Bleomycin Health Dictionary

In?ammation of the alveoli (see ALVEOLUS) of the lungs caused by an allergic reaction. When the in?ammation is caused by infection it is called PNEUMONIA, and when by a chemical or physical agent it is called pneumonitis. It may be associated with systemic sclerosis or RHEUMATOID ARTHRITIS.

Extrinsic allergic alveolitis is the condition induced by the lungs becoming allergic (see ALLERGY) to various factors or substances. It includes BAGASSOSIS, FARMER’S LUNG and BUDGERIGAR-FANCIER’S LUNG, and is characterised by the onset of shortness of breath, tightness of the chest, cough and fever. The onset may be sudden or gradual. Treatment consists of removal of the affected individual from the o?ending material to which he or she has become allergic. CORTICOSTEROIDS give temporary relief.

Fibrosing alveolitis In this disease there is di?use FIBROSIS of the walls of the alveoli of the lungs. This causes loss of lung volume with both forced expiratory volume and vital capacity affected, but the ratio between them remaining normal. The patient complains of cough and progressive DYSPNOEA. Typically the patient will be cyanosed (blue – see CYANOSIS), clubbed (see CLUBBING), and have crackles in the mid- and lower-lung ?elds. Blood gases will reveal HYPOXIA and, in early disease, hypocapnia (de?ciency of carbon dioxide in the blood due to hyperventilation). There is an association with RHEUMATOID ARTHRITIS (about one-eighth of cases), systemic lupus erythematosus (see under LUPUS), and systemic SCLEROSIS. Certain drugs – for example, bleomycin, busulphan and hexamethonium – may also cause this condition, as may high concentrations of oxygen, and inhalation of CADMIUM fumes.... alveolitis

Cytotoxic means destructive to living cells. Cytotoxic drugs possess anti-cancer properties but also have the potential to damage normal tissue. Their use is twofold: to eliminate a cancer and so prolong life; or to alleviate distressing symptoms, especially in patients whose prospects of a cure are poor. In many cases CHEMOTHERAPY with cytotoxic drugs is combined with surgery, RADIOTHERAPY or both. Chemotherapy may be used initially to reduce the size of the primary TUMOUR (a process called neoadjuvant therapy) before using radiotherapy or surgery to eliminate it. Cytotoxic drugs may also be used as adjuvant treatment to prevent or destroy secondary spread of the primary tumour that has either been removed by surgery or treated with radiotherapy. All chemotherapy causes side-effects: the ONCOLOGIST – a specialist in cancer treatment – has to strike a balance between hoped-for bene?ts and acceptable (for the patient) toxic effects, which include nausea and vomiting, BONE MARROW suppression, ALOPECIA (hair loss) and teratogenic effects (see TERATOGENESIS).

Cytotoxic drugs are used either singly or in combination, when an enhanced response is the aim. Chemotherapy of cancer is a complex process and should be supervised by an oncologist in co-operation with physicians, surgeons, radiotherapists and radiologists as appropriate.

The cytotoxic drugs include:

(1) The alkylating agents which act by damaging DNA, thus interfering with cell reproduction. Cyclophosphamide, ifosfamide, chlorambucil, kelphalan, busulphan, thiotepa and mustine are examples of alkylating agents.

(2) There are a number of cytotoxic antibiotics used in the treatment of cancer – doxorubicin, bleomycin, dactinomycin, mithramycin and amsacrine are examples. They are used primarily in the treatment of acute leukaemia and lymphomas.

(3) Antimetabolites – these drugs combine irreversibly with vital enzyme systems of the cell and hence prevent normal cell division. Methotrexate, cytarabine, ?uorouracil, mercaptopurine and azathioprine are examples.

(4) Another group of cytotoxic drugs are the vinca alkaloids such as vincristine, vinblastine and vindesima.

(5) Platinum compounds such as carboplatin, cisplatin and oxaliplatin are e?ective. All of them are given intravenously, but the latter two tend to have more unpleasant side-effects. Carboplatin and cisplatin are useful in the treatment of solid tumours. Carboplatin, a derivative of cisplatin, is given intravenously in ovarian cancer and in small-cell lung cancer. Better tolerated than cisplatin, the drug causes less nausea and vomiting, nephrotoxicity, neurotoxicity and ototoxicity. Where platinum-containing therapy has failed, intravenous treatment with paclitaxel may be tried. With only a limited success rate, it is relatively toxic and should be carefully supervised; responses, however, are sometimes prolonged.

Also of increasing importance in treating cancer are interferons. These are naturally occurring proteins with complex effects on immunity and cell function. Although toxic, with numerous adverse effects, they have shown some anti-tumour e?ect against certain lymphomas and solid tumours.... cytotoxic

n. an *interventional radiology technique in which a sclerosant is used to obliterate vascular malformations, recurrent cysts, or varicose veins. This is a substance that damages the lining of the structure into which it is injected, hardening the tissue and eventually obliterating the vessel or cavity. Sodium tetradecyl sulphate, alcohol, ethanolamine, bleomycin, and poldocanol are commonly used sclerosants.... sclerotherapy

Linn.

Synonym: Catharanthus roseus (Linn.) G.Don.

Family: Apocynaceae.

Habitat: Native of West Indies; commonly grown in Indian gardens.

English: Madagascar Periwinkle.

Ayurvedic: Sadaapushpaa, Sadam- pushpa, Nityakalyaani, Sadaaba- haar.

Siddha: Nithiya kalyani, Sudukadu mallikai.

Action: Cytotoxic.

Over one hundred monomeric and bisindole alkaloids have been isolated.

The indole alkaloid, vincamine, is a vasodilator; the bisindole alkaloids vinblastine and vincristine proved to be highly effective as cancer chemothera- peutic agents.

Vinblastine and vincristine are clinically used in a number of thrombo- cytopenic disorders, such as refractory idiopathic thrombocytopenic purpurea and haemolytic anaemia.

Vinblastine in combination with other chemotherapeutic agents (cis- platin and bleomycin) is used for the treatment of metastatic testicular cancer; also against bladder cancer, breast cancer, non-small cell lung cancer and Hodgkin's lymphoma in combination with other drugs.

Vincristine, in various combinations, is highly effective in acute leukemia in children and lymphocytic leukemia; and pediatric tumours. (The Treatise on Indian Medicinal Plants.)... vinca rosea

n. cancer of the lymph nodes, including *Hodgkin’s disease and non-Hodgkin’s lymphomas. There is a broad spectrum of malignancy, with prognosis ranging from a few months to many years. The patient usually shows evidence of multiple enlarged lymph nodes and may have constitutional symptoms such as weight loss, fever, and sweating (the so-called ‘B symptoms’). Disease may be widespread, but in some cases is confined to a single area, which may be extranodal (such as the tonsil). Treatment is with drugs such as chlorambucil or combinations of cyclophosphamide, vincristine, and prednisolone, sometimes with the addition of doxorubicin and/or bleomycin; response to these drugs is often dramatic. New *targeted agents are used depending on the expression of cell surface molecules, particularly *rituximab against CD20 in diffuse B-cell lymphoma. Localized disease may be treated with radiotherapy followed by drugs. Patients with non-Hodgkin’s lymphoma who do not respond to chemotherapy may be considered for a bone-marrow transplant.... lymphoma

n. a tumour composed of a number of tissues that are not usually found at that site and are derived from all three embryonic *germ layers. Teratomas most frequently occur in the testis and ovary (see dermoid cyst), possibly derived from remnants of embryonic cells that have the ability to differentiate into many types of tissue; in most malignant teratomas, cells from all three *germ layers are present. Malignant teratoma of the testis is found in young men: it is more common in patients with a history of undescended testis. Like *seminoma, it frequently occurs as a painless swelling of one testis (pain is not a good indication that the swelling is benign). Treatment is by *orchidectomy avoiding an incision into the scrotum. The tumour can spread to lymph nodes, lungs, and bone, treatment of which may involve the use of chemotherapy drugs, such as vinblastine, bleomycin, cisplatin, and etoposide, with a high cure rate even in metastatic disease.

Teratomas often produce *alpha-fetoprotein, beta human chorionic gonadotrophin, or both; the presence of these substances (*tumour markers) in the blood is a useful indication of the amount of tumour and the effect of treatment.... teratoma