RT Book, Section
A1 Higgins, John P.
A1 Ali, Asif
A1 Filsoof, David M.
SR Print(0)
ID 1173757801
T1 Medications
T2 Cardiology Clinical Questions, 2e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9781259643330
LK accesscardiology.mhmedical.com/content.aspx?aid=1173757801
RD 2024/04/19
AB Table  Graphic  Jump  Location|Download  (.pdf)|PrintIn  patients  receiving  doxorubicin  chemotherapy,  monitoring  of  cardiac  function  is  based  upon  baseline  left  ventricular  function  and  total  chemotherapy  dosage  received.HPI:  Patient  with  acute  lymphoblastic  leukemia,  Hodgkin  lymphoma,  breast,  bladder,  stomach,  or  recurrent  small  cell  lung  cancer  receiving  chemotherapy  with  doxorubicin.PMH:  Congestive  heart  failure,  hypertension,  coronary  artery  disease.SH:  Alcohol.Dyspnea,  rales,  tachycardia,  jugular–venous  distention,  hepatomegaly,  lower  extremity  edema.Acute  toxicity:  Arrhythmias,  electrocardiographic  abnormalities,  a  pericarditis–myocarditis  syndrome,  and  ventricular  dysfunction  during  or  immediately  after  administration  of  anthracyclines.Early  toxicity:  Observed  as  dose-related  occurrence  of  CHF  in  patients  that  received  500–550  mg/m2  of  doxorubicin.Late  toxicity:  The  onset  of  symptomatic  CHF  can  occur  as  late  as  10–12  years  after  the  last  anthracycline  dose.  Late  CHF  is  due  to  a  nonischemic  dilated  cardiomyopathy.ECHO:  LVEF  100  mg/m2DOXorubicin.EF-EVAL  =  Refer  patient  for  echocardiogram,  radionuclide  angiography,  or  other  imaging  test  for  left  ventricular  Ejection  Fraction  EVALuation.LVEF-OK  =  LVEF  normal  or  if  follow-up  study  shows  decline  in  less  than  10%  from  baseline  study  and  absolute  EF  ≥30%.LVEF65  years  are  predisposed  to  cardiotoxicity  at  lower  cumulative  doses  of  doxorubicin.1.  Singal  PK.  Doxorubicin-induced  cardiomyopathy.  N  Engl  J  Med.  1998;339:900–905.2.  Schwartz  RG,  McKenzie  WB,  Alexander  J,  et  al.  Congestive  heart  failure  and  left  ventricular  dysfunction  complicating  doxorubicin  therapy.  Am  J  Med.1987;82(6):1109–1118.3.  Lee  BH,  Goodenday  LS,  Muswick  GJ,  et  al.  Alterations  in  left  ventricular  diastolic  function  with  doxorubicin  therapy.  J  Am  Coll  Cardiol.  1987;9:184–188.