• Title/Summary/Keyword: gastrointestinal toxicity

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The Effects of Strychni Ignatii Semen on Toxicity Levels and Gastrointestinal Tract (보두(寶豆)의 수치법(修治法)에 따른 독성(毒性) 및 소화기계(消化器系)에 미치는 영향(影響))

  • Kim, Jin-Sung;Yoon, Sang-Hyub;Ryu, Bong-Ha;Ryu, Ki-Won;Cho, Yu-Kyung
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.107-115
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    • 2002
  • Objective : These experiments were designed to investigate the effects of Strychni Ignatii Semen on the gastrointestinal system and declining of toxicity. About experiments of acute toxicity, I investigated the quantity of Strychni $(C_{21}H_{22}N_2O_2)\;and\;LD_{50}$. In order to study the effects on gastrointestinal tract, I investigated the changes of gastric juice, discharging level of pepsin, inhibiting effects of ulceration, and transporting of intestine. Methods : Sample I : No making Strychni Ignatii Semen Sample II : Depositing for three days in water and then dry it. Sample III : Depositing for one hour in sesame oil and bum it. The results were as follows : 1. The average values of Strychnine decreased in Sample III. 2. The levels of $LD_{50}$ increased in Sample Ⅲ by about 70%. 3. In Sample III, inhibiting effects of ulceration and discharging level of pepsin were great. 4. In the level of gastric juice decreased in Sample I.II.III. 5. The transporting ability of large intestine elevated in Sample I.II.III. According to the results, making Strychni Ignatii Semen, especially Sample 3, toxicity decreased and has good effects on the gastrointestinal system.

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Gastrointestinal Adverse Effects in Advanced Colorectal Carcinoma Patients Treated with Different Schedules of FOLFOX

  • Bano, Nusrat;Najam, Rahila;Qazi, Faaiza;Mateen, Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8089-8093
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    • 2014
  • Background: To assess the frequency and severity of gastrointestinal adverse effects in advanced colorectal carcinoma patients treated with four different schedules of FOLFOX. Materials and Methods: Patients (median age 61 years) who underwent surgery were included in the study. All had measureable disease at CT scan, ultrasonography or clinical examination. Toxicity was graded on a scale of 1-5 according to the general grade definition of CTC v2.0. The severity of adverse effects (Grade 3 and 4) assessed in each treatment arm was compared. Results: Differences between the incidence rates of 3 and 4 toxicity and all grades of toxicity for all parameters in GI toxicity were very highly significant (p<0.001). Severe gastrointestinal symptoms of toxicity were noted with FOLFOX7 (oxaliplatin $130mg/m^2$). Grade 3 diarrhea was reported in 25% patients and grade 4 diarrhea in 4% in the FOLFOX7 treatment arm. Grade 2 vomiting was very frequently reported in the FOLFOX4 treatment arm (oxaliplatin $85mg/m^2$). Grade 2 stomatitis was reported in 42% patients treated with mFOLFOX6 (oxaliplatin $100mg/m^2$). Differences in the incidence rate of nausea, diarrhea and stomatitis among all treatment arms of FOLFOX were significant (p<0.05). Conclusions: Severe diarrhea is associated with FOLFOX7 treatment. No grade 3 or 4 GI toxicity was reported in patients of the mFOLFOX6 arm.

Metabolic profiling study of ketoprofen-induced toxicity using 1H NMR spectroscopy coupled with multivariate analysis

  • Jung, Jee-Youn;Hwang, Geum-Sook
    • Journal of the Korean Magnetic Resonance Society
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    • v.15 no.1
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    • pp.54-68
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    • 2011
  • $^1H$ nuclear magnetic resonance (NMR) spectroscopy of biological samples has been proven to be an effective and nondestructive approach to probe drug toxicity within an organism. In this study, ketoprofen toxicity was investigated using $^1H$-NMR spectroscopy coupled with multivariate statistical analysis. Histopathologic test of ketoprofen-induced acute gastrointestinal damage in rats demonstrated a significant dose-dependent effect. Furthermore, principal component analysis (PCA) derived from $^1H$-NMR spectra of urinary samples showed clear separation between the vehicle-treated control and ketoprofen-treated groups. Moreover, PCA derived from endogenous metabolite concentrations through targeted profiling revealed a dose-dependent metabolic shift between the vehicle-treated control, low-dose ketoprofen-treated (10 mg/kg body weight), and high-dose ketoprofen-treated (50 mg/kg) groups coinciding with their gastric damage scores after ketoprofen administration. The resultant metabolic profiles demonstrated that the ketoprofen-induced gastric damage exhibited energy metabolism perturbations that increased urinary levels of citrate, cis-aconitate, succinate, and phosphocreatine. In addition, ketoprofen administration induced an enhancement of xenobiotic activity in fatty oxidation, which caused increase levels of N-isovalerylglycine, adipate, phenylacetylglycine, dimethylamine, betaine, hippurate, 3-indoxylsulfate, N,N-dimethylglycine, trimethyl-N-oxide, and glycine. These findings demonstrate that $^1H$-NMR-based urinary metabolic profiling can be used for noninvasive and rapid way to diagnose adverse drug effects and is suitable for explaining the possible biological pathways perturbed by nonsteroidal anti-inflammatory drug toxicity.

Safety and Management of Toxicity Related to Aflibercept in Combination with Fluorouracil, Leucovorin and Irinotecan in Malaysian Patients with Metastatic Colorectal Cancer

  • Yusof, Mastura Md;Abdullah, Nik MA;Sharial, MSN Mohd;Zaatar, Adel
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.973-978
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    • 2016
  • Background: Between October 2012 and February 2015, 25 patients with metastatic colorectal cancer (mCRC) (mean age, $57.0{\pm}12.1years$) were granted access to aflibercept via the Aflibercept Named Patient Program at four centers. Materials and Methods: Here we reported the initial experience of aflibercept / FOLFIRI in combination. We evaluated treatment-related adverse events (AEs), progression-free survival (PFS) and overall survival (OS). Results: The majority of the patients experienced gastrointestinal toxicity (grade 1-2), with diarrhea (52%), mucositis (52%), and nausea/vomiting (20%) being largely observed. Neutropenia (16%) and febrile neutropenia (8%) were common grade 3-4 hematological events. Aflibercept-related toxicity was managed as per practice guidelines. No grade 5 event was reported. Median PFS was 6.12 months (95% CI, 4.80-7.20) and OS was 12 months (95% CI, 9.80-14.18). The partial response (PR), stable disease (SD), and progressive disease (PD) rates were 25% (95% CI: 23.4-27.0), 37.5% (95% CI: 31.6-43.3), and 37.5% (95% CI: 22.5-52.5), respectively. Conclusions: Aflibercept/FOLFIRI can be administered safely in a second line setting to Malaysian patients with mCRC, as the AEs experienced were generally reversible and manageable. The safety and efficacy outcomes were consistent with those observed in Western populations.

Long-term tolerance and outcomes for dose escalation in early salvage post-prostatectomy radiation therapy

  • Safdieh, Joseph J.;Schwartz, David;Weiner, Joseph;Weiss, Jeffrey P.;Rineer, Justin;Madeb, Isaac;Rotman, Marvin;Schreiber, David
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.179-186
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    • 2014
  • Purpose: To study the long-term outcomes and tolerance in our patients who received dose escalated radiotherapy in the early salvage post-prostatectomy setting. Materials and Methods: The medical records of 54 consecutive patients who underwent radical prostatectomy subsequently followed by salvage radiation therapy (SRT) to the prostate bed between 2003-2010 were analyzed. Patients included were required to have a pre-radiation prostate specific antigen level (PSA) of 2 ng/mL or less. The median SRT dose was 70.2 Gy. Biochemical failure after salvage radiation was defined as a PSA level >0.2 ng/mL. Biochemical control and survival endpoints were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis were used to identify the potential impact of confounding factors on outcomes. Results: The median pre-SRT PSA was 0.45 ng/mL and the median follow-up time was 71 months. The 4- and 7-year actuarial biochemical control rates were 75.7% and 63.2%, respectively. The actuarial 4- and 7-year distant metastasis-free survival was 93.7% and 87.0%, respectively, and the actuarial 7-year prostate cancer specific survival was 94.9%. Grade 3 late genitourinary toxicity developed in 14 patients (25.9%), while grade 4 late genitourinary toxicity developed in 2 patients (3.7%). Grade 3 late gastrointestinal toxicity developed in 1 patient (1.9%), and grade 4 late gastrointestinal toxicity developed in 1 patient (1.9%). Conclusion: In this series with long-term follow-up, early SRT provided outcomes and toxicity profiles similar to those reported from the three major randomized trials studying adjuvant radiation therapy.

The Effect of Hwangryunhaedoktang on the Toxicity of Dried Mylabris phalerata Extract (황련해독탕(黃蓮解毒湯)이 반묘(斑猫)의 독성에 미치는 영향)

  • Kim, Seong-Mo;Choi, Hong-Sik;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.25 no.2
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    • pp.41-54
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    • 2010
  • Objectives : This study was carried out to investigate the anti-toxicity effect of Hwangryunhaedoktang on the dried Mylabris phalerata extract containing cantharidin in ICR mouse. Methods : Dried Mylabris phalerata extracts were orally administered at dosage level 2000, 1000, 500, 250 and 125mg/kg, respectively with and/or without administration of Hwangryunhaedoktang 200mg/kg. During 2 weeks, the changes of body weight, mortality, $LD_{50}$, macroscopic changes of gastrointestinal tract and liver, changes of serum gastrin and somatostatin levels were observed. Results : Decrease of body weight gains was observed in dried Mylabris phalerata extract-dosing groups, but it was significantly developed in Hwangryunhaedoktang extract-dosing groups after dosaging. Increase of mortality rates was observed in dried Mylabris phalerata extract-dosing groups, but it was significantly developed in Hwangryunhaedoktang extract-dosing groups after dosaging. The $LD_{50}$ of dried Mylabris phalerata extract in male mice significantly increased in a case of concomitant used of Hwangryunhaedoktang 268.86 vs 662.05mg/kg. Clinical signs were observed in dried Mylabris phalerata extract-dosing groups, but it was significantly developed in Hwangryunhaedoktang extract-dosing groups after dosaging after dosaging. Increase of number of hemorrhagic and/or erythematous spots in the gastrointestinal tracts, enlargement and congestion in the liver were observed in dried Mylabris phalerata extract-dosing groups, but it was significantly developed in Hwangryunhaedoktang extract-dosing groups after dosaging. Increase of serum gastrin level was observed in dried Mylarbis phalerata extract-dosing groups, these state of abnormal increase was significantly developed in Hwangryunhaedoktang extract-dosing groups after dosaging. Decrease of serum somatostatin level was observed in dried Mylabris phalerata extract-dosing groups, these state of abnormal decrease was significantly developed in Hwangryunhaedoktang extract-dosing groups after dosaging. Conclusions : We could conclude that the Hwangryunhaedoktang has anti-toxicity effect on the dried Mylabris phalerata extract containing cantharidin.

A Study of Gastrointestinal and Bone Marrow Adverse Events after Administration of Various Chemotherapeutic Agents in Canine Malignant Tumor Patients

  • Ji, Na-Ni;Song, Joong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.36 no.1
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    • pp.30-37
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    • 2019
  • The purpose of this present study was to objectively evaluate gastrointestinal and bone marrow AEs after administration of various chemotherapeutic agents in canines with malignant tumors, using the Veterinary Cooperative Oncology Group-Common Terminology Criteria for Adverse Events (VCOG-CTCAE), which includes descriptive terminology used for adverse events (AEs) reported in dogs and cats. The medical records of 42 dogs with malignant tumor that underwent chemotherapy were reviewed retrospectively. There were no significant differences in the prevalence of gastrointestinal AEs among the 5 chemotherapeutic agents (vincristine, cyclophosphamide, doxorubicin, lomistine, and carboplatin). The prevalence of bone marrow AEs was significantly higher after administration of lomustine than after administration of vincristine or doxorubicin. Grade 1 AEs of the gastrointestinal tract and bone marrow were most often observed after administration of various chemotherapeutic agents. Delayed and cumulative myelosuppression of lomustine in some dogs receiving regular blood examination were identified. The findings of this study will help predict possible gastrointestinal and bone marrow AEs due to the use of chemotherapeutic agents to treat canines with malignant tumors.

Safety of radiotherapy in patients with Behcet's disease: a case report and review of the literature

  • Ko, Dahui;Kim, Young Suk;Choi, Yunseon
    • Journal of Medicine and Life Science
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    • v.18 no.2
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    • pp.35-39
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    • 2021
  • Exaggerated acute and late toxicities following radiotherapy have been reported in patients with pre-existing connective tissue diseases, such as systemic lupus and scleroderma. Behcet's disease (BD) is a relapsing multisystem connective tissue disease characterized by vasculitis in the mucocutaneous, ocular, gastrointestinal, respiratory, neurologic, urogenital, articular, and cardiovascular systems. Data concerning the relationship between radiotherapy toxicity and BD are limited in the literature. Here, we report a case of lung cancer treated with radiotherapy (60 Gy) in a patient with BD. No severe radiation-induced toxicity was observed. Radiation-induced toxicity in patients with BD has also been discussed.

Characteristics of Toxicity Occurring in Outpatients at Korean Medical Clinics in Korean (한방의료기관이용환자의 부작용 및 독성발생의 특성 - 2011년 한방의료이용실태조사(보건복지부)를 중심으로 -)

  • Lee, Ki-Bum;Park, Yeongchul;Lee, Sundong
    • The Journal of Korean Medicine
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    • v.37 no.1
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    • pp.135-150
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    • 2016
  • Research Methods: This research analyzed the data on those aged 20 and older from the Report on Korean Medicine Usage Research, which was conducted in 2011. The definitions of toxicity were defined by the presence of toxicity listed in the survey. The questions used in analysis were sex, age, household income, health insurance, medical fees, satisfaction rates on treatments, as well as the types of diseases and the presence of toxicity from treatments. The analysis was done through frequency analysis using SAS 9.2 and Fisher's Exact Test. Results: Toxicity occurred in 2.1% patients out of the 3518 studied. The types of toxicity were skin problems, such as hives and pruritus (34.7%), gastrointestinal problems (20.8%), neurological diseases (4.2%), liver(1.4%), kidney toxicity(1.4%), and others (22.2%). There were no differences in toxicity by sex, age, household income and the types of health insurances. However, toxicity were positively correlated with the increase in standard of education (p=0.0124). In addition, as treatment costs increased (p<0.0001) and satisfaction rates decreased, toxicity increased (p<0.0001). Toxicity increased in patients with low back pain (p=0.0429), hwabyung (p=0.0392), lumbar sprain (p=0.0004), correction body type (p=0.0118), growth (p=0.0045), and from motor accidents (p=0.0448). In logistic regression analysis, Toxicity were positively correlated with medical fees, and cancer treatment and negatively correlated with satisfaction rate on treatments. Conclusion: The toxicity that occurred in outpatients who used Korean medical clinics mostly happened in skin, digestive organs, nerves, livers, and kidneys toxicity. The occurrences differed by the Educational lengths, expensive costs of treatments, low satisfaction rates of the treatments, and cancer.

GSTT1 null and MPO -463G>A Polymorphisms and Carboplatin Toxicity in an Indian Population

  • Bag, Arundhati;Pant, Nirdosh Kumar;Jeena, Lalit Mohan;Bag, Niladri;Jyala, Narayan Singh
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4739-4742
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    • 2013
  • Carboplatin, a second generation platinum drug, is widely used to treat different types of cancers. However, myelosuppression remains a major consideration in its use. Genetic polymorphisms of enzymes involved in drug disposition can influence therapeutic outcome. The homozygous null deletion of phase II metabolic gene GSTT1 that abolishes its xenobiotic- detoxifying ability may be associated with carboplatin toxicity. Further, since carboplatin generates oxidative stress, polymorphisms of oxidative stress genes that regulate the cellular level of free radicals may have important roles in generating drug- related adverse effects. We here investigated the null polymorphism of GSTT1, and the -463G>A promoter polymorphism of oxidative stress gene myeloperoxidase (MPO) for carboplatin toxicity in a population of northern India. Cancer patients who were treated with carboplatin, and developed toxicity was considered. The study group comprised of 10 patients who developed therapy- related adverse effects. Peripheral blood was taken from patients for DNA isolation. GSTT1 null genotype was determined by conducting duplex PCR and MPO-463 G>A was determined by PCR followed by RFLP. Hematologic toxicity was experienced by 5 patients, 2 of them had grade 3 and 4 toxicity and 3 others had grade 2 toxicity. They also had gastrointestinal (GI) toxicity. Remaining 5 individuals developed GI toxicity but no hematological toxicity. While GG homozygous of MPO was present in majority of patients having hematologic toxicity (in 4 out of 5 individuals), one A allele (AG genotype) was present in 4 patients who did not have any hematological toxicity. Thus variant A allele of MPO -463G>A may be related to lower hematological toxicity. These preliminary data, however, are required to be confirmed in larger studies along with other relevant polymorphisms.