination with mesna for prophylaxis of hemorrhagic cystitis.
Is etoposide nephrotoxic?
Etoposide has been shown to induce cytotoxicity in human kidney proximal tubule cells via the generation of reactive oxygen species and signaling by extracellular signal–regulated kinase (ERK) [30,31], with the incidence of nephrotoxicity in SCLC patients receiving platinum- etoposide doublet therapy having previously …
Can encephalopathy be reversed?
In reversible encephalopathy, such as from organ failure, metabolic conditions, or infections, symptoms usually go away when you fix the problem that’s causing them, and you may be able to regain your previous mental abilities.
Who should not take methylene blue?
You should not be treated with methylene blue if you are allergic to it, or if you have: a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Is bleomycin nephrotoxic?
As bleomycin is often administered with nephrotoxic drugs, it is suggested that renal function should be checked prior to each administration of bleomycin. It is proposed that appropriate dose modifications could significantly reduce the morbidity and mortality associated with bleomycin administration.