Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Aug 2012
Review Case Reports[Prolonged disturbance of consciousness and respiratory depression induced by controlled-release morphine, requiring long-term naloxone administration in a hemodialysis patient with cancer--a case report].
An 82-year-old female on hemodialysis was diagnosed with advanced breast cancer. She received 20 mg of controlled-release oral morphine per day for the relief of cancer pain. After a total dose of 30 mg was administered, she was hospitalized with disturbance of consciousness. ⋯ Morphine is therefore not recommended for use in renal failure and dialysis patients. The use of fentanyl or oxycodone is recommended as an alternative opioid. It is essential that medical staff are aware that these patients have an increased risk of developing serious morphine-related toxicity.
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Gan To Kagaku Ryoho · Aug 2012
[Efficacy of granisetron for preventing chemotherapy-induced nausea and vomiting in patients with acute myelogenous leukemia treated with a combination of anthracycline and cytarabine].
In Japan, the combination of anthracycline and cytarabine(Ara-C)is a standard therapy for acute myelogenous leukemia(AML). Chemotherapy-induced nausea and vomiting(CINV)are frequently reported as side effects related to the administration of these regimens. In our hospital, patients received prophylactic granisetron at a dose of 3 mg daily during chemotherapy. However, granisetron is known to induce constipation as a side effect. The present study evaluated the efficacy of a single dose of granisetron administered throughout the entire period of chemotherapy in AML patients receiving anthracycline and Ara-C combination therapy, and also examined the incidence of constipation during chemotherapy. ⋯ The CR rate in this study was 61. 8%, thus indicating that there is still room for improvement. The combination of dexamethasone and a neurokinin-1 receptor antagonist, or the changeover from granisetron to palonosetron could therefore increase the CR rate.