Abstract

GONZALEZ-CARRASCOSA VEGA, Triana et al. Customization of doses in oncological patients with impaired hepatic function. Rev Cubana Farm [online]. 2013, vol.47, n.4, pp.517-526. ISSN 0034-7515.

Objective: to determine the cytostatic drugs requiring dose adjustment in patients with impaired hepatic function. Methods: aliterature review of all the papers about dosage of cytostatic drug in patients with impaired hepatic function published till July 2011 in Pubmed search was made. They were assessed as rated by the Scottish Intercollegiate Guidelines Network. An index of pharmacotherapy recommendation strength was developed, for which the grade of recommendation of the evidence found and the number of patients included in the studies were then correlated, ranking the strength of recommendation for each drug as high, medium or low. Results: atotal of 46 publications with information about dosing in liver failure were found for 17 cytostatic drugs. Sixty seven percent (n= 31) of the publications were cohort studies with a level of evidence 2+. High strength recommendations could not been established, but moderate strength (76 %; 13 drugs) and low strength (24 %; 4 drugs) recommendations were finally established. Conclusions: although level of evidence was low, dosage recommendations of cytostatic drugs to be used in liver failure patients were established to improve safety in the use of these drugs in the stated group of patients.

Keywords : cytostatic; impaired hepatic function; dosage adjustment; levels of evidence.

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