File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Arsenic trioxide: Safety issues and their management

TitleArsenic trioxide: Safety issues and their management
Authors
Issue Date2008
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/aps/index.html
Citation
Acta Pharmacologica Sinica, 2008, v. 29 n. 3, p. 296-304 How to Cite?
AbstractArsenic trioxide (As2O2) has been used medicinally for thousands of years. Its therapeutic use in leukaemia was described a century ago. Recent rekindling in the interest of As2O3 is due to its high efficacy in acute promyelocytic leukaemia (APL). As2O 3 has also been tested clinically in other blood and solid cancers. Most studies have used intravenous As2O3, although an oral As2O3 is equally efficacious. Side effects of As 2O3 are usually minor, including skin reactions, gastrointestinal upset, and hepatitis. These respond to symptomatic treatment or temporary drug cessation, and do not compromise subsequent treatment with As2O3. During induction therapy in APL, a leucocytosis may occasionally occur, which can be associated with fluid accumulation and pulmonary infiltration. The condition is similar to the APL differentiation syndrome during treatment with all-trans retinoic acid, and responds to cytoreductive treatment and corticosteroids. Intravenous As2O 3 treatment leads to QT prolongation. In the presence of underlying cardiopulmonary diseases or electrolyte disturbances, particularly hypokalaemia and hypomagnesaemia, serious arrhythmias may develop, with torsades du pointes reported in 1% of cases. This may be related to a dose-dependent arsenic-mediated inhibition of potassium ion channels that compromises cardiac repolarization. Because of slow intestinal absorption, oral-As2O 3 gives a lower plasma arsenic concentration, which is associated with lesser QT prolongation and hence a more favorable cardiac safety profile. As2O3 does not appear to enter the central nervous system. However, if the blood brain barrier is breached, elemental arsenic may enter the cerebrospinal fluid. As2O3 is predominantly excreted in the kidneys, and dose adjustment is required when renal function is impaired. © 2008 CPS and SIMM.
Persistent Identifierhttp://hdl.handle.net/10722/77834
ISSN
2015 Impact Factor: 3.166
2015 SCImago Journal Rankings: 1.161
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAu, WYen_HK
dc.contributor.authorKwong, YLen_HK
dc.date.accessioned2010-09-06T07:36:15Z-
dc.date.available2010-09-06T07:36:15Z-
dc.date.issued2008en_HK
dc.identifier.citationActa Pharmacologica Sinica, 2008, v. 29 n. 3, p. 296-304en_HK
dc.identifier.issn1671-4083en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77834-
dc.description.abstractArsenic trioxide (As2O2) has been used medicinally for thousands of years. Its therapeutic use in leukaemia was described a century ago. Recent rekindling in the interest of As2O3 is due to its high efficacy in acute promyelocytic leukaemia (APL). As2O 3 has also been tested clinically in other blood and solid cancers. Most studies have used intravenous As2O3, although an oral As2O3 is equally efficacious. Side effects of As 2O3 are usually minor, including skin reactions, gastrointestinal upset, and hepatitis. These respond to symptomatic treatment or temporary drug cessation, and do not compromise subsequent treatment with As2O3. During induction therapy in APL, a leucocytosis may occasionally occur, which can be associated with fluid accumulation and pulmonary infiltration. The condition is similar to the APL differentiation syndrome during treatment with all-trans retinoic acid, and responds to cytoreductive treatment and corticosteroids. Intravenous As2O 3 treatment leads to QT prolongation. In the presence of underlying cardiopulmonary diseases or electrolyte disturbances, particularly hypokalaemia and hypomagnesaemia, serious arrhythmias may develop, with torsades du pointes reported in 1% of cases. This may be related to a dose-dependent arsenic-mediated inhibition of potassium ion channels that compromises cardiac repolarization. Because of slow intestinal absorption, oral-As2O 3 gives a lower plasma arsenic concentration, which is associated with lesser QT prolongation and hence a more favorable cardiac safety profile. As2O3 does not appear to enter the central nervous system. However, if the blood brain barrier is breached, elemental arsenic may enter the cerebrospinal fluid. As2O3 is predominantly excreted in the kidneys, and dose adjustment is required when renal function is impaired. © 2008 CPS and SIMM.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/aps/index.htmlen_HK
dc.relation.ispartofActa Pharmacologica Sinicaen_HK
dc.subject.meshAdministration, Oralen_HK
dc.subject.meshAntineoplastic Agents - administration & dosage - pharmacokinetics - pharmacology - therapeutic useen_HK
dc.subject.meshArsenicals - administration & dosage - pharmacokinetics - pharmacology - therapeutic useen_HK
dc.subject.meshClinical Trials as Topicen_HK
dc.subject.meshDose-Response Relationship, Drugen_HK
dc.subject.meshDrug Toxicityen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLethal Dose 50en_HK
dc.subject.meshOxides - administration & dosage - pharmacokinetics - pharmacology - therapeutic useen_HK
dc.subject.meshProdrugs - administration & dosage - therapeutic useen_HK
dc.titleArsenic trioxide: Safety issues and their managementen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1671-4083&volume=29&issue=3&spage=296&epage=304&date=2008&atitle=Arsenic+trioxide:+safety+issues+and+their+managementen_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1111/j.1745-7254.2008.00771.xen_HK
dc.identifier.pmid18298894-
dc.identifier.scopuseid_2-s2.0-39849088561en_HK
dc.identifier.hkuros145651en_HK
dc.identifier.volume29en_HK
dc.identifier.issue3en_HK
dc.identifier.spage296en_HK
dc.identifier.epage304en_HK
dc.identifier.isiWOS:000253605500002-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.citeulike2451783-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats