Vynblastyn

When ATH:
L01CA01

Characteristic.

The antitumor agent of plant origin. Alkaloid, isolated from the periwinkle plant pink (Vinca rosea L.). Vinblastine sulfate - white or white with blue polka crystalline powder. Hygroscopic, sensitive to light. Easily soluble in water, Soluble in methanol, practically insoluble in alcohol.

Pharmacological action.
Antitumor, cytostatic.

Application.

Limfogranulematoz, limfotsitarnaya lymphoma, lymphosarcoma, retikulosarkoma, nehodzhkinskaya lymphoma, gistiotsitarnaya lymphoma, chronic leukemia, granulosarcoid, Testicular germ cell tumors, germ cell tumors of the ovary, testicular tumor, multiple myeloma, horionэpitelioma, Kaposi's sarcoma, Letterer's disease - Gray, sympathicoblastoma, kidney cancer, bladder cancer, lung cancer.

Contraindications.

Hypersensitivity, leukopenia, infectious diseases, suppression of bone marrow function, pregnancy, lactation.

Pregnancy and breast-feeding.

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.)

Side effects.

From the nervous system and sensory organs: headache, dizziness, defeated VIII pair of cranial nerves, depression, paraesthesia, reduction of deep tendon reflexes, peripheral neuritis, convulsions.

Cardio-vascular system and blood (hematopoiesis, hemostasis): hypertension, cerebrovascular accident, Raynaud's disease (increased symptoms), myocardial infarction, leukopenia, granulocytopenia, anemia, thrombocytopenia.

From the digestive tract: loss of appetite, nausea, vomiting, stomatitis, abdominal pain, pseudoileus, diarrhea, hemorrhagic enterocolitis, jaundice, bleeding from the gastrointestinal tract.

From the respiratory system: acute respiratory failure, bronchospasm, progressive shortness of breath, pharyngitis.

Other: generalized weakness, ossalgia, pain in the jaw, inappropriate secretion of antidiuretic hormone, albuminuria, nosebleeds, skin ulceration, photophobia, alopecia, hives, inflammation, phlebitis and necrosis at the injection site.

Cooperation.

While the use of mitomycin C increases the risk of respiratory depression, bronchospasm (especially in predisposed patients); against the background of radiation therapy and taking other action mielodepressantov enhanced mielotoksicskie. Reduces the effects of anticonvulsants. Care should be taken in the combined use with other potentially ototoxic drugs (eg, containing platinum and others.).

Overdose.

Symptoms: leukopenia, peripheral nerve, convulsions, coma.

Treatment: simptomaticheskaya therapy, monitoring vital functions, careful monitoring of peripheral blood, if necessary - blood transfusion. No specific antidote. Hemodialysis nyeeffyektivyen.

Dosing and Administration.

B /, bolus or infusion, 1 once a week. Apply freshly prepared solution. The dose is determined individually, taking into account the clinical picture, condition of the patient and the number of leukocytes in peripheral blood. The initial dose for adults is 0.025-0.1 mg / kg (3,7 mg / m²), daily control the number of leukocytes in peripheral blood: if their number within a week does not fall below 2000-3000 cells / μl - re-inject 0,15 mg / kg. Further (with insufficient therapeutic effect and the absence of leukopenia) the dose can be increased to 0,2 mg / kg. After achieving visible regression of tumor growth, they switch to a maintenance dose - 0,15 mg / kg every 7-14 days.

Another possible treatment regimen: initial dose - 0.025-0.1 mg / kg, further (with daily monitoring of leukocytes in peripheral blood) injected every day in a dose 2,5 mg and gradually increase the dose to 5 mg (no more). Therapeutic effect of the introduction of such a scheme is achieved in 2-3 days. After normalization of white blood cells, treatment can proceed, using a lower dose.

Children appoint the initial dose 0, 075 mg / kg (2,5 mg / m²) 1 once a week, reinjected after normalization of leukocytes in peripheral blood (usually at 3-7 day); if after the first injection, the number of leukocytes is not reduced, increase the dose.

Precautions.

With extreme caution should be used in elderly patients (possible hypersensitivity).

You should not assign vinblastine on the background radiation therapy or drugs, TARGET ORGANS hematopoiesis (mutual reinforcement myelotoxicity), with the exception of special programs of chemotherapy. The treatment must be monitored daily number of leukocytes in the blood (at least leukopenia 3000 in 1 l advisable to take a break and prescribe antibiotics).