A 58 year old woman has been diagnosed with locally advanced breast cancer and has been recommended for chemotherapy. She has five years history of myocardial infarction and congestive heart failure. Which antineoplastic drug should be best avoided?
High-Yield Explanation
Ans. is 'a' i.e. AnthracyclineRef: Katzung 8th/e 937-938, Harrison 16th/e p 475 (15th/e p 434)Anthracyclines are anticancer antibiotics and they include Doxorubicin (Adriamycin) and Daunorubicin.The major toxicity of anthracyclines is potentially irreversible cumulative dose related toxicity.They may causes arrhythmias and cardiomyopathy. Because of their cardiotoxicity these drugs should be avoided in the patient mentioned in the questionUses of DoxorubicinCa Breast Ca Endometrium Ca ovary Ca testicleCa thyroid Ca lungHodgkin's disease Non Hodgkin disease SarcomasUses of DaunorubicinIt has far narrower spectrum of activity than Doxorubicin It is mainly used in acute leukemia