Optymalizacja terapii lekami kardiologicznymi stosowanymi w praktyce onkologicznej
Optimisation of cardiovascular drugs therapy applied in oncology. Cardiac injury is the often event observed during and after therapy of oncological diseases. Cardiotoxycity of cytostatics may manifests as ischeamic heart disease with its acute form such cardiac infarction, may also occurs as cardiac rhythm disturbances and blood hypertension, or leads to heart insufficiency. During treatment of these states are, among different drugs, administered also drugs with genetically determined metabolism. Genetically determined differences in drug metabolism may influence either efficacy of the pharmacological treatment as enhance the risk of occurrence of successive complications. Adverse events or ineffective treatment lead to worsening of medical status of patients, sometimes even to death. Cytochrome P-450 enzymes are involved in oxidative metabolism process of many drugs used in the therapy of cardiovascular system diseases. Its izoenzymes: CYP2D6, CYP2C19 and CYP2C9 exhibit genetically determined polymorphism with consequence of changes of velocity of biotransformation influencing the profile of pharmacological activity of drugs. To drugs used in cardiology, metabolized by enzymes with genetically determined activity, belong: some beta adrenolitics, antiarhythmic drugs, anticoagulants, some diuretics and statins. Taking into account genetically determined predispositions of patients to drugs biotransformations should be the part of therapy optimisation, especially in oncology.