A 54-year-old woman with lymphoma receiving high-dose cyclophosphamide presents with dysuria and gross hematuria. Vital signs show BP 128/82, HR 92, RR 18, Temp 37.2°C, SpO2 98% on room air. Urinalysis reveals 50 RBCs/hpf and blood 3+ with negative nitrites and leukocyte esterase. Cystoscopy demonstrates hemorrhagic cystitis. She denies fever or flank pain. Which medication reduces this chemotherapy-induced bladder toxicity when given prophylactically?

  1. A)Amifostine
  2. B)MesnaGABARITO
  3. C)Filgrastim
  4. D)Dexrazoxane
  5. E)Leucovorin

Explicação

Cyclophosphamide and ifosfamide produce the toxic metabolite acrolein, which can cause hemorrhagic cystitis. Mesna binds acrolein in the urine and protects the bladder. Ver explicação completa e trilha adaptativa →

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