title: Cyclophosphamide-induced facial discomfort.
abstract: OBJECTIVE
  To report the occurrence of cyclophosphamide-induced facial discomfort in patients at our institution, to review previous literature reports, and to discuss possible methods of prevention.
  
  
  METHODS
  An oncology clinic in a university teaching hospital.
  
  
  METHODS
  From January 1990 to March 1993, 14 patients experienced uncomfortable sensations of the skin or mucous membranes associated with cyclophosphamide administration. Details pertaining to each patient are described.
  
  
  METHODS
  Initial interventions included changing the duration of infusion or concentration of cyclophosphamide. We postulated that an anticholinergic medication such as ipratropium bromide may prevent cyclophosphamide-induced facial discomfort.
  
  
  METHODS
  Changing the infusion duration or cyclophosphamide concentration or administering ipratropium bromide intranasally resulted in variable degrees of improvement.
  
  
  CONCLUSIONS
  The number of cyclophosphamide reactions seen at our institution indicates that facial or scalp burning, oropharyngeal tingling, nasal congestion, rhinorrhea, sneezing, and/or lacrimation may occur more frequently than previously noted. Thus, careful questioning is necessary to determine whether these clinical symptoms are present and bothersome in patients treated with cyclophosphamide. Intranasal ipratropium bromide, as well as other measures to prevent or decrease the intensity of cyclophosphamide-induced facial discomfort should be investigated.
authors.affiliation: Department of Pharmacy Practice, University of Illinois at Chicago.
authors.forename: J L
authors.initials: JL
authors.lastname: Kosirog-Glowacki
authors.forename: L R
authors.initials: LR
authors.lastname: Bressler
mesh_terms: D000368:Aged; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D005145:Face; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D009241:Ipratropium / Q000627:therapeutic use; D007765:Lacrimal Apparatus / Q000187:drug effects*; D009297:Nasal Mucosa / Q000187:drug effects*; D010051:Ovarian Neoplasms / Q000188:drug therapy; D012137:Respiratory System / Q000187:drug effects*; D013666:Tears / Q000378:metabolism
chemical_list: D003520:Cyclophosphamide; D009241:Ipratropium