Viele C S, Holmes B C
Department of Physiological Nursing, University of California, San Francisco, USA.
Oncol Nurs Forum. 1998 Apr;25(3):515-23.
PURPOSE/OBJECTIVES: To review the drug profile and nursing implications of amifostine, a new cytoprotective agent.
Published articles, abstracts, professional communications, drug manufacturer, and personal experience with amifostine clinical studies.
Amifostine increases the selectivity of specific anticancer agents for neoplastic cells by protecting normal tissue. It is indicated for reduction of the cumulative renal toxicity associated with repeated administration of cisplatin, in radiation therapy, and in several types of chemotherapies in patients with a variety of malignancies. Studies of amifostine used as a radioprotective and cytotoxic chemoprotective agent have demonstrated results against nephrotoxicity, neurotoxicity, hematotoxicity (granulocytopenia, leukopenia, and thrombocytopenia), and ototoxicity without adversely affecting tumor response or patient survival. The most common side effects are hypotension, nausea and vomiting (which may be severe), and a decrease in serum calcium concentrations.
Amifostine is a new cytoprotectant, the first such agent with pancytoprotection. With appropriate management and premedication, amifostine is generally well-tolerated. Side effects are reversible following treatment discontinuation.
Nurses need to be knowledgeable about cytoprotectants, a new class of drugs, in order to teach patients and their families about the need for cytoprotection so they can comply with and participate in treatment plans and to identify the need for and management of amifostine administration. Patient-care concerns include the risk of decreased systolic blood pressure that requires fluid infusion and postural management and potentially severe nausea and vomiting.
目的/目标：综述新型细胞保护剂氨磷汀的药物概况及护理注意事项。
已发表的文章、摘要、专业交流资料、药品制造商信息以及本人在氨磷汀临床研究中的经验。
氨磷汀通过保护正常组织来提高特定抗癌药物对肿瘤细胞的选择性。它适用于减少与顺铂重复给药相关的累积肾毒性，用于放射治疗以及多种恶性肿瘤患者的几种化疗。作为辐射防护剂和细胞毒性化学保护剂使用的氨磷汀研究已证明其对肾毒性、神经毒性、血液毒性（粒细胞减少、白细胞减少和血小板减少）以及耳毒性有防治效果，且不会对肿瘤反应或患者生存产生不利影响。最常见的副作用是低血压、恶心和呕吐（可能很严重）以及血清钙浓度降低。
氨磷汀是一种新型细胞保护剂，是首个具有全血细胞保护作用的此类药物。通过适当的处理和预处理，氨磷汀通常耐受性良好。停药后副作用可逆转。
护士需要了解细胞保护剂这一类新型药物，以便向患者及其家属讲解细胞保护的必要性，使他们能够遵守并参与治疗计划，并确定氨磷汀给药的必要性及处理方法。患者护理方面的关注点包括收缩压降低的风险，这需要进行液体输注和体位管理，以及可能出现的严重恶心和呕吐。
