Противоопухолевые средства


Противоопухолевые средства
I Противоо́пухолевые сре́дства
лекарственные средства, используемые для лечения опухолей.
Применяемые в онкологии лекарственные средства могут оказывать цитотоксический эффект или угнетать пролиферативную активность опухолевых клеток (цитостатический эффект). Большое число противоопухолевых средств свидетельствует о том, что до настоящего времени не создано универсального противоопухолевого препарата. Иными словами, противоопухолевые средства не обладают высокой избирательностью действия. Наряду с опухолевыми они повреждают клетки нормальных пролиферирующих тканей (лимфоидной, костного мозга, желудочно-кишечного тракта, половых желез и др.)
Противоопухолевые средства по происхождению условно делят на две группы: синтетические противоопухолевые средства и противоопухолевые средства природного происхождения. Клинико-фармакологическая характеристика основных противоопухолевых средств приведена в таблице.
Таблица
Клинико-фармакологическая характеристика основных противоопухолевых средств
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| Название средства             | Показания*                 | Способы                  | Побочные эффекты и  | Формы выпуска     |
| (русское и латинское) и       |                                   | применения и          | осложнения                 |                              |
| основные синонимы -          |                                   | терапевтические     |                                    |                              |
|                                            |                                   | дозы                       |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1                                         | 2                                 | 3                             | 4                                 | 5                           |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Синтетические противоопухолевые средства Алкилирующие агенты                                                                            |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1. Хлорэтиламины           |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Дегранол, Degranol;             | Хронические               | Внутривенно,          | Лейкопения,                | Ампулы по 0,05 г   |
| синоним: R-2, ВСМ,             | лимфолейкоз и           | внутрь или в            | тромбоцитопения,       |                              |
| Mannomustin, Mannitol         | миелолейкоз,              | полости по 0,05—    | реже тошнота, рвота,  |                              |
| nitrogen mustard                  | лимфогранулематоз,   | 0,15 г через день,    | потеря аппетита          |                              |
|                                            | лимфосаркома и         | суммарная доза      |                                    |                              |
|                                            | ретикулосаркома,       | 0,8—2 г                   |                                    |                              |
|                                            | множественная           |                                |                                    |                              |
|                                            | миелома, эритремия   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Допан, Dopanum; синоним   | Лимфогранулематоз   | Внутрь по 0,006—   | Тошнота, рвота,          | Таблетки по          |
| Chlorethylaminouracil            | (кроме острых форм), | 0,012 г 1 раз в 5       | потеря аппетита,         | 0,002 г                  |
|                                            | сублейкемические      | дней; суммарная     | лейкопения,                |                              |
|                                            | формы хронического  | доза 0,05—0,08 г     | тромбоцитопения        |                              |
|                                            | миелолейкоза (со        |                                |                                    |                              |
|                                            | спленомегалией),        |                                |                                    |                              |
|                                            | хронический               |                                |                                    |                              |
|                                            | лимфолейкоз              |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| * Общими противопоказаниями для противоопухолевых средств (кроме гормонов) являются лейкопения (меньше       |
| 3000 лейкоцитов в 1 мкл крови), тромбоцитоления (меньше 1․1011/л), резкое истощение, терминальная стадия             |
| болезни, тяжелые сопутствующие заболевания сердечно-сосудистой системы, легких, печени, почек, нервной           |
| системы, беременность                                                                                                                                               |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Ифосфамид, lfosfamide;      | Рак яичников,             | Внутривенно по       | Тошнота, рвота,          | Флаконы по 0,2;    |
| синоним Holoxan                 | молочной железы,       | 50—60 мг/кг            | угнетение гемопоэза,  | 0,5; 1 и 2 г             |
|                                            | злокачественные        | ежедневно 3—5       | алопеция,                    |                              |
|                                            | опухоли яичка,            | дней или 20—30      | неврологические         |                              |
|                                            | мелкоклеточный рак    | мг/кг ежедневно в   | изменения,                  |                              |
|                                            | легкого.                      | течение 10 дней      | нефротоксичность,     |                              |
|                                            |                                   |                                | геморрагический         |                              |
|                                            |                                   |                                | цистит, гепатит           |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Лофенал, Lophenalum         | Рак яичников,             | Внутрь по 0,6—1,2   | Такие же, как при       | Таблетки по 0,3 г   |
|                                            | дополнительное          г ежедневно,           | приеме допана, но      |                              |
|                                            | средство при              | суммарная доза      | нерезко выраженные   |                              |
|                                            | хроническом               | 30—50 г                  |                                    |                              |
|                                            | лимфолейкозе,           |                                |                                    |                              |
|                                            | лимфогранулематозе, |                                |                                    |                              |
|                                            | лимфосаркоме и         |                                |                                    |                              |
|                                            | ретикулосаркоме        |                                |                                    |                              |
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| Новэмбихин,                       | Такие же, как для       | Внутривенно по 6— | Такие же, как при        | Порошок в             |
| Novembichinum; синоним:    | дегранола                   | 9 мг в растворе       | приеме допана, редко | ампулах по 10 мг   |
| Novembichin, Noveembichin  |                                   | Рингера 3 раза в     | флебиты, анемия        |                              |
|                                            |                                   | неделю; суммарная |                                    |                              |
|                                            |                                   | доза 80—150 мг      |                                    |                              |
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| Сарколизин, Sarcolysinum;  | Семинома яичка,         | Внутривенно, в        | Такие же, как при        | Таблетки по 0,01 г |
| синоним:                             | лимфосаркома,           | полость и внутрь     | приеме допана, и        | ; порошок во         |
| Racemelphalanum,               | ретикулосаркома,       | (после еды) по         | анемия                        | флаконах по 0,02  |
| Sarcoclorin и др.                  | злокачественная         | 0,03—0,04 г 1 раз в  |                                   г                           |
|                                            | ангиоэндотелиома,     | неделю; суммарная |                                    |                              |
|                                            | опухоль Юинга,          | доза чаще 0,2—      |                                    |                              |
|                                            | миеломная болезнь,    | 0,25 г. Разовая        |                                    |                              |
|                                            | рак молочной железы, | доза детям 0,5—     |                                    |                              |
|                                            | рак яичников,              | 0,7 мг/кг                  |                                    |                              |
|                                            | лимфоэпителиальная  |                                |                                    |                              |
|                                            | опухоль                      |                                |                                    |                              |
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| Мелфалан, Melphalan,         | Такие же, как при        | Внутрь по 10 мг/м  | Анорексия, тошнота,   | Таблетки по 2 мг;  |
| синоним: Alkeran,                | приеме сарколизина    | ежедневно в            | рвота, лейкопения,      | флаконы по 100    |
| Phehylalanin-mustard и др.   |                                   | течение 4 дней или  | тромбоцитопения,       мг                         |
|                                            |                                   | 0,1—0,15 мг/кг         | анемия                        |                              |
|                                            |                                   | ежедневно в            |                                    |                              |
|                                            |                                   | течение 2—3 нед.    |                                    |                              |
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| Хлорбутин, Chlorbutmum;    | Хронический               | Внутрь по 0,005—   | Такие же, как при        | Таблетки по          |
| синоним: Chlorambuciluin,    | лимфолейкоз              | 0,02 г (0,2—0,3        | приеме допана            | 0,002 г или по        |
| Leukeran                             | (преимущественно      мг/кг) в течение 3— |                                    | 0,005 г                  |
|                                            | лейкемическая            | 6 нед.; суммарная   |                                    |                              |
|                                            | форма),                      | доза 0,3—0,6 г.       |                                    |                              |
|                                            | лимфогранулематоз,   | Поддерживающая   |                                    |                              |
|                                            | рак яичников,              | доза 0,002 г 2—3     |                                    |                              |
|                                            | лимфомы                    | раза в неделю         |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Циклофосфан,                    | Рак яичников,             | Внутрь,                   | Такие же, как при        | Таблетки по 0,05 г |
| Cyclophosphanum; синоним | молочной железы,       | внутривенно,           | приеме допана; кроме | ; порошок по 0,2 г  |
| Циклофосфамид, Cytoxan,  | легкого,                      | внутримышечно, в   | того (редко), гепатит,  | во флаконах          |
| Endoxan, Mitoxan                | лимфосаркома,           | полость по 0,2 г       | стоматит, анемия,       |                              |
|                                            | ретикулосаркома,       | ежедневно. по 0,4 г | геморрагический         |                              |
|                                            | миеломная болезнь,    | через день или по   | цистит, алопеция,        |                              |
|                                            | хронический               | 1 г через 5 дней,     | гиперпигментация       |                              |
|                                            | лимфолейкоз, острый  | суммарная доза      | кожи                           |                              |
|                                            | лимфолейкоз,             | 8—14 г.                   |                                    |                              |
|                                            | саркома Юинга,          | Поддерживающие   |                                    |                              |
|                                            | нейробластома,          | дозы: 0,1—0,2 г       |                                    |                              |
|                                            | рабдомиосаркома,      | внутривенно или      |                                    |                              |
|                                            | лимфогранулематоз,   | внутримышечно 2    |                                    |                              |
|                                            | семинома яичка,         | раза в неделю         |                                    |                              |
|                                            | нефробластома          |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Эмбихин, Embichinum;        | Лимфогранулематоз,  | Внутривенно по 5— | Такие же, как при        | Ампулы по 10 мг   |
| синоним Azotoperite,           | хронические лейкозы, | 6 мг 3 раза в           | приеме допана, редко |                              |
| Chlorethamine, Dimitan, HN2 | ретикулосаркома и      | неделю; суммарная | флебиты,                    |                              |
| , Nitrogen, Mechlorethamine  | лимфосаркома.           | доза 40—120 мг. В  | ототоксический           |                              |
|                                            | мелкоклеточный рак    | полость по 12—16   | эффект                       |                              |
|                                            | легкого                       мг                           |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 2. Этиленамины                |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Бензотэф, Benzotephum:     | Метастазы и               | Внутривенно по 24   | Такие же, как при       | Ампулы или          |
| синоним А-16                      | поражение плевры      мг 2—3 раза в         | приеме допана            | флаконы по 24 мг  |
|                                            | при раке легкого и       | неделю; суммарная |                                    |                              |
|                                            | раке молочной            | доза 360—480 мг.    |                                    |                              |
|                                            | железы, метастазы и  | В полость по 24 мг  |                                    |                              |
|                                            | обсеменение               | на инъекцию            |                                    |                              |
|                                            | брюшины при раке      |                                |                                    |                              |
|                                            | яичников,                    |                                |                                    |                              |
|                                            | мезотелиома               |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Дипин, Dipinum                    | Хронический               | Внутривенно или     | Тошнота, рвота,          | Флаконы по 20 мг  |
|                                            | лимфолейкоз              | внутримышечно по  | лимфоцитопения,        |                              |
|                                            |                                   | 30—40 мг 1 раз в     | тромбоцитопения        |                              |
|                                            |                                   | 3—4 дня или 5—15  |                                    |                              |
|                                            |                                   мг через день,         |                                    |                              |
|                                            |                                   | суммарная доза      |                                    |                              |
|                                            |                                   | 200 мг                     |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Имифос, Imiphosum,           | Эритремия (истинная  | Внутривенно или     | Лейкопения,                | Флаконы по 0,05 г  |
| синоним маркофан             | полицитемия) II           | внутримышечно по  | тромбоцитопения        |                              |
|                                            | стадии, особенно при  | 0,05 г через день     |                                    |                              |
|                                            | резистентности к 32Р   | или 3—4 дня;          |                                    |                              |
|                                            |                                   | суммарная доза      |                                    |                              |
|                                            |                                   | 0,5—0,65 г               |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Тиофосфамид,                   | Опухоли яичника, рак  | Внутримышечно,     | Такие же, как при        | Флаконы по 0,01 г  |
| Thiophosphamidum;             | молочной железы,       | внутривенно,           | приеме допана, редко |                              |
| синоним: Тио-ТЭФ, ТЕРА,   | мезотелиома               | внутриартериально, | васкулиты                   |                              |
| Thiophosyl, Thio-TEPA         | брюшины с асцитом,   | в полость по 0,01— |                                    |                              |
|                                            | хронический               | 0,02 г 3 раза в         |                                    |                              |
|                                            | лимфолейкоз и           | неделю или 40—60  |                                    |                              |
|                                            | миелолейкоз,              мг 1 раз в неделю;  |                                    |                              |
|                                            | лимфогранулематоз,   | суммарная доза в   |                                    |                              |
|                                            | ретикулосаркома,       | среднем 0,1—0,25 г |                                    |                              |
|                                            | лимфосаркома, рак     |                                |                                    |                              |
|                                            | мочевого пузыря         |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Фотрин, Photrmum;              | Хронический               | Внутривенно по 5— | Угнетение                   | Ампулы по 20 мг   |
| синоним Fotretamine            | лимфолейкоз,             | 15 мг через день,    | кроветворения,           |                              |
|                                            | эритремия,                 | суммарная доза до  | анорексия                   |                              |
|                                            | грибовидный микоз,    | 360 мг                     |                                    |                              |
|                                            | ретикулосаркома        |                                |                                    |                              |
|                                            | кожи, саркома             |                                |                                    |                              |
|                                            | Капоши, рак яичников |                                |                                    |                              |
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| Фторбензотэф,                    | Рак почки,                  | Внутривенно по       | Такие же, как при        | Флаконы по 0,04 г  |
| Phthorbenzotephum              | плоскоклеточный рак  | 0,04 г через день;    | приеме допана; редко |                              |
|                                            | гортани, рак яичников | суммарная доза      | отек голосовых           |                              |
|                                            |                                   | 0,4—0,6                   | связок, конъюктивит   |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 3. Метилсульфонаты       |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Миелосан, Myelosanum,      | Обострение                | Внутрь по 4—6 мг   | В случаях                   | Таблетки по 2 мг   |
| синоним: Busulfanum,          | хронического              | ежедневно;             | повышенной                |                              |
| Mielucin, Myleran, Sulfabutin | миелолейкоза             | суммарная доза      | чувствительности       |                              |
|                                            | (лейкемическая           | 80—500 мг;             | возможно развитие     |                              |
|                                            | форма)                       | суточная доза при   | лейкопении и               |                              |
|                                            |                                   | поддерживающей    | тромбоцитопении;       |                              |
|                                            |                                   | терапии 1—2 мг       | кроме того, могут        |                              |
|                                            |                                   | ежедневно или        | быть небольшие          |                              |
|                                            |                                   | через день в           | головокружения,         |                              |
|                                            |                                   | течение нескольких | неприятные                 |                              |
|                                            |                                   | месяцев                  | ощущения в области   |                              |
|                                            |                                   |                                | сердца,                       |                              |
|                                            |                                   |                                | гиперпигментация       |                              |
|                                            |                                   |                                | кожи, аменорея,          |                              |
|                                            |                                   |                                | снижение потенции у   |                              |
|                                            |                                   |                                | мужчин; при                |                              |
|                                            |                                   |                                | длительном                 |                              |
|                                            |                                   |                                | применении                 |                              |
|                                            |                                   |                                | пневмосклероз, редко |                              |
|                                            |                                   |                                | аддисоноподобный     |                              |
|                                            |                                   |                                | синдром                      |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 4. Производные                |                                   |                                |                                    |                              |
нитрозомочевины            |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| BCNU. Carmustine:              | Опухоли головного      | Внутривенно по       | Тошнота, рвота,          | Порошок по 100     |
| синоним Bischlorethye         | мозга,                         | 100 мг/м 1 раз в 6  | гепатит, лейкопения,   мг во флаконах     |
| nitrosourea, Carmubris,         | лимфогранулематоз,   | нед.                        | тромбоцитопения,       |                              |
| Nitrumon                              | лимфомы, миеломная |                                | нефрит, редко             |                              |
|                                            | болезнь, меланома, в  |                                | пневмофиброз,           |                              |
|                                            | составе                      |                                | невриты                      |                              |
|                                            | лекарственных            |                                |                                    |                              |
|                                            | комбинаций при раке   |                                |                                    |                              |
|                                            | желудка, толстой и     |                                |                                    |                              |
|                                            | прямой кишки             |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| CCNU, Lomustine; синоним, | Лимфогранулематоз,  | Внутрь по 100—      | Тошнота, рвота,          | Желатиновые        |
| CINU, Belustine, CeCeNU     | лимфомы,                   | 130 мг/м 1 раз в 6  | лейкопения,                | капсулы по 10, 40  |
|                                            | глиобластомы, в         | нед.                        | тромбоцитопения,       | и 100 мг                |
|                                            | составе                      |                                | стоматит, алопеция     |                              |
|                                            | лекарственных            |                                |                                    |                              |
|                                            | комбинаций при          |                                |                                    |                              |
|                                            | меланоме, раке           |                                |                                    |                              |
|                                            | желудка, толстой        |                                |                                    |                              |
|                                            | кишки                         |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Нитрозометилмочевина,      | Рак легкого,                | Внутривенно по 6— | Тошнота, рвота,          | Флаконы по 300 и  |
| Nitrosomethylurea синоним   | лимфогранулематоз,   | 8 через 2—3 дня,    | диарея, анорексия,     | 500 мг                   |
| NMM                                   | лимфосаркома,           | суммарная доза      | лейкопения,                |                              |
|                                            | меланома (в                | 3—4г                       | тромбоцитопения,       |                              |
|                                            | сочетании с другими   |                                | местнораздражающее |                              |
|                                            | противоопухолевыми  |                                | действие,                    |                              |
|                                            | средствами)               |                                | пигментация,               |                              |
|                                            |                                   |                                | дерматиты                  |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Стрептозотоцин,                  | Островково-                | Внутривенно по 1    | Тошнота, рвота,          | Порошок по 1 г во  |
| Streptozotocin                      | клеточный рак             | г/м1 раз в неделю  | нефрит, лейкопения,   | флаконах              |
|                                            | поджелудочной           | в течение 4 нед.      | редко — гепатит         |                              |
|                                            | железы, инсулома,      |                                |                                    |                              |
|                                            | злокачественный        |                                |                                    |                              |
|                                            | карциноид,                  |                                |                                    |                              |
|                                            | лимфогранулематоз,   |                                |                                    |                              |
|                                            | в составе                    |                                |                                    |                              |
|                                            | лекарственных            |                                |                                    |                              |
|                                            | комбинаций при раке   |                                |                                    |                              |
|                                            | поджелудочной           |                                |                                    |                              |
|                                            | железы                       |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 5. Другие                           |                                   |                                |                                    |                              |
алкилирующие агенты    |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Миелобромол,                     | Хронический               | Внутрь по 0,25 г в   | Тошнота, рвота,          | Таблетки по 0,25 г |
| Myelobromolum; синоним:    | миелолейкоз               | сутки в течение 3— | потеря аппетита,         |                              |
| Дибромоманнитол,              | (особенно при             | 6 нед., далее дозу   | лейкопения,                |                              |
| Dibrommannit                       | устойчивости к           | снижают в 2 раза;   | тромбоцитопения,       |                              |
|                                            | миелосану),                | суммарная доза      | анемия                        |                              |
|                                            | эритремия                  | 6—7 г. При              |                                    |                              |
|                                            |                                   | поддерживающей    |                                    |                              |
|                                            |                                   | терапии 0,125—       |                                    |                              |
|                                            |                                   | 0,25 г 1—3 раза в    |                                    |                              |
|                                            |                                   | 7—10 дней в           |                                    |                              |
|                                            |                                   | течение 8—12 нед.; |                                    |                              |
|                                            |                                   | суммарная доза 3 г |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Проспидин, Prospidinum;     | Рак гортани,               | Внутривенно или     | Анорексия, тошнота,   | Флаконы по 0,1 и   |
| синоним Prospidii chloridum  | злокачественные        | внутримышечно по  | снижение АД (редко),  | 0,2 г; 30 и 50%      |
|                                            | опухоли глотки,           | 0,15—0,4 г в день;   | головокружение,         | мазь в тубах         |
|                                            | папилломатоз             | суммарная доза до  | парестезии                 |                              |
|                                            | верхних дыхательных | 2—3 г. Наружно       | (повышенная               |                              |
|                                            | путей, ангиосаркома   | применяется в         | чувствительность к     |                              |
|                                            | Капоши, ретикулез      | виде мази               | холоду)                       |                              |
|                                            | кожи, грибовидный      |                                |                                    |                              |
|                                            | микоз,                         |                                |                                    |                              |
|                                            | ретинобластома          |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Спиробромин,                     | Гемобластозы             | Внутривенно или     | Парестезии, редко      | Флаконы по 0,1 г   |
| Spirobrominum                     | неходжскинские          | внутримышечно по  | тахикардия,                |                              |
|                                            | лимфомы, рак             | 0,2—0,6 г                | лейкопения,                |                              |
|                                            | гортани                       | ежедневно,             | анорексия, тошнота     |                              |
|                                            |                                   | суммарная доза      |                                    |                              |
|                                            |                                   | 5—12 г                    |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Антиметаболиты                                                                                                                                                          |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Меркаптопурин,                  | Острый лейкоз (в        | Внутрь по 0,002—   | Тошнота, рвота,          | Таблетки по 0,05 г |
| Mercaptopurinum; синоним   | сочетании с другими   | 0,003 г/кг                 | анорексия; реже          |                              |
| Ismipur, Leupurin,                 | противоопухолевыми  | ежедневно в            | стоматит, диарея и     |                              |
| Mercapurin, Mycaptine,         | средствами),              | течение 2—3 нед.    | нарушение функции    |                              |
| Purinethol и др.                    | обострение                 | (при хорошей           | печени, лейкопения,    |                              |
|                                            | хронического              | переносимости        | тромбоцитопения,       |                              |
|                                            | миелолейкоза,            | разовую дозу          | анемия, головная        |                              |
|                                            | лимфосаркомы,          | повышают до          | боль, нефрит; редко    |                              |
|                                            | хорионэпителиома      | 0,005 г/кг);               | стоматит, алопеция,    |                              |
|                                            | матки                          | суммарная доза до  | лейкопения                 |                              |
|                                            |                                   | 1,09—0,12 г             |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Метотрексат,                      | Острые лейкозы, рак   | Внутрь,                   | Стоматит, диарея,       | Таблетки по 2,5     |
| Methotrexatum; синоним      | молочной железы,       | внутривенно,           | нарушение функции    мг; ампулы по 5    |
| Amethopterin, Methopterine,  | легкого, шейки матки,  | внутримышечно,     | печени, лейкопения,    мг                         |
| Methylaminopterinum            | хорионэпителиома,     | интралюмбально по | тромбоцитопения,       |                              |
|                                            | остеогенная саркома,  | 10 мг ежедневно     | анемия, нарушение     |                              |
|                                            | рабдомиосаркома,      | или по 30—40 мг 1   | функции почек,           |                              |
|                                            | семинома яичка,         | раз в 5 дней:           | алопеция (редко),        |                              |
|                                            | плоскоклеточный рак  | суммарная доза      | дерматит (редко),        |                              |
|                                            | области головы и шеи | 200—300 мг             | остеопороз при           |                              |
|                                            |                                   |                                | длительном                 |                              |
|                                            |                                   |                                | применении у детей    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Тиогуанин, Tioguaninum;      | Острый лейкоз            | Внутрь 2 мг/кг         | Тошнота, рвота,          | Таблетки по 40 мг  |
| синоним: Lanvis, 6-Tg          |                                   | ежедневно или        | лейкопения,                |                              |
|                                            |                                   | внутривенно 135      | тромбоцитопения,       |                              |
|                                            |                                   мг/межедневно в   | анемия                        |                              |
|                                            |                                   | течение 45 дней      |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Фторафур, Phthorafurum;     | Рак прямой и толстой  | Внутривенно по      | Возможно                   | Ампулы по 10 мл   |
| синоним: Futraful, Lifril,        | кишки, желудка,          | 20—30 мг/кг в          | головокружение во      | 4% раствора (400  |
| Tegafur и др.                       | молочной железы        | сутки за 2 приема    | время введения;         мг)                        |
|                                            |                                   | (через 12 ч),            | анорексия, тошнота,    |                              |
|                                            |                                   | ежедневно;             | рвота, диарея,            |                              |
|                                            |                                   | суммарная доза      | стоматит, лейкопения, |                              |
|                                            |                                   | 30—40 г                  | тромбоцитопения        |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Фторурацил,                        | Рак желудка, толстой  | Внутривенно по      | Анорексия, тошнота,   | Ампулы по 5 мл    |
| Phthoruracilum; синоним:     | и прямой кишки,          | 10—15 мг/кг через   | рвота, диарея,            | 5% раствора (250  |
| Efundex, Efodix,                  | молочной железы,       | день, суточная        | стоматит, лейкопения, | мг)                        |
| Fluorouracilum, 5-FU и др.    | печени, яичников,       | доза не более 1 г;    | тромбоцитопения,       |                              |
|                                            | поджелудочной           | суммарная доза      | анемия, редко             |                              |
|                                            | железы, легкого,         | 3—5 г                      | дерматит,                   |                              |
|                                            | злокачественные        |                                | гиперпигментация       |                              |
|                                            | опухоли области         |                                | кожи, атаксия              |                              |
|                                            | головы и шеи              |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Цитарабин, Cytarabinum;     | Острый                       | Внутривенно по 2— | Анорексия, тошнота,   | Флаконы по 100 и  |
| синоним: Цитозар, Alexan,  | миелобластный           | 4 мг/кг в течение     | рвота, стоматит,         | 500 мг                   |
| Aracytidine, Cytarabine и      | лейкоз (в сочетании с  | 1—10 дней; 100      | диарея, нарушение     |                              |
| др.                                      | другими                      мг/мвнутривенно   | функции печени          |                              |
|                                            | противоопухолевыми  | каждые 12 ч;           | (редко), лейкопения,    |                              |
|                                            | средствами)               | суммарная доза      | тромбоцитопения        |                              |
|                                            |                                   | 20—40 мг/кг            |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Другие синтетические препараты                                                                                                                                 |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Гидроксимочевина,             | Хронический               | Внутрь 80 мг/кг 1     | Анорексия, тошнота,   | Капсулы по 500 м  |
| Hydioxyurea; синоним          | миелолейкоз, острый  | раз в 3 дня или        | рвота, стоматит,         |                              |
| Hydrea                                | миелобластный           | 20—30 мг/кг            | лейкопения,                |                              |
|                                            | лейкоз,                       | ежедневно в            | тромбоцитопения,       |                              |
|                                            | плоскоклеточный рак  | течение 3—4 нед.    | анемия, алопеция,       |                              |
|                                            | области головы и шеи |                                | дерматит                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Дибунол, Dibunolum;            | Палилломатоз и рак    | Внутрипузырно 10   | Отсутствуют               | Линимент 5%,       |
| синоним. Бутилокситолуол, | мочевого пузыря         | мл линимента в       |                                    | 10% по 250, 500    |
| Ионол, Топокол                   |                                   | 25—30 мл 0,25—     |                                    | мл во флаконах и  |
|                                            |                                   | 1% раствора           |                                    | тубах по 12 и 25 г  |
|                                            |                                   | новокаина               |                                    |                              |
|                                            |                                   | ежедневно 15—25   |                                    |                              |
|                                            |                                   | дней                        |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Имидазол-карбоксамид,      | Лимфогранулематоз,  | Внутривенно 2—     | Тошнота, рвота,          | Порошок во           |
| Imidazol carboxamide;          | меланома, саркома     | 4,5 мг/кг ежедневно | анорексия, гепатит,     | флаконах по 0,1 и |
| синоним, Dacarbazine,         | мягких тканей,            | в течение 10 дней   | редко гипертермия      | 0,2 г                      |
| DTIC, DIC, ICDT                   | нейробластома           | или 250 мг/мв        |                                    |                              |
|                                            |                                   | течение 5 дней        |                                    |                              |
|                                            |                                   | ежедневно:             |                                    |                              |
|                                            |                                   | суммарная доза      |                                    |                              |
|                                            |                                   | 2,5—3 г                   |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Прокарбазин,                      | Генерализованные      | Внутрь по 0,05 г с   | Анорексия, тошнота,   | Капсулы по 0,05 г  |
| Procarbazinum, синоним:     | формы                        | повышением дозы   | рвота, стоматит          |                              |
| Натулан, Matulaner,             | лимфогранулематоза  | до 0,3 г ежедневно; | (редко), диарея,          |                              |
| Matulane                             | (III—IV стадии),           | суммарная доза      | лейкопения,                |                              |
|                                            | опухоли мозга,            | 4—7 г.                     | тромбоцитопения,       |                              |
|                                            | лимфомы,                   | Поддерживающие   | анемия, сонливость,   |                              |
|                                            | мелкоклеточный рак    | дозы 0,05—0,15 г в  | депрессия,                  |                              |
|                                            | легкого                       | день                        | невралгия, судороги    |                              |
|                                            |                                   |                                | (редко), иногда            |                              |
|                                            |                                   |                                | дерматиты,                 |                              |
|                                            |                                   |                                | гиперпигментация       |                              |
|                                            |                                   |                                | кожи, артралгии          |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Оримитен, Orimitenum;        | Рак молочной             | Внутрь ежедневно,  | Аллергическая            | Таблетки по 125    |
| синоним Aminoglutethimide, | железы, рак                | начиная с 125 мг,    | реакция, сонливость,  мг                         |
| AG                                      | предстательной          | вместе с                 | отеки, редко тошнота, |                              |
|                                            | железы                       | гидрокортизоном     | рвота, нистагм            |                              |
|                                            |                                   | (10 мг 4 раза в         |                                    |                              |
|                                            |                                   | день), постепенно   |                                    |                              |
|                                            |                                   | повышая дозу до     |                                    |                              |
|                                            |                                   | 500 или 1000 мг в    |                                    |                              |
|                                            |                                   | день                        |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Тамоксифен, Tamoxifenum, | Рак молочной             | Внутрь по 10—20    | Иногда тошнота,         | Таблетки по 10 мг  |
| синоним: Nolvadex,             | железы, рак тела        мг 2 раза в день,     | головокружение,         |                              |
| Зитазониум                         | матки, почки               | длительно               | кожная сыпь,              |                              |
|                                            |                                   |                                | гиперкальциемия,        |                              |
|                                            |                                   |                                | метрорагия, флебит    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Хлодитан, Chloditanum;       | Рак коры                     | Внутрь, начиная с   | Тошнота, рвота,          | Таблетки по 0,5 г   |
| синоним: Mitotan, Lysodren  | надпочечников            | 2—3 г в сутки,         | диарея (редко),           |                              |
| и др.                                   | (гормонально-             | постепенно              | угнетение психики,      |                              |
|                                            | активный)                   | повышая дозу до     | сонливость,                |                              |
|                                            |                                   | 8—10 г в сутки;       | нарушение зрения,      |                              |
|                                            |                                   | суммарная доза      | кожная сыпь,              |                              |
|                                            |                                   | 200—300 г (лечение | головная боль             |                              |
|                                            |                                   | проводят под          |                                    |                              |
|                                            |                                   | контролем               |                                    |                              |
|                                            |                                   | содержания в моче  |                                   |                              |
|                                            |                                   | кортикостероидов)   |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Цисплатин, Cisplatin;           | Злокачественные        | Внутривенно           | Тошнота, рвота,          | Флаконы по 10 и    |
| синоним: ДДП, Платидиам,  | опухоли яичника,        | капельно по 20        | диарея, нефрит,          | 25 мг                     |
| Цис-платина, DDP, CDDP,   | плоскоклеточный рак  мг/межедневно в   | лейкопения,                |                              |
| Platinol                                | области головы и        | течение 5 дней с     | тромбоцитопения,       |                              |
|                                            | шеи, шейки матки,      | повторением           | снижение слуха,         |                              |
|                                            | мочевого пузыря,        | каждые 4 нед. или   | полиневриты,              |                              |
|                                            | остеогенная саркома,  | 60—120 мг/м         | дерматит. Для             |                              |
|                                            | мелкоклеточный рак    | каждые 3—5 нед.    | уменьшения                |                              |
|                                            | легкого,                      | или 30 мг/м1 раз в | токсичности                |                              |
|                                            | нейробластома           | неделю                   | проводятся                 |                              |
|                                            |                                   |                                | гипергидратация и       |                              |
|                                            |                                   |                                | форсированный          |                              |
|                                            |                                   |                                | диурез                        |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Противоопухолевые средства природного происхождения Алкалоиды                                                                          |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Розевин, Rosevinum;           | Лимфогранулематоз,  | Внутривенно по       | Тошнота, рвота,          | Порошок во           |
| синоним: Винбластин,         | лимфосаркома и         | 0,1—0,25 мг/кг 1      | анорексия, боли в       | флаконах по 5 мг  |
| Velban, Vincaleukoblastine,  | ретикулосаркома, рак  | раз в 1—2 нед.;       | животе; лейкопения,    |                              |
| VLB                                    | молочной железы        | курсовая доза         | тромбоцитопения,       |                              |
|                                            | хорионэпителиома,     | около 100 мг            | головная боль,            |                              |
|                                            | семинома яичка          |                                | парестезии, флебиты, |                              |
|                                            |                                   |                                | запоры, аменорея       |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Винкристин, Vincristinum;    | Острый лимфолейкоз, | Внутривенно по 1— | Парестезии, снижение | Порошок во           |
| синоним: Leurocristine,        | рак молочной железы, | 2 мг/м1 раз в         | сухожильных              | флаконах по 0,5    |
| Oncovin, VCR, LCR и др.     | саркома Юинга,          | неделю: суммарная | рефлексов, атаксия,   мг                         |
|                                            | лимфогранулематоз,   | доза до 18,5 мг/м2   | парез кишечника,        |                              |
|                                            | нейробластома,          |                                | алопеция,                    |                              |
|                                            | лимфосаркома,           |                                | гематотоксичность,     |                              |
|                                            | рабдомиосаркома,      |                                | флебиты                     |                              |
|                                            | нефробластома,         |                                |                                    |                              |
|                                            | меланома                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Колхамин, Colchaminim;      | Рак кожи I и II стадии  | Наружно в виде       | Тошнота, рвота,          | Мазь 0,5% по 25 г |
| синоним Омаин, Colcemid,  |                                    | 0,5% мази               | стоматит, лейкопения, | во флаконах         |
| Demecolcin                          |                                   | ежедневно в            | алопеция,                    |                              |
|                                            |                                   | течение 20—35        | местнораздражающее |                              |
|                                            |                                   | дней                        | действие                     |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Тенипозид; синоним VM-26  | Опухоли мозга,          | Внутривенно по       | Тошнота, рвота,          | Ампулы по 50 мг   |
|                                            | лимфогранулематоз,   | 30—60 мг/м2 (0,8     | диарея, лейкопения,    |                              |
|                                            | лимфомы, рак             | мг/кг) ежедневно     | тромбоцитопения,       |                              |
|                                            | мочевого пузыря,        | (3—5 дней через     | анемия, алопеция,       |                              |
|                                            | яичников                     | 2—4 нед.); 100—     | слабость                     |                              |
|                                            |                                   | 150 мг/м                |                                    |                              |
|                                            |                                   | еженедельно           |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Этопозид; синоним VP-16    | Острый миелолейкоз   | Внутривенно           | Те же                          | Ампулы по 10 мг   |
|                                            |                                   | капельно по 60—     |                                    | и капсулы по 25 и  |
|                                            |                                   | 120 мг/м2 (1,4 мг/кг) |                                    | 50 мг                     |
|                                            |                                   | ежедневно в            |                                    |                              |
|                                            |                                   | течение 5 дней        |                                    |                              |
|                                            |                                   | через 2—4 нед.;      |                                    |                              |
|                                            |                                   | внутрь по 60—300   |                                    |                              |
|                                            |                                   мг/м1,6 мг/кг)         |                                    |                              |
|                                            |                                   | ежедневно в            |                                    |                              |
|                                            |                                   | течение 5 дней        |                                    |                              |
|                                            |                                   | через 2—4 нед.       |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Противоопухолевые антибиотики                                                                                                                                  |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1. Антрациклины              |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Адриамицин,                       | Острый миелолейкоз,  | Внутривенно по 30   | Тошнота, рвота,          | Порошок во           |
| Adriamycinum, синоним:      | рак молочной железы, | мг/межедневно 3   | диарея, стоматит,       | флаконах по 10     |
| Adriblasin, Doxorubicinum и  | мочевого пузыря,        | дня подряд с           | лейкопения,                мг (прилагается     |
| др.                                      | легкого, печени,          | перерывом между   | тромбоцитопения,       | растворитель)       |
|                                            | предстательной          | курсами 3 нед. или  | изменения на ЭКГ,      |                              |
|                                            | железы,                      | по 60—75 мг/м1     | снижение АД,              |                              |
|                                            | плоскоклеточный рак  | раз в месяц;            | миокардит, алопеция,  |                              |
|                                            | области головы и        | суммарная доза не  | местнораздражающее |                              |
|                                            | шеи, рак щитовидной  | должна превышать  | действие, красный      |                              |
|                                            | железы, саркома         | 550—600 мг/м2        | цвет мочи без             |                              |
|                                            | Юинга,                        |                                | гематурии                   |                              |
|                                            | лимфогранулематоз,   |                                |                                    |                              |
|                                            | нейробластома,          |                                |                                    |                              |
|                                            | лимфомы,                   |                                |                                    |                              |
|                                            | остеогенная саркома,  |                               |                                    |                              |
|                                            | рабдомиосаркома,      |                                |                                    |                              |
|                                            | опухоли яичка,            |                                |                                    |                              |
|                                            | яичников,                    |                                |                                    |                              |
|                                            | нефробластома          |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Карминомицин,                   | Лимфосаркома,          | Внутривенно по       | Такие же, как при        | Порошок во           |
| Carminomycinum; синоним:  | ретикулосаркома,       | 10—15 мг 2 раза в   | приеме адриамицина   | флаконах по 5 мг  |
| Carminomycin. NSC-80024   | саркомы мягких          | неделю; суммарная |                                    |                              |
|                                            | тканей, острый            | доза 60—75 мг;       |                                    |                              |
|                                            | лимфобластный          | ежедневно в            |                                    |                              |
|                                            | лейкоз, саркома          | течение 5 дней по   |                                    |                              |
|                                            | матки                          | 8 мг; интервал         |                                    |                              |
|                                            |                                   | между курсами 3—  |                                   |                              |
|                                            |                                   | 4 нед.                      |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Рубомицин, Rubomycin;       | Хорионэпителиома      | Внутривенно по       | Такие же, как при        | Порошок во           |
| синоним: Daunomycin,         | матки, острый лейкоз, | 20—40 мг/м           | приеме адриамицина   | флаконах по 20 и  |
| Daunoblastin,                       | ретикулосаркома,       | ежедневно курсами |                                    | 40 мг                     |
| Daunorubicinum,                  | хронический               | по 5—10 дней;         |                                    |                              |
| Rubidomycine                      | миелолейкоз,              | суммарная доза до  |                                   |                              |
|                                            | лимфосаркома,           | 300 мг/м2                 |                                    |                              |
|                                            | нейробластома,          |                                |                                    |                              |
|                                            | рабдомиосаркома       |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 2. Производные                |                                   |                                |                                    |                              |
ауреоловой кислоты       |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Митрамицин,                       | Опухоли яичка            | Внутривенно по       | Анорексия, тошнота,   | Флаконы по 2,5—  |
| Mithramycinum; синоним      |                                   | 25—50 мкг/кг через  | рвота, пирогенная       | 5 мг (2500 и 5000   |
| Mithracin                             |                                   | день; суммарная     | реакция, увеличение   мкг)                       |
|                                            |                                   | доза 6—25 мг;         | протромбинового         |                              |
|                                            |                                   | повторный курс       | времени и нарушение  |                              |
|                                            |                                   | через 4—8 нед.       | свертывания крови,     |                              |
|                                            |                                   |                                | кровотечения,             |                              |
|                                            |                                   |                                | геморрагический         |                              |
|                                            |                                   |                                | диатез, лейкопения,    |                              |
|                                            |                                   |                                | тромбоцитопения        |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Оливомицин, Olivomycinum | Опухоли яичка,           | Внутривенно по       | Анорексия, тошнота,   | Порошок во           |
|                                            | миндалин, меланома   | 0,01 г через день,    | рвота, стоматит,         | флаконах по 0,02  |
|                                            | III—IV стадии,             | 10—20 инъекций;     | пирогенная реакция,    | г                           |
|                                            | хорионэпителиома      | повторный курс       | лейкопения,                |                              |
|                                            | матки                          | через 3—4 нед.       | тромбоцитопения,       |                              |
|                                            |                                   |                                | изменения на ЭКГ       |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 3. Прочие                          |                                   |                                |                                    |                              |
противоопухолевые        |                                   |                                |                                    |                              |
антибиотики                     |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Блеомицин, Bleomycinum;   | Плоскоклеточный рак  | Внутривенно или     | Пирогенная реакция,   | Ампулы по 15 мг   |
| синоним Блеоцин                | различной                   | внутримышечно по  | дерматит,                   |                              |
|                                            | локализации,               | 15 мг 3 раза или по  | гиперкератоз,              |                              |
|                                            | ретикулосаркома,       | 30 мг 2 раза в          | стоматит, алопеция,    |                              |
|                                            | лимфогранулематоз,   | неделю; суммарная | пневмония, иногда      |                              |
|                                            | гератобластомы          | доза до 300 мг        | заканчивающаяся       |                              |
|                                            | яичка и яичника          |                                | пневмофиброзом        |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Брунеомицин,                     | Лимфогранулематоз,  | Внутривенно по       | Тошнота, рвота,          | Флаконы по 0,5 мг |
| Bruneomycinum                   | хронический               | 200—400 мкг через  | диарея, боли в            | (500 мкг)               |
|                                            | лимфолейкоз,             | 2—3 дня;                 | животе, гингивит,        |                              |
|                                            | нефробластома,         | суммарная доза      | стоматит, лейкопения, |                              |
|                                            | нейробластома,          | 2—4 мг                    | тромбоцитопения,       |                              |
|                                            | ретикулосаркома        |                                | анемия, алопеция,       |                              |
|                                            |                                   |                                | дерматит                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Дактиномицин,                    | Хорионэпителиома      | Внутривенно           | Анорексия, тошнота,   | Ампулы по 1 мл    |
| Dactinomycinum; синоним:   | матки,                         | ежедневно на          | рвота, диарея,            | (0,5 мг или 500      |
| Актиномицин D, Cosmegen  | нефробластома,         | протяжении 5 дней  | стоматит, хейлит,        | мкг)                       |
| и др.                                   | ретикулосаркома,       | взрослым по 10       | глоссит, проктит,         |                              |
|                                            | рабдомиосаркома (у   мкг/кг в день,          | тромбоцитопения,       |                              |
|                                            | детей), саркома          | детям по 15 мкг/кг | лейкопения, анемия,   |                              |
|                                            | Юинга,                        | повторный курс       | алопеция, эритема,     |                              |
|                                            | тератобластома          | через 3—5 нед.       | гиперпигментация       |                              |
|                                            | яичка,                         |                                | кожи, сыпи,                 |                              |
|                                            | лимфогранулематоз    |                                | местнораздражающее |                              |
|                                            |                                   |                                | действие при              |                              |
|                                            |                                   |                                | попадании под кожу    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Митомицин С, Mitomycinum | Рак желудка,              | Внутривенно           | Тошнота, рвота,          | Флаконы по 2 мг    |
| С; синоним; Ametycine,       | кишечника,                 | капельно 10 мг/м1  | диарея,                      |                              |
| Mytamycin и др.                  | поджелудочной           | раз в 2—3 нед. или  | тромбофлебит,            |                              |
|                                            | железы, мочевого       | 0,05 мг/кг с 1-го по  | стоматит, лейкопения, |                              |
|                                            | пузыря                        | 5-й и с 8-го по 12-й  | тромбоцитопения,        |                              |
|                                            |                                   | день; курса;            | алопеция, гематурия   |                              |
|                                            |                                   | суммарная доза 50  |                                    |                              |
|                                            |                                   мг/м2                       |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Ферменты                                                                                                                                                                    |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| L-Аспарагиназа,                  | Острый лимфолейкоз, | Внутривенно           | Анорексия, тошнота,   | Флаконы по 3000   |
| Asparaginasum; синоним:    | лимфосаркома,           | капельно по 200—   | рвота, нарушение        | — 10 000 МЕ         |
| Краснитин, Leunase и др.    | ретикулосаркома        | 300 МЕ/кг                | функции печени и       | (прилагаются        |
|                                            |                                   | ежедневно или        | поджелудочной           | ампулы с              |
|                                            |                                   | через день;             | железы, лейкопения,   | растворителем)     |
|                                            |                                   | суммарная доза до  | тромбоцитопения,       |                              |
|                                            |                                   | 400 000 МЕ             | аллергические             |                              |
|                                            |                                   |                                | реакции, головная       |                              |
|                                            |                                   |                                | боль, склонность к      |                              |
|                                            |                                   |                                | геморрагиям, нефрит, |                              |
|                                            |                                   |                                | гипотермия                 |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Гормональные препараты                                                                                                                                             |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1. Андрогены                    |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Медротестрона пропионат,  | Рак молочной железы | Внутримышечно      | Гиперкальциемия и     | Ампулы по 1 мл    |
| Medrotestroni propionas;       | у женщин с                 | ежедневно по 50—  | гиперкальциурия,        | 5% масляного       |
| синоним Мастерон,             | сохраненной               | 100 мг, длительно   | гепатит, нарушения     | раствора               |
| Метилдигидротестостерона | менструальной           |                                | сердечной                   |                              |
| пропионат                           | функцией                    |                                | деятельности,             |                              |
|                                            |                                   |                                | явления вирилизации  |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Метиландростендиол,         | Показания такие же,   | Сублингвально по    | Нарушения функции    | Таблетки по 0,01   |
| Methylandrostendiolum;        | как у                           | 0,2—0,3 г в сутки,   | печени, желтуха,         | и 0,025 г                |
| синоним: Androdiol,             | медротестостерона     | длительно               | аллергические             |                              |
| Diolostene, Masdiol,             | пропионата                 |                                | реакции, вирилизация, |                              |
| Mestendiol, Metandiol,          |                                   |                                | задержка жидкости,    |                              |
| Methandriol, Methandriolum,  |                                   |                                | усиление либидо         |                              |
| Neosteron, Notandron,          |                                   |                                |                                    |                              |
| Novandrol, Stenediol, и др.   |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Метилтестостерон,              | Рак молочной железы | Сублингвально по    | Явления                      | Таблетки по 0,005  |
| Methyltestosteronum;           |                                   | 0,05—0,1 г в сутки,  | маскулинизации          | и 0,01 г                 |
| синоним:                             |                                   | длительно               | (вирилизма),                |                              |
| Methyltestosterone, Androral |                                   |                                | гиперкальциемия,        |                              |
| (B). Glosso-Sterandryl,         |                                   |                                | гепатит, нарушения     |                              |
| Hormale, Malogen,               |                                   |                                | кровообращения         |                              |
| Metandren, Oraviron, Oreton  |                                   |                                | (редко)                        |                              |
| M, Stenendiol, Testoral,        |                                   |                                |                                    |                              |
| Virormoneoral и др.              |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Пролотестон,                      | Рак молочной железы | Внутримышечно по  | Такие же, как при        | Ампулы по 1 мл    |
| Prolotestanum                      |                                   | 0,35—0,7 г 1 раз в   | введении                    | 35% масляного     |
|                                            |                                   | 2 нед., длительно    | медротестостерона     | раствора               |
|                                            |                                   |                                | пропионата                 |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Тестостерона пропионат,    | Показания такие же,   | Внутримышечно по  | То же                          | Ампулы по 1 мл    |
| Testosteroni propionas,         | как для                       | 50—100 мг              |                                    | 1% и 5% раствора |
| синоним: Agovirin,               | медротестостерона     | ежедневно или        |                                    | в масле                 |
| Androfort, Testolutin и др.     | пропионата                 | через день              |                                    |                              |
|                                            |                                   | длительно, в           |                                    |                              |
|                                            |                                   | течение 4—5 мес.   |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Тестэнат, Testoenatum        | Рак молочной железы | Внутримышечно      | То же                          | Ампулы по 1 мл    |
|                                            |                                   | 1—2 мл раз в 2        |                                    | 10% раствора в     |
|                                            |                                   | нед., длительно       |                                    | масле                   |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 2. Эстрогены                     |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Диэтилстильбэстрола          | Рак молочной железы | Внутримышечно в    | У женщин                    | Ампулы по 1 мл    |
| пропионат,                          | у женщин в возрасте  | суточной дозе 20—  | кровянистые               | 3% раствора в      |
| Diaethylstilboestroli              | старше 60 лет, рак      | 50 мг, длительно     | выделения из              | масле                   |
| propionas: синоним Dibestil  | предстательной          |                                | влагалища, учащение  |                             |
| и др.                                   | железы                       |                                | мочеиспускания и       |                              |
|                                            |                                   |                                | недержание мочи; у    |                              |
|                                            |                                   |                                | мужчин симптомы       |                              |
|                                            |                                   |                                | феминизации; у лиц    |                              |
|                                            |                                   |                                | обоих полов                |                              |
|                                            |                                   |                                | геморрагический         |                              |
|                                            |                                   |                                | диатез, сердечно-       |                              |
|                                            |                                   |                                | сосудистая                 |                              |
|                                            |                                   |                                | недостаточность,        |                              |
|                                            |                                   |                                | тошнота, рвота,           |                              |
|                                            |                                   |                                | головокружение,         |                              |
|                                            |                                   |                                | обострение                 |                              |
|                                            |                                   |                                | хронического              |                              |
|                                            |                                   |                                | гепатита, острый         |                              |
|                                            |                                   |                                | гепатит                       |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Полиэстрадиол-фосфат,     | Рак предстательной    | Внутримышечно      | Такие же, как при        | Ампулы по 40 мг   |
| Polyestradiol phosphate,       | железы                       | 80—160 мг 1 раз в   | приеме                        |                              |
| синоним: Эстрадурин,         |                                   | месяц в течение      | диэтилстильбэстрола  |                              |
| Estradurin                            |                                   | 2—3 мес., затем      |                                    |                              |
|                                            |                                   | дозу уменьшают до |                                    |                              |
|                                            |                                   | 40— 80 мг в месяц  |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Синэстрол, Synoestrolum;    | Такие же, как у           | Внутримышечно      | Такие же, как при        | Ампулы по 1 мл    |
| синоним Dihydrostilböstrol,   | диэтилстильбэстрола  | или подкожно в       | приеме                        | 2% масляного       |
| Estrene, Hexestrol,               |                                   | суточной дозе 60—  | диэтилстильбэстрола  | раствора              |
| Novostrol и др.                    |                                   | 100 мг ежедневно,   |                                    |                              |
|                                            |                                   | длительно. В           |                                    |                              |
|                                            |                                   | период ремиссии     |                                    |                              |
|                                            |                                   | по 40 мг ежедневно |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Фосфэстрол,                       | Рак предстательной    | Лечение начинают   | Тошнота, рвота,          | Таблетки по 0,1 г;  |
| Phosphoestrolum; синоним:  | железы                       | с внутривенного      | слабость, зуд или       | ампулы по 5 мл     |
| Cytonal, Difostilben,             |                                   | введения 2,5 мл      | боли в анальной и       | 6% раствора         |
| Fosfostilben, Honvan и др.   |                                   | 6% раствора (0,15 г | генитальной                |                              |
|                                            |                                   | ), при хорошей         | областях, реже в         |                              |
|                                            |                                   | переносимости        | области лица и шеи,    |                              |
|                                            |                                   | дозу увеличивают   | возможны понижение  |                              |
|                                            |                                   | до 0,5—1,5 г,           | свертываемости          |                              |
|                                            |                                   | вводят ежедневно   | крови,                         |                              |
|                                            |                                   | в течение 10—15     | геморрагический         |                              |
|                                            |                                   | дней; затем внутрь  | диатез,                       |                              |
|                                            |                                   | по 0,1 г 2—3 раза в  | незначительная          |                              |
|                                            |                                   | день или                 | феминизация              |                              |
|                                            |                                   | внутривенно по 5     |                                    |                              |
|                                            |                                   мл 6% раствора      |                                    |                              |
|                                            |                                   | (0,3 г) 1—2 раза в    |                                    |                              |
|                                            |                                   | неделю в течение    |                                    |                              |
|                                            |                                   | 2—3 мес.                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Хлортрианизен,                   | Такие же, как у           | Внутрь по 0,012 г    | Такие же, как при        | Таблетки по          |
| Chlortrianisenum; синоним:   | диэтилстильбэстрола  | 2—3 раза в день,    | приеме                        | 0,012 г                  |
| Chlortrianisoestrolum,           |                                   | длительно               | диэтилстильбэстрола  |                              |
| Trianisoestrol и др.               |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Этинилэстрадиол,               | Такие же, как у           | Внутрь по 0,05—0,1 | Такие же, как при        | Таблетки по 0,05   |
| Aethinyloestradiolum            | диэтилстильбэстрола; | мг ежедневно,         | приеме                        | мг                         |
| синоним: Микрофоллин (В), | чаще назначается       | длительно               | диэтилстильбэстрола  |                              |
| Aethinyloestradiol Follikoral,  | для поддерживающей |                                |                                    |                              |
| Oestralyn и др.                    | терапии                      |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 3. Кортикостероиды         |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Гидрокортизона                   | Острые лимфолейкоз  | Внутривенно или     | При продолжительном | Ампулы по 0,025   |
| гемисукцинат,                     | и миелолейкоз            | внутримышечно в    | применении                 | и 0,1 г для             |
| Hydrocortisoni hemisuccinas |                                   | суточной дозе 150   | возможны ожирение,   | внутривенного       |
|                                            |                                   мг в течение 3—5    | гирсутизм, появление  | введения,             |
|                                            |                                   | дней, далее по 50    | угрей, нарушение        | суспензия             |
|                                            |                                   мг в сутки,              | менструального          | гидрокортизона     |
|                                            |                                   | длительно               | цикла, остеопороз,      | ацетата во            |
|                                            |                                   |                                | синдром Иценко —      | флаконах по 5 мл  |
|                                            |                                   |                                | Кушинга,                     | (125 мг) для          |
|                                            |                                   |                                | возникновение язв      | внутримышечного  |
|                                            |                                   |                                | желудочно-кишечного  | введения              |
|                                            |                                   |                                | тракта и их                  |                              |
|                                            |                                   |                                | прободение,                |                              |
|                                            |                                   |                                | геморрагический         |                              |
|                                            |                                   |                                | панкреатит,                 |                              |
|                                            |                                   |                                | гипергликемия,            |                              |
|                                            |                                   |                                | понижение                  |                              |
|                                            |                                   |                                | сопротивляемости к    |                              |
|                                            |                                   |                                | инфекциям,                 |                              |
|                                            |                                   |                                | повышение                  |                              |
|                                            |                                   |                                | свертываемости          |                              |
|                                            |                                   |                                | крови, психические     |                              |
|                                            |                                   |                                | нарушения                  |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Дексаметозон,                    | Такие же, как у           | Внутрь в суточной   | Такие же, как при        | Таблетки по 0,5     |
| Dexamethasonum; синоним: | гидрокортизона           | дозе по 3—6 мг,      | приеме                        | мг; ампулы по 1    |
| Decardon, Dexacortin,          |                                   | поддерживающая    | гидрокортизона           мл, содержащие   |
| Dexason, Hexadecadrol,       |                                   | доза 1—1,5 мг в      |                                    | 4 мг                      |
| Millicorten, Graderon и др.    |                                   | сутки                       |                                    | дексаметазон-21-  |
|                                            |                                   |                                |                                    | фосфата               |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Кортизона ацетат, Cortisoni  | Такие же, как у           | Внутрь или              | Такие же, как при        | Таблетки по          |
| acetas: синоним: Adieson,   | гидрокортизона           | внутримышечно по  | приеме                        | 0,025 г; суспензия |
| Cortelan, Cortone, Rincorten  |                                   | 0,075—0,1 г 3 раза  | гидрокортизона           | (1 мл содержит     |
|                                            |                                   | в сутки в течение    |                                    | 0,025 г) во             |
|                                            |                                   | 3—5 дней; после     |                                    | флаконах по 10     |
|                                            |                                   | этого по 0,05 г 3      |                                    | мл                         |
|                                            |                                   | раза в сутки,           |                                    |                              |
|                                            |                                   | длительно               |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Преднизолон,                      | Такие же, как у           | Внутрь по 0,05—     | Такие же, как при        | Таблетки по 0,001  |
| Prednisolonum; синоним:     | гидрокортизона           | 0,08 г в сутки; для   | приеме                        | и 0,005 г                |
| Dacortin, Nisolone,               |                                   | поддержания           | гидрокортизона           |                              |
| Prenolone, Ultracorten H и    |                                   | ремиссии по            |                                    |                              |
| др.                                      |                                   | 0,015—0,03 г в        |                                    |                              |
|                                            |                                   | сутки, длительно     |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Триамцинолон,                    | Такие же, как у           | Внутрь в суточных  | Такие же, как при        | Таблетки по          |
| Triamcinolonum; синоним:    | гидрокортизона           | дозах 16—40 мг,     | приеме                        | 0,004 г (4 мг)         |
| Aristocort, Kenacort,             |                                   | поддерживающие    | гидрокортизона           |                              |
| Polcortolon                          |                                   | дозы 2—10 мг         |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 4. Прогестины                   |                                   |                                |                                    |                              |
(гестагены)                       |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Гестоноронкапроат,             | Рак эндометрия,         | Внутримышечно      | Боли в области           | Шприц-ампулы по  |
| Gestonoroncaproat;              | аденома                     | 200 мг 1 раз в          | молочных желез (у      | 200 мг                   |
| синоним Depostat,               | предстательной          | неделю; суммарная | мужчин), снижение      |                              |
| Primostat и др.                    | железы                       | доза 2—3 г              | потенции, редко          |                              |
|                                            |                                   |                                | гепатит                       |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Оксипрогестерона               | Рак тела матки,          | Внутримышечно по  | Тахикардия при           | Ампулы по 1 мл    |
| капронат, Oxyprogesteroni   | молочной железы,       | 1 г ежедневно или   | длительном                 | 12,5% и 25%         |
| caproas; синоним:               | почки                          | через день в           | применении,                | масляного             |
| Hydroxyprogesterone            |                                   | течение                   | задержка жидкости,    | раствора               |
| Caproate, Primolut-Depot,     |                                   | длительного            | редко синдром            |                              |
| Progesieron-retard и др.        |                                   | времени                  | Иценко — Кушинга      |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Провера, Provera; синоним  | Рак эндометрия,         | Внутрь по 200—      | Анафилаксия,             | Таблетки по 100,   |
| медроксипрогестерона        | молочной железы,       | 800 мг ежедневно    | тромбоэмболические   | 200, 250 мг            |
| ацетат                                 | почки                          | длительно (не          | расстройства,             |                              |
|                                            |                                   | менее 8—10 нед.)    | бессонница, головная  |                              |
|                                            |                                   |                                | боль, зуд, гирсутизм,  |                              |
|                                            |                                   |                                | алопеция, тошнота,     |                              |
|                                            |                                   |                                | задержка жидкости,    |                              |
|                                            |                                   |                                | синдром Иценко —      |                              |
|                                            |                                   |                                | Кушинга                      |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 5. Гормоноцитостатики   |                                   |                                |                                    |                              |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Эстрацит, Estracyt;             | Рак предстательной    | Внутрь или              | Лейкопения,                | Ампулы по 150 и   |
| синоним Estramustin           | железы                       | внутривенно 15       | тромбоцитопепения,    | 300 мг; капсулы    |
| phosphat                             |                                   мг/кг ежедневно,     | феминизация              | по 140 мг              |
|                                            |                                   | суммарная доза      |                                    |                              |
|                                            |                                   | 100—200 мг/кг         |                                    |                              |
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Примечание. Большинство противоопухолевых средств следует хранить в сухом, прохладном, защищенном от света месте.
Библиогр.: Блохин Н.Н. и Переводчикова Н.И. Химиотерапия опухолевых заболеваний, М., 1984; Гарин А.М. и Алиев Д.А. Лечение диссеминированных форм злокачественных новообразований, Баку, 1988; Гершанович М.Л. Осложнения при химио- и гормонотерапии злокачественных опухолей, М., 1982.
II Противоо́пухолевые сре́дства (antitumoralia, antineoplastica; син. антибластомные средства)
лекарственные средства, применяемые для лечения злокачественных новообразований (фторурацил, циклофосфамид, тиофосфамид, меркаптопурин, оливомицин и др.).

1. Малая медицинская энциклопедия. — М.: Медицинская энциклопедия. 1991—96 гг. 2. Первая медицинская помощь. — М.: Большая Российская Энциклопедия. 1994 г. 3. Энциклопедический словарь медицинских терминов. — М.: Советская энциклопедия. — 1982—1984 гг.

Смотреть что такое "Противоопухолевые средства" в других словарях:

  • противоопухолевые средства — (antitumoralia, antineoplastica; син. антибластомные средства) лекарственные средства, применяемые для лечения злокачественных новообразований (фторурацил, циклофосфамид, тиофосфамид, меркаптопурин, оливомицин и др.) …   Большой медицинский словарь

  • Противоопухолевые средства —         группа веществ синтетического или природного происхождения для лечения злокачественных опухолей (См. Злокачественные опухоли); подразделяются на т. н. алкилирующие (эмоихин, новэмбихин, хлорбутин, допан, сарколизин, циклофосфан, миелосан… …   Большая советская энциклопедия

  • ПРОТИВООПУХОЛЕВЫЕ СРЕДСТВА — лек. в ва, нарушающие жизнедеятельность опухолевых клеток. Один из характерных признаков большинства П. с. способность в относительно небольших дозах нарушать митоз (процесс деления) клеток, подавлять рост тканей организма, сопровождающийся… …   Химическая энциклопедия

  • Противоопухолевые препараты — (антибластомные препараты)  препараты, которые нарушают развитие истинных опухолей (рак, саркома и др.) и гемобластозов[1]. Согласно международной анатомо терапевтическо химической классификации (рус. АТХ, англ. ATC), относится к коду L …   Википедия

  • Противоопухолевые антибиотики — Противоопухолевые антибиотики  фармакологическая группа, объединяющая противоопухолевые препараты антибиотики с противоопухолевым действием.[1] АТХ группа L01D[2] В настоящее время из противоопухолевых антибиотиков наибольшее практическое… …   Википедия

  • Противоопухолевые препараты, цитостатические препараты — Анатомо терапевтическо химическая классификация (АТХ) Общие статьи по теме: Фармакология Лекарственные средства Фармакотерапия Код A: Препараты, влияющие на пищеварительный тракт и обмен веществ Код B: Препараты, влияющие на кроветворение и кровь …   Википедия

  • Химиотерапевтические средства — I Химиотерапевтические средства лекарственные средства, избирательно подавляющие в организме человека развитие и размножение возбудителей инфекционных болезней и инвазий или угнетающие пролиферацию опухолевых клеток либо необратимо повреждающие… …   Медицинская энциклопедия

  • Цитостатические средства — (от Цито... и греч. statikós способный останавливать, останавливающий)         различные по химической структуре лекарственные вещества, блокирующие деление клеток. Механизмы подавления определённых этапов клеточного деления этими препаратами… …   Большая советская энциклопедия

  • Антианемические средства — I Антианемические средства (греч. anti против + Анемии) лекарственные средства, применяемые для лечения анемий. Общепринятой классификации А. с. нет. Среди них условно различают препараты, нормализующие образование эритроцитов и гемоглобина, и… …   Медицинская энциклопедия

  • ПРОТИВОВОСПАЛИТЕЛЬНЫЕ СРЕДСТВА — лек. в ва, подавляющие проявления воспалит. процессов. Различия в хим. строении и механизмах действия обусловливают деление П. с. на стероидные и нестероидные ср ва. Стероидные П. с. по хим. строению относятся к 11,17 дигидроксистероидам. Наряду… …   Химическая энциклопедия

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