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Effect of ethanol in Paclitaxel injections on the ethanol concentration in exhaled breath.
Aomori, T, Makino, H, Sekizuka, M, Hashita, T, Araki, T, Iizuka, K, Nakamura, T, Yamamoto, K
Drugs in R&D. 2012;(3):165-70
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Abstract
BACKGROUND Ethanol is included in certain injectable preparations of anticancer drugs to increase their solubility. Since the volume of ethanol in these preparations is approximately half of the total injection volume, the potential inhibitory effects of ethanol on the central nervous system cannot be disregarded, especially considering that patients may drive immediately after administration of the medication. Therefore, the concentration of ethanol was examined in exhaled breath after administration of paclitaxel, an anticancer medication containing ethanol. METHODS The ethanol concentration in exhaled breath immediately after an intravenous infusion of paclitaxel was measured in 30 patients, using a balloon-type gas detector tube. Correlations between the concentration of ethanol in exhaled breath and the total amount of ethanol administered or the intravenous infusion speed were calculated. RESULTS The mean ethanol concentration in exhaled breath was 0.028 ± 0.015 mg/L. The correlation between the ethanol concentration in exhaled breath and the total dose of ethanol was weak (R2 = 0.25; p = 0.055), while the intravenous infusion speed showed a stronger positive correlation with the concentration of ethanol in the breath (R2 = 0.49; p = 0.11). The maximum concentration of ethanol measured in exhaled breath (0.06 mg/L) was equivalent to 40% of the threshold for drunk driving, as specified in the Road Traffic Act in Japan. CONCLUSION In this study, no patient had a breath ethanol concentration exceeding the legal threshold for drunk driving. However, it is still advisable for patients to avoid driving after receiving paclitaxel injections. When driving cannot be avoided, patients should wait for a sufficient time after receiving the injection before driving.
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[Evidenced-based medicine and future direction of Taxol].
Hatae, M, Nakamura, T, Ohnishi, Y
Gan to kagaku ryoho. Cancer & chemotherapy. 2000;(8):1279-87
Abstract
Taxol was introduced for the clinical treatment of several solid tumor malignancies in the 1990s. It has been established that primary chemotherapy based on Taxol is the standard for non-small cell lung cancer and epithelial ovarian cancer. After initial chemotherapy containing doxorubicin, sequential administration of Taxol for advanced or metastatic breast cancer is recommended by the Food and Drug Administration in the United States. Taxol-based chemotherapy and/or concurrent chemoradiation for head and neck cancer, esophageal carcinoma, urothelial and prostate cancer are under investigation, but these trials have not produced evidence showing that they are superior to the present standard treatment for these malignancies. Although phase I/II trials of Taxol combined with new agents such as vinorelbine, topotecan, CPT-11 and others may demonstrate efficacy to a certain extent for some solid tumor malignancies, a phase III study will be required in the next stage. Taxol combined with other agents focusing on molecular targets will be an important approach in next decade. Inhibition of signal transduction by a noncytotoxic agent such as herceptine has the potential to enhance the cytotoxic effect of Taxo.