化疗药物的防护分析.ppt

* * Any drugs that exhibit at least one of the characteristics listed. The oncogenic and teratogenic effects of therapeutic doses of many drugs are well established. Mutagenic effects of cytotoxic drugs, immunosuppressant drugs, antiviral agents, and biological response modifiers have been documented. Genotoxic: produce gene mutations and damage DNA. Most cancers are a result of multiple gene mutations (estimated 2-7) Reproductive risks: Fetal loss, spontaneous abortions, infertility, low birth weight, fetal abnormalities. Major organ toxicities: review any chemotherapy drug reference. Hepatotoxicity, etc. Carcinogenicity in animals or humans Teratogenicity in animals or treated patients Organ toxicity at low doses in animals or treated patients * Harrison (2001) reviewed fourteen studies that looked at adverse reproductive outcomes of healthcare workers exposed to hazardous drugs. Nine of the studies showed adverse outcomes related to exposure. The outcomes included fetal loss, congenital malformations, and infertility. Selevan, Lindbohm, Hornung, and Hemminki (1985) reported an odds ratio of 2.3 for fetal loss among nurses exposed during the first trimester of pregnancy. An odds ratio of 1.7 for spontaneous abortion was found in another study of nurses exposed to antineoplastic drugs (Stucker et al., 1990). Hemminki reported an odds ratio of 4.7 for fetal malformations in nurses who were exposed to hazardous drugs greater than once per week in the first trimester of pregnancy (Hemminki, Kyyronen, Lindbohm, 1985). In a matched case-control study of nurses and pharmacists, a small but significant relationship was found between women who handled antineoplastic agents and infertility. A similar odd ratio was found for men, but was not statistically significant because of the small number of men in the study (Valanis, Volmer, Labuhn Glass, 1997). * 俄勒冈 The Valanis study is a perfect example of this. She looked at over 7,000 pregnancies in approximately