TAXANES 

*****

        Act by binding to micro-tubules and preventing de-polymerisation into

tubulin dimmers and disrupting mitosis - opposite effect to vinca alkaloids

PACLITAXEL

        Administered by slow intravenous infusion over 3-24h

        Associated with hypersensitivity reactions - risk reduced by pre-treatment

with corticosteroids, H1 and H2 antagonists

        95% protein bound

        Metabolised by hepatic cytochrome P450 dependent pathways. 5-10%

excreted by the kidneys

        Hepatic enzyme inducers accelerate paclitaxel metabolism

        In combination chemotherapy with platinum agents, paclitaxel should be

administered first as this reduces risk of myelotoxicity

        Principal toxicity is neutropaenia - onset 8-10 days after administration with

complete recovery bay 15-21 days

        Other side-effects include asymptomatic bradycardia during administration

and other more serioud brady-arrhythmias including heart block; mucositis
and sensory peripheral neuropathy. Alopecia is almost universal and involves
all body hair sites including eye brows, pubic and axillary hair.

        Very little tendency to cause nausea & vomiting

1
2