SIADH is caused by all EXCEPT:
Actinomycin D (Dactinomycin) :It is a very potent antineoplastic drug, highly efficacious in Wilms&; tumour and rhabdomyosarcoma. It has also produced good results in Mtx resistant choriocarcinoma and few other malignancies. Prominent adverse effects are vomiting, stomatitis, Vincristine ( oncovin): It is a rapidly acting drug, very useful for inducing remission in childhood acute leukaemia, but is not good for maintenance therapy. Other indications are lymphosarcoma, Hodgkin&;s disease, Wilms&; tumour, Ewing&;s sarcoma and carcinoma lung. Prominent adverse effects are peripheral neuropathy and alopecia. Bone marrow depression is minimal. diarrhoea, erythema and desquamation of skin, alopecia and bone marrow depression. Vinblastine: It is primarily employed with other drugs in Hodgkin&;s disease and testicular carcinoma. Bone marrow depression is more prominent while neurotoxicity and alopecia are less marked than with vincristine. Cyclophosphamide: It is inactive as such produces few acute effects and is not locally damaging. Transformation into active metabolites (aldophosphamide, phosphoramidemustard) occurs in the liver, and a wide range of anti tumour actions is exeed. It has prominent immunosuppressant propey. Thus, it is one of the most popular anticancer drugs. It is less damaging to platelets, but alopecia and cystitis (due to another metabolite acrolein) are prominent. Chloramphenicol retards the metabolism of cyclophosphamide. Hyponatremia is a common potential complication in cancer patients. It can be related to anticancer medical therapy. Vincristine, vinblastine, cisplatin and cyclophosphamide are the chemotherapeutic agents most frequently associated with hyponatremia. More recently, analogs such as carboplatin and ifosfamide have also been. incriminated. Hyponatremia is also associated with new immunomodulators (interferon, interleukin-2 and levamisole) and monoclonal antibodies. The mechanism by which all these drugs act on the sodium steady state is only paially known. The syndrome of inappropriate antidiuretic hormone secretion is described secondary to vinca alkaloids and cisplatin and possibly with alkylating agents. Renal salt wasting is described with platinum compounds. REFERENCE: ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:822,825,826
Vincristine
Vinblastine
Actinomycin D
Cyclophosphamide
Chemotherapy