The side effects of chemotherapeutic agents

SummaryIt is becoming increasingly common for patients who have had or who are receiving chemotherapy to present for anaesthesia or for potential admission to the intensive care unit.To effectively manage these patients care, it is important to be aware of both the short- and long-term side effects of chemotherapeutic agents, and to understand the physiological changes that may occur during the course of their treatment.Complications such as nausea and vomiting and diarrhoea are well recognised and may cause metabolic disturbances that are relevant to anaesthesia and critical care. However, many treatments have side effects which are more organ specific and severity may not necessarily be dose related. These include cardiomyopathies and irreversible lung fibrosis. Over 200 chemotherapeutic agents are available, and there has recently been a proliferation of agents such as the monoclonal antibodies (e.g. Herceptin) whose side-effect profile, though potentially of great relevance, is not widely known.