多种成像在DEFEROXAMINE相关的眼睛毒性:由于SUPRATHERPEUTIC剂量和进展的快速发展,尽管剂量减少
Elisah M Huynh1, Mahmood Khan2, Yanhan Ren1
1Department of Ophthalmology and Visual Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States.
Retinal cases & brief reports
|March 11, 2025
概括
德费洛克萨可以导致逐渐的视网膜损伤,包括RPE变化和光受体损失,即使在剂量减少或停止服用药物后. 这种毒性会影响铁过载患者的视力.
科学领域:
- 眼科医生 眼科 眼科
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 德菲洛克萨是一种合剂,用于治疗铁过载,常见于β-thalassemia患者.
- 超治疗剂量的德费洛克萨明可以导致严重的不良反应,包括眼睛毒性.
- 了解脱胺诱导的视网膜毒性进展对于患者管理至关重要.
研究的目的:
- 为了描述与deferoxamine相关的视网膜毒性的演变.
- 评估剂量减少和停止对毒性进展的影响.
- 为了研究德费洛胺诱导的眼部变化的可逆性.
主要方法:
- 观察性临床病例报告.
- 详细的患者病史,包括β-thalassemia和输血要求.
- 眼科检查以评估视觉敏度和视野.
主要成果:
- 一名59岁的女性经历了外周视野损失和近视视障碍在超治疗性德菲洛克萨明剂量后.
- 观察到渐进的视网膜色素表皮质 (RPE) 加厚和光感受器损失.
- 视力从20/25和20/30下降到20/60和20/50,尽管剂量减少.
结论:
- 使用deferoxamine可以导致RPE变化,加厚和光受体损失.
- 这些眼部毒性甚至在降低德费洛克萨剂量或停止药物使用后也可能进展.
- 这些发现突出了由于德费洛克萨明毒性的不可逆转视力损伤的可能性.
相关概念视频
Desensitization and Tachyphylaxis
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
Several...
Several...
Drugs Affecting Neurotransmitter Release or Uptake
Certain drugs can affect how neurotransmitters called catecholamines, are released or taken back up in the adrenergic neuron. They can have different effects on the body's sympathetic transmission. Reserpine, a natural compound found in the Rauwolfia shrub, blocks a transporter called vesicular monoamine transporter (VMAT), which leads to a buildup of catecholamines in the cell and reduces sympathetic transmission. Another drug called guanethidine works in multiple ways, including blocking...
Enhanced Elimination of Poison
Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Drugs Affecting Neurotransmitter Synthesis
Drugs affecting neurotransmitter synthesis can impact the adrenergic neuron and the synthesis of neurotransmitters. For example, α-methyltyrosine and carbidopa target specific enzymes involved in catecholamine synthesis. α-methyltyrosine inhibits the enzyme tyrosine hydroxylase, which converts tyrosine into dopamine. By blocking this enzyme, α-methyltyrosine reduces dopamine production and other catecholamines. Carbidopa, on the other hand, inhibits the enzyme dopa decarboxylase, which converts...
Drug Toxicity: Overview
Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
Drug Toxicity: Dose-Dependent Reactions
Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...


