Vynkrystyn

When ATH:
L01CA02

Characteristic.

The antitumor agent of plant origin. Alkaloid, contained in the plant periwinkle pink (Vinca rosea L.). Vincristine liofilizirovanny powder- white or slightly yellowish. Vincristine sulfate is readily soluble in water (1:2), Soluble in methanol, xloroforme (1:30), slightly soluble in ethanol, practically insoluble in ether.

Pharmacological action.
Antitumor, cytostatic.

Application.

Acute leukemia, acute lymphoblastic leukemia in children (combination therapy), limfogranulematoz (Hodgkin's disease), non-Hodgkin's lymphoma, multiple myeloma, raʙdomiosarkoma, sarcomas of bone and soft tissue, sarkoma Juinga, mycosis pellets, mammary cancer, small cell lung cancer, melanoma, granulosarcoid, Kaposi's sarcoma, cancer of the renal pelvis and ureter, bladder cancer, sympathicoblastoma, Wilms' tumor, cervical cancer, uterine sarcoma, testicular germ cell tumors and ovarian cancer, horionepitelioma uterus, ependymoma, meningoblastoma, pleurisy tumor etiology, genital cancers in girls, idiopaticheskaya trombotsitopenicheskaya purpura (in the absence of the effect of splenectomy and treatment with glucocorticoids).

Contraindications.

Hypersensitivity, infectious diseases, neurodystrophic disease (in particular, demyelinating form syndrome behind-Marie-Tuta), intrathecal (possible death), pregnancy, lactation.

Restrictions apply.

Giperʙiliruʙinemija, obstructive jaundice, bone marrow hypoplasia, prior radiotherapy hepatobiliary region and the spinal cord, advanced age.

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: cramps with an increase in blood pressure, paraesthesia, headache, loss of sensation, neuralgia, neuropathy, violation of the motor function, decrease in muscle strength, ataxia, reduction of deep tendon reflexes, isolated paresis, paralysis of the muscles, dysfunction of the cranial nerves (especially VIII pair), depression, hallucinations, sleep disturbance, diplopia, ptosis, transient blindness and optic atrophy.

Cardio-vascular system and blood (hematopoiesis, hemostasis): labile blood pressure, in patients with previously irradiated mediastinum in the application of chemotherapy to include vincristine may cause angina and myocardial infarction, moderate leukopenia, thrombocytopenia and anemia.

From the respiratory system: acute respiratory failure, breathlessness, bronchospasm (especially when combined with mitomycin).

From the digestive tract: nausea, vomiting, anorexia, stomatitis, spasm of smooth muscles of the digestive tract, abdominal pain, constipation or diarrhea, pseudoileus (especially in children), necrosis or perforation of the intestinal wall.

With the genitourinary system: dizurija, urinary retention due to bladder atony, ostraya mochekislaya nephropathy, Azoospermia, amenorrhea.

Allergic reactions: anaphylaxis, rash, angioedema.

Other: alopecia, feeling the heat, syndrome of inappropriate secretion of antidiuretic hormone, giponatriemiya, polyuria, weight loss; local reactions at the contact under the skin - cellulite, phlebitis, necrosis.

Cooperation.

Vincristine can reduce anticonvulsant activity of phenytoin (reduces its concentration in the blood). Vincristine may increase the concentration of uric acid in the blood (in the treatment of hyperuricemia and gout may need dose adjustment protivopodagricakih funds). Together with the admission urikozuricheskimi means increased risk of nephropathy, associated with increased production of uric acid. The most preferred drug for the prevention or elimination of hyperuricemia, related to vincristine therapy is allopurinol. When concomitantly with other drugs, providing neurotoxic effects (eg, Isoniazid, itraconazole) or irradiation of the spinal cord enhanced neurotoxicity. Несовместим с L-аспарагиназой (the latter can only enter with an interval of 12-24 hours) Perhaps additive neurotoxic action. Against the background of mitomycin increases the likelihood of developing respiratory depression and bronchoconstriction (especially in predisposed patients). Pharmaceutical incompatible with a solution of furosemide (possible precipitation). Glucocorticoids, androgens, oestrogens and progestogens potentiate the action of vincristine.

Overdose.

Symptoms: increased severity of side effects.

Treatment: Warning syndrome of ADH secretion (limiting fluid intake, diuretics), pentobarbital (to prevent seizures) and etc. means symptomatic therapy, intestinal lavage (prevention of obstruction), If necessary, the appointment of calcium folinata (I / dose 100 mg every 3 h for 24 no, then every 6 h for, at least, 2 Nights), monitoring function of the cardiovascular system, haematological monitoring. Spetsificheskiy antidote unknown. Hemodialysis nyeeffyektivyen.

Dosing and Administration.

B /, bolus or infusion, 1 once a week. The mode set individually. Under dose for adults is 1-1, 4 mg/m² (maximum — 2 mg / m²), the exchange rate is 10-12 mg/m². If abnormal liver function using smaller doses.

Children designate depending on body weight, 1 once a week for 4-6 weeks.

Intrapleural - 1 mg.

Precautions.

For the prevention of acute urate nephropathy is required to regularly monitor the levels of uric acid in the plasma and urine output to ensure adequate. Do not appoint on a background of radiotherapy or use of drugs, TARGET ORGANS hematopoiesis (due to a possible increase mutual myelotoxic action), with the exception of special programs with personalized chemotherapy dose selection. During treatment should monitor the peripheral blood (leukopenia when caution, it is advisable to take a break and prescribe antibiotics), bilirubin and sodium ion concentration in the serum (for correction of hyponatremia recommended the introduction of appropriate solutions). Any complaints of eye pain or decreased vision require careful ophthalmic examination. The neurotoxicity of vincristine may adversely affect the speed of psychomotor reactions and the ability to drive vehicles. The elderly and patients with a history of neurological diseases are more susceptible to the neurotoxic effects.

Invalid / m administration because of possible tissue necrosis.

Cautions.

Avoid contact with eyes vincristine solution.