Reddy Vamsi, Winston Nicole R.
McKinsey & Company
Augusta University Medical College of Georgia
This program discusses mesna (sodium 2-mercapto-ethane sulfonate), a detoxifying agent employed to avert hemorrhagic cystitis in patients undergoing chemotherapy with high-dose cyclophosphamide or ifosfamide. The discussion centers on mesna's distinctive mechanism of action wherein it undergoes initial inactivation to dimesna (mensa disulfide) within the bloodstream. Once filtered through the kidneys and subsequently excreted into the bladder, mesna undergoes reactivation. In the bladder, the reactivated mesna detoxifies acrolein, a urotoxic byproduct of ifosfamide and cyclophosphamide, thereby mitigating the risk of hemorrhagic cystitis.
本节目讨论了美司钠（2-巯基乙烷磺酸钠），一种用于预防接受高剂量环磷酰胺或异环磷酰胺化疗的患者发生出血性膀胱炎的解毒剂。讨论集中在美司钠独特的作用机制上，即在血液中它最初会失活转化为二巯基乙烷磺酸钠（美司钠二硫化物）。一旦通过肾脏过滤并随后排入膀胱，美司钠会重新激活。在膀胱中，重新激活的美司钠会使异环磷酰胺和环磷酰胺的尿毒性副产物丙烯醛解毒，从而降低出血性膀胱炎的风险。
