Expert opinion on pharmacotherapy
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Expert Opin Pharmacother · Jun 2007
ReviewAnthracycline-induced cardiotoxicity: course, pathophysiology, prevention and management.
Although effective anti-neoplastic agents, anthracyclines are limited by their well recognized and pervasive cardiotoxic effects. The incidence of late progressive cardiovascular disease in long-term survivors of cancer is established and may contribute to heart failure and death. To maximize the benefits of these drugs, a high-risk population has been identified and new strategies have been investigated to minimize toxic effects, including limiting the cumulative dose, controlling the rate of administration and using liposomal preparations and novel anthracycline analogues. ⋯ The treatment of adult cancer survivors who have had anthracycline-related cardiotoxicity has not been systematically studied. Empirically, anthracycline-associated cardiac dysfunction is treated very similarly to other forms of heart failure. These treatments include avoiding additional cardiotoxic regimens, controlling hypertension, lifestyle changes, medications and heart transplantation.
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Adrenal insufficiency is a life-threatening disorder. In the treatment of adrenal insufficiency, it is essential to administer the optimal medication at the optimal dose. Glucocorticoids are the main therapeutic approach in all forms of adrenal insufficiency. ⋯ Additional glucocorticoid supplementation should be administered in stressful states. During critical illness, inadequate or no temporary increase in the dose of the replacement glucocorticoid can lead to acute adrenal failure. When acute adrenal failure occurs, it becomes necessary to administer intravenous hydrocortisone.
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Expert Opin Pharmacother · Jun 2007
EditorialAntibodies against RAGE in sepsis and inflammation: implications for therapy.
Many agents have been tried in the hope of providing clinical benefit in sepsis and inflammatory processes. The receptor for advanced glycation end products (RAGE) is involved in inflammation and sepsis, and anti-RAGE antibodies have been studied in models of diabetic complications, chronic inflammation and sepsis. ⋯ The pathophysiology of sepsis and inflammation is incompletely understood. The complicated nature of these processes may make new techniques, such as computer simulation and genomics, vital in understanding how to target therapies.