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Arzneimitteltherapiesicherheit in der klinischen Onkologie

Safe drug treatment in clinical oncology

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Zusammenfassung

In der Onkologie spielt beim Einsatz von Zytostatika, zielgerichtet wirksamen Arzneimitteln, immunmodulierend wirksamen Pharmaka (z. B. Checkpoint-Inhibitoren) und Supportivmaßnahmen die Gewährleistung einer bestmöglichen Arzneimitteltherapiesicherheit (AMTS) eine sehr wichtige Rolle. Beim Thema Arzneimittelwechselwirkungen wurden im Rahmen einer oralen Therapie substanzabhängig Interaktionen mit Magen-pH-verändernden Komedikationen oder fetthaltiger Nahrung beschrieben. Ferner können Zytochrom-P450-Inhibitoren und -induktoren die metabolische Clearance einer Reihe von Tumortherapeutika nachhaltig beeinflussen. In diesem Zusammenhang gehen auch von Produkten der komplementären und alternativen Medizin (z. B. Johanniskraut, grüner Tee) relevante Interaktionen aus. Neben Leber- und Nierenfunktionsstörungen können auch genetische Polymorphismen eine relevante Veränderung des Nebenwirkungsprofils nach sich ziehen, während geschlechtsspezifische Unterschiede in der metabolischen Clearance von Tumortherapeutika bisher von vergleichsweise untergeordneter Bedeutung sind.

Abstract

Optimization of safe drug treatment with the administration of cytostatic agents, targeted therapy drugs, immunomodulatory drugs (e.g. checkpoint inhibitors) and supportive measures, plays a pivotal role in clinical oncology. Regarding potential drug interactions with oral anticancer drugs, even changes in gastric pH or concomitant intake of fat-containing food can have a significant impact on substance-specific drug levels in plasma. In addition, coadministration of cytochrome P450 inducers and inhibitors including products for complementary and alternative medicine (CAM), e.g. green tea and St John’s wort, can significantly alter the metabolic clearance of anticancer drugs. Further aspects of safe drug treatment include appropriate dose modifications in cases of liver and kidney dysfunction as well as genetic polymorphisms, whereas gender-related effects appear to be of minor quantitative importance

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H.-P. Lipp gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Apotheke, Universitätsklinikum Tübingen, Röntgenweg 9, 72076, Tübingen, Deutschland

    H.-P. Lipp

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Lipp, HP. Arzneimitteltherapiesicherheit in der klinischen Onkologie. Forum 30, 517–522 (2015). https://doi.org/10.1007/s12312-015-1401-6

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