Idaruʙiцin
When ATH:
L01DB06
Characteristic.
Synthetic antratziklinovy antibiotic, analog downorubitina, molecular weight 533,96.
Pharmacological action.
Antitumor.
Application.
Sharp myeloid leukemia, lymphoma, lung cancer and breast cancer (an advanced tool).
Contraindications.
Hypersensitivity (incl. to other anthracyclines), the liver and kidneys, Heart Disease (miokardit, heart failure, arrhythmia, myocardial infarction), leukopenia, thrombocytopenia, pregnancy, lactation.
Restrictions apply.
Childhood (Safety and efficacy have not determined), suppression of bone marrow function, enable vetryanaya, herpes zoster (the risk of generalization), infectious diseases (It is necessary to cure before applying idarubitsina), gout or renal calculi in history (the risk of hyperuricemia).
Pregnancy and breast-feeding.
Contraindicated in pregnancy.
Category actions result in FDA - D. (There is evidence of the risk of adverse effects of drugs on the human fetus, obtained in research or practice, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk, if the drug is needed in life-threatening situations or severe disease, when safer agents should not be used or are ineffective.)
At the time of treatment should stop breastfeeding.
Side effects.
Cardio-vascular system and blood (hematopoiesis, hemostasis): cardiotoxicity (arrhythmia, heart failure, breathlessness, swelling of feet and ankles), mielosuprescia, gemorragii.
From the digestive tract: nausea, vomiting, abdominal pain, inflammation of the mucous membrane of the mouth, esophagitis, diarrhea, increased liver enzymes and bilirubin (in 10-30 % cases).
With the genitourinary system: giperurikemiya or nephropathy, associated with increased production of uric acid (joint pain, lower back or side).
Other: severe infections with possible fatal consequences, fever, chills, baldness, peeling of the skin, skin rash, headache, less frequently — jekstravazat or tissue necrosis, perifericheskaya neuropathy, recurrence of radiation erythema (darkening or redness of the skin).
Cooperation.
Compatible with other chemotherapeutical means. Incompatible (you can not mix) Heparin (a precipitate), with alkaline solutions (collapses). Ters protivopodagricescuu effectiveness allopourinola, colchicine, sulifinpirazona. Other drugs, causing bone marrow suppression, and radiation therapy potenziruut oppression of bone marrow. With the introduction of live viral vaccines possible intensification of vaccine virus replication and its side effects, inactivated vaccines - reduction of production of antiviral antibodies.
Overdose.
Symptoms: prolonged mielosuprescia with increased gastrointestinal toxic manifestations, arrhythmia (which can be fatal).
Treatment: maintenance therapy (transfusion of thrombocyte mass, use of antibiotics, symptomatic treatment of mucositis). The specific antidote is absent.
Dosing and Administration.
Inside, proglatawaya entirely with a little water, adult on 30 mg / m2 /day for 3 days. B / (very slow) by 10/8/12-10-12 mg/m2 daily for 3-5 days in the form alone or in combination with citarabinom (or with other agents).
Precautions.
Be wary appoint patients with a level of bilirubin in blood plasma of more 34,2 mmol / l, having passed a course of radiation therapy or therapy antratziklinami (Daunorubicin or doxorubicin), After bone marrow transplantation, older patients 60 years (increased risk of cardiotoxicity, reduced bone marrow reserves, probable age of renal dysfunction).
During treatment to monitor heart function, liver and kidneys. Requires strict control of the hematological status, including granulocytes, erythrocytes and platelets.
The appearance of signs of depression of bone marrow function, unusual bleeding or hemorrhage, degteobraznogo black stool, blood in the urine or feces or point of red spots on the skin require immediate doctor's advice.
To prevent secondary gieperriquemii recommended the appointment allopourinola and adequate fluid intake during treatment. In patients with severe inflammation of mucous membranes of the oral cavity repeated course is possible with full removal of similar adverse reactions (the dose must be reduced by 25%).
Dental procedures should be completed before the start of therapy or deferred until the normalization of the blood picture (possible increase in the incidence of microbial infections, slowing the healing process, krovotochivosty right). In the course of treatment must be careful when using toothbrushes, threads or toothpicks.
Avoid falling drug beneath the skin or soft tissue. In the formation of extravasates (burning or sharp pain at the injection site) infusion should cease immediately and resume it in another vein. If any signs of local reaction (pain, эritema, edema) you must inform the doctor.
During the period of treatment is not recommended vaccination virus vaccines, Avoid contact with people, received the vaccine against polio, patients with bacterial infections. During treatment is recommended to use contraception.
Cautions.
Applying idarubitsina should be under the supervision of specialists, with experience of chemotherapy of malignant diseases, with the usual precautions when cooking, dilution of injectable solutions (in the sterile box with the use of protective eyewear, masks and disposable gloves) and disposal of needles, syringes, bottles, ampoules and the remainder of the unused product. In the event of accidental ingestion of powder or solution on the skin or mucous membranes must be thoroughly rinsed with water.
For treatment of apparent or presumptive subcutaneous infiltration on the affected area with ice packs (on 30 mines immediately after the education ekstrawazata, then 30 m 4 twice a day for 3 days).
Cooked solution should be stored at a temperature of 2-8° c for no more 24 no.
It should be taken into account, that during 1-2 days after the introduction of the urine becomes red.
