Health news blog

A. L-AsparaginaseL-Asparaginase can result in fatty metamorphosis.Liver enzyme abnormalities may be reversible while continuing therapy.Stop therapy for grade 3 or greater liver toxicity; resume at grade 2.B. 6-Mercaptopurine and 6-Thioguanine6-Mercaptopurine (6-MP) or 6-thioguanine (6-TG) can resultin cholestasis.Stop if toxicity is grade 3 or greater.Rule out viral hepatitis, Gilbert disease, or tumor effect.If drugs are the cause of liver toxicity, restart at 50% dose when the toxicity decreases to grade 2.If grade 3 or greater toxicity persists, it may be necessary to perform a liver biopsy to determine the histologic extent of the disease and whether 6-MP/6-TG can be restarted.C. MethotrexateMethotrexate can result in fibrosis and cirrhosis.1. There does not appear to be a need to modify the dosage in patients with preexisting liver damage, other than to consider whether the patient can tolerate the potential additional hepatic dysfunction induced by methotrexate.Stop if toxicity is grade 3 or greater.Rule out viral hepatitis, Gilbert disease, or drug effect.If the drug is the cause of liver toxicity, restart at 50% dose when toxicity decreases to grade 2.If grade 3 or greater toxicity persists, it may be necessary to perform a liver biopsy to determine the histologic extent of the disease and whether methotrexate can be restarted.D. Carmustine and lomustineBCNU and CCNU can result in increased liver enzymes.Stop if toxicity is grade 3 or greater.Rule out viral hepatitis or tumor effect.If drugs are the cause, restart at 50% dose when the toxicity decreases to grade 1.If grade 3 or greater toxicity persists, it may be necessary to perform a liver biopsy to determine the histologic extent of the disease and whether BCNU/CCNU can be restarted.*37\168\2*

The most common side effect of tamoxifen is hot flashes. Directly related to the antiestrogenic and partial estrogenic effects of tamoxifen, these have occurred in as many as 10 to 20 percent of patients studied. Menstrual irregularities, vaginal bleeding, and vaginal dryness or itching have all been reported. Mild nausea with or without vomiting occurs in about 10 percent of patients. Other gastrointestinal problems including loss of appetite, constipation, and diarrhea have also been reported. Edema (water retention) and weight gain take place in 2 to 16 percent of patients.
DOES TAMOXIFEN CAUSE ANY OF THE PSYCHOLOGICAL SYMPTOMS ASSOCIATED WITH MENOPAUSE?
Tamoxifen does produce a number of other symptoms similar to those noted during menopause. It has been associated with depression or irritability in some patients, whose signs may go largely ignored by physicians. Dizziness or light-headedness, nervousness, headache, fatigue, and lethargy have all been noted. Additional studies are needed to define the incidence of psychological side effects.
*31\320\2*