Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Medline ® Abstract for Reference 252

of 'Overview of neurologic complications of non-platinum cancer chemotherapy'

Successful treatment of ifosfamide neurotoxicity with dexmedetomidine.
Bernard PA, McCabe T, Bayliff S, Hayes D Jr
J Oncol Pharm Pract. 2010;16(4):262. Epub 2010 Jan 29.
Neurotoxicity related to the use of ifosfamide is a well-known complication. While the use of methylene blue is a known antidote, symptomatic treatment of the central nervous system (CNS) effects can be challenging. We present a case of class IV neurotoxicity with the successful treatment of symptomology. In this case report we present a 2-year-old female with relapsed alveolar rhabdomyosarcoma undergoing palliative chemotherapy. Patient received ifosfamide in addition to etoposide and mesna. The patient developed acute hallucinations, agitation, and delirium. The patient was transferred to the pediatric intensive care unit where she was administered dexmedetomidine overnight in addition to methylene blue. The patient awoke the next morning following discontinuation of the dexmedetomidine infustion and subsequently had no further central nervous system effects. This case demonstrates the novel use of an alpha-2 agonist in the treatment of neurotoxicity related to ifosfamide administration.
Department of Pediatrics, University of Kentucky College of Medicine, Lexington, KY 40536, USA. philip.bernard@uky.edu