Oxaliplatin neuro physiotherapy courses

Introduction oxaliplatin is an intravenously administered platinum containing alkylating agent neuro physiotherapy courses which is used for the treatment of advanced colorectal cancer. Oxaliplatin therapy is associated with a low rate of transient neuro physiotherapy courses serum aminotransferase elevations, but is commonly associated with sinusoidal and vascular injury to neuro physiotherapy courses the liver which can lead to sinusoidal obstruction syndrome and neuro physiotherapy courses to nodular regenerative hyperplasia with noncirrhotic portal hypertension.

Oxaliplatin (ox al i pla’ tin) is a cisplatin analog with a tetravalent platinum molecule which neuro physiotherapy courses is referred to as a platinum coordination complex. Oxaliplatin acts as an alkylating agent causing cross linking between neuro physiotherapy courses and within DNA strands leading to inhibition of DNA, RNA and protein synthesis and the triggering of programmed cell neuro physiotherapy courses death, mostly in rapidly dividing cells. Oxaliplatin was approved for use in cancer chemotherapy in the neuro physiotherapy courses united states in 2002. Its current indications are colorectal carcinoma and it is usually neuro physiotherapy courses administered in combination with other agents such as 5-fluorouracil (5-FU), irinotecan or capecitabine. Oxaliplatin is available in an aqueous solution for injection in neuro physiotherapy courses 50, 100 and 200 mg vials in generic forms and under neuro physiotherapy courses the brand name eloxatin. The platinum based antineoplastic agents have similar toxicities, including nausea and vomiting, diarrhea, bone marrow suppression, as well as neuro-, oto- and nephrotoxicity. They are also mutagenic, teratogenic and carcinogenic, and their use has been associated with an increased risk neuro physiotherapy courses of secondary leukemias.

Mild and transient elevations in serum aminotransferase levels are found neuro physiotherapy courses in an appreciable proportion of patients taking oxaliplatin, but their relationship to oxaliplatin is often unclear. Chemotherapy with oxaliplatin has been associated with histological changes in neuro physiotherapy courses the liver marked by sinusoidal dilatation, congestion and centrolobular necrosis. These changes are usually not clinically significant during the acute neuro physiotherapy courses phase, but they can progress to clinically apparent sinuosidal obstruction syndrome neuro physiotherapy courses or, with chronic therapy, to nodular regenerative hyperplasia with splenomegaly, thrombocytopenia and esophageal varices. Nodular regerative hyperplasia typically requires 6 to 18 months to neuro physiotherapy courses develop and arises after repeated cycles of chemotherapy with oxaliplatin. Serum enzyme and bilirubin elevations are minimal, the major laboratory finding being a progressive and persistent thrombocytopenia neuro physiotherapy courses reflecting the development of splenomegaly and portal hypertension. The first clinical evidence of nodular regenerative hyperplasia may be neuro physiotherapy courses ascites, esophageal variceal hemorrhage or hepatic encephalopathy. Attempts at hepatic resection, severe gastrointestinal bleeding and septicemia may trigger hepatic decompensation and neuro physiotherapy courses liver failure. Interestingly, nodular regenerative hyperplasia and portal hypertension tend to improve slowly neuro physiotherapy courses once chemotherapy is stopped, but the long term consequences of the changes are not neuro physiotherapy courses well defined.

The majority of instances of sinusoidal dilatation, vascular injury and congestion found histologically after oxaliplatin therapy occur neuro physiotherapy courses without significant serum enzyme elevations or clinically apparent liver injury. Rare instances of acute onset of sinusoidal obstruction syndrome with neuro physiotherapy courses ascites and hepatic failure have been described after oxaliplatin therapy, but usually when given in combination with other antineoplastic agents. Repeated cycles of oxaliplatin and chronic therapy have been linked neuro physiotherapy courses to nodular regenerative hyperplasia which can be associated with portal neuro physiotherapy courses hypertension and complications of ascites, variceal hemorrhage and hepatic encephalopathy. There is likely to be cross sensitivity to liver toxicities neuro physiotherapy courses of the various platinum coordination complexes and continued use or neuro physiotherapy courses rechallenge after clinically apparent liver injury from oxaliplatin should be neuro physiotherapy courses avoided.

Introduction oxaliplatin is an intravenously administered platinum containing alkylating agent neuro physiotherapy courses which is used for the treatment of advanced colorectal cancer. Oxaliplatin therapy is associated with a low rate of transient neuro physiotherapy courses serum aminotransferase elevations, but is commonly associated with sinusoidal and vascular injury to neuro physiotherapy courses the liver which can lead to sinusoidal obstruction syndrome and neuro physiotherapy courses to nodular regenerative hyperplasia with noncirrhotic portal hypertension.

Oxaliplatin (ox al i pla’ tin) is a cisplatin analog with a tetravalent platinum molecule which neuro physiotherapy courses is referred to as a platinum coordination complex. Oxaliplatin acts as an alkylating agent causing cross linking between neuro physiotherapy courses and within DNA strands leading to inhibition of DNA, RNA and protein synthesis and the triggering of programmed cell neuro physiotherapy courses death, mostly in rapidly dividing cells. Oxaliplatin was approved for use in cancer chemotherapy in the neuro physiotherapy courses united states in 2002. Its current indications are colorectal carcinoma and it is usually neuro physiotherapy courses administered in combination with other agents such as 5-fluorouracil (5-FU), irinotecan or capecitabine. Oxaliplatin is available in an aqueous solution for injection in neuro physiotherapy courses 50, 100 and 200 mg vials in generic forms and under neuro physiotherapy courses the brand name eloxatin. The platinum based antineoplastic agents have similar toxicities, including nausea and vomiting, diarrhea, bone marrow suppression, as well as neuro-, oto- and nephrotoxicity. They are also mutagenic, teratogenic and carcinogenic, and their use has been associated with an increased risk neuro physiotherapy courses of secondary leukemias.

Mild and transient elevations in serum aminotransferase levels are found neuro physiotherapy courses in an appreciable proportion of patients taking oxaliplatin, but their relationship to oxaliplatin is often unclear. Chemotherapy with oxaliplatin has been associated with histological changes in neuro physiotherapy courses the liver marked by sinusoidal dilatation, congestion and centrolobular necrosis. These changes are usually not clinically significant during the acute neuro physiotherapy courses phase, but they can progress to clinically apparent sinuosidal obstruction syndrome neuro physiotherapy courses or, with chronic therapy, to nodular regenerative hyperplasia with splenomegaly, thrombocytopenia and esophageal varices. Nodular regerative hyperplasia typically requires 6 to 18 months to neuro physiotherapy courses develop and arises after repeated cycles of chemotherapy with oxaliplatin. Serum enzyme and bilirubin elevations are minimal, the major laboratory finding being a progressive and persistent thrombocytopenia neuro physiotherapy courses reflecting the development of splenomegaly and portal hypertension. The first clinical evidence of nodular regenerative hyperplasia may be neuro physiotherapy courses ascites, esophageal variceal hemorrhage or hepatic encephalopathy. Attempts at hepatic resection, severe gastrointestinal bleeding and septicemia may trigger hepatic decompensation and neuro physiotherapy courses liver failure. Interestingly, nodular regenerative hyperplasia and portal hypertension tend to improve slowly neuro physiotherapy courses once chemotherapy is stopped, but the long term consequences of the changes are not neuro physiotherapy courses well defined.

The majority of instances of sinusoidal dilatation, vascular injury and congestion found histologically after oxaliplatin therapy occur neuro physiotherapy courses without significant serum enzyme elevations or clinically apparent liver injury. Rare instances of acute onset of sinusoidal obstruction syndrome with neuro physiotherapy courses ascites and hepatic failure have been described after oxaliplatin therapy, but usually when given in combination with other antineoplastic agents. Repeated cycles of oxaliplatin and chronic therapy have been linked neuro physiotherapy courses to nodular regenerative hyperplasia which can be associated with portal neuro physiotherapy courses hypertension and complications of ascites, variceal hemorrhage and hepatic encephalopathy. There is likely to be cross sensitivity to liver toxicities neuro physiotherapy courses of the various platinum coordination complexes and continued use or neuro physiotherapy courses rechallenge after clinically apparent liver injury from oxaliplatin should be neuro physiotherapy courses avoided.

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