استراموستین
Estramustine
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)
موارد مصرف استراموستین:
استراموستین در درمان کارسینوم پروستات مصرف می شود.
مکانیسم اثر استراموستین:
استراموستین یک آلیکه کننده ضعیف بوده و ممکن است در بیماران مقاوم به استروژن موثر باشد. اثر دیگر آن مهار تقسیم میتوز است . اثرات دیگر آن مهار تقسیم میتوز است. اثرات استروژنیک آن مشابه استرادیول است و از طریق تضعیف محور هیپوتالاموس – هیپوفیز سبب کاهش غلظت سرمی تستوسترون می شود.
فارماکوکینتیک استراموستین:
جذب خوراکی آن 75 در صد است. متابولیسم آن سریع بوده و در اثر عبور اولیه کبدی به استرادیول ( به مقدار جزئی )، استرون و نیتروژن موستارد هیدرولیز می شود. نیمه عمر آن در فاز نهایی 20 ساعت است و دفع آن از طریق صفرا و مدفوع است.
منع مصرف استراموستین:
استراموستین در اختلالات ترومبوآمبولیک فعال ( انفارکتوس میوکارد، خونریزی مغزی ) و ترومبوفیلیت فعال، مگر در مواردی که خود تومور سبب عارضه ترومبوآمبولیک گردد، نباید مصرف شود.
عوارض جانبی استراموستین:
عارضه شایع استراموستین احتباس سدیم و مایعات ( تورم پاها ) است.
تداخلات دارویی استراموستین:
استراموسیون با داروهایی که سمیت کبدی ایجاد می کنند تداخل دارد.
هشدارهای استراموستین:
- در صورت وجود ترومبوفلبیت، سابقه درمان با استروژن، زیادی کلسیم خون و زخم معده باید با احتیاط مصرف شود.
- دارو یک ساعت قبل یا دو ساعت بعد از غذا مصرف شود.
- هنگام مصرف دارو از مصرف شیر و سایر فراورده های لبنی و دارو های حاوی کلسیم خود داری شود.
توصیه های دارویی استراموستین:
- مصرف یک دوره 90-30 روز برای ارزیابی اثر بخشی دارو کافی است. درمان با استراموستین ممکن است تا ظهور اثر مطلوب دارو ادامه یابد.
- گاهی اوقات برای رفع تهوع و استفراغ از فنوتیازین ها استفاده می شود ولی ممکن است شدت تهوع و استفراغ در بعضی از بیماران به حدی باشد که قطع درمان ضروری باشد.