2010/06/09

DACTINOMYCIN

Pharmacological action

Antitumor agents from the group aktinomitsinovyh antibiotics. Inhibits cell proliferation through the formation of a stable complex with DNA and DNA-dependent violations of RNA synthesis. Provides an immunosuppressive effect.


Pharmacokinetics

To a large extent associated with the proteins of tissues. Metabolised weak. Do not cross the BBB. T 1 / 2 of 36 hours is excreted in the bile - 50% as unchanged by the kidneys - 10% unchanged.


Statement

Wilms' tumor, rhabdomyosarcoma, choriocarcinoma (including metastatic), metastatic carcinoma neseminomatoznaya testicles, Kaposi's sarcoma, Ewing's tumor, melanoma, racemose sarcoma, ovarian cancer, endometrial cancer (in a combination and / or adjuvant therapy).


Dosage regimen

Set individually, depending on the testimony and stage of disease, the state of the hemopoietic system, the scheme of anticancer therapy.


Side effect

On the part of the digestive system: nausea, vomiting, cheilitis, esophagitis, ulcerative stomatitis, pharyngitis, anorexia, dysphagia, abdominal pain, diarrhea, erosive and ulcerative lesions gastrointestinal tract, proctitis.

On the part of the hemopoietic system: anemia (up to aplastic anemia), agranulocytosis, leukopenia, thrombocytopenia, pancytopenia, reticulopenia.

On the part of the reproductive system: azoospermia, amenorrhea.

Dermatological reactions: alopecia, skin rashes, acne.

Local reactions: tissue necrosis (with extravasation).

Other: malaise, fatigue, lethargy, fever, muscle pain, hypocalcemia, hyperuricemia, and nephropathy.


Contraindications

Chickenpox, herpes zoster, marked disturbances of liver function, pregnancy, sensitivity to dactinomycin. Do not use in newborns and infants.


Application of pregnancy and breastfeeding

Dactinomycin contraindicated in pregnancy. If necessary, use during lactation should stop breastfeeding.

Women of childbearing age should use reliable methods of contraception in the period of receiving dactinomycin.

In experimental studies revealed teratogenic, mutagenic and embryotoxic action of dactinomycin.


Cautions

The treatment is conducted under the strict supervision of a doctor who has experience working with antitumor agents.

With careful application dactinomycin in patients with gout or nephrolithiasis (including history).

During the period of treatment necessary to control the degree mielodepressii, as well as liver and kidney function, the concentration of uric acid in blood plasma.

It has been reported that dactinomycin may distort the results of biological samples used to determine the concentration of antibacterial drugs in blood plasma.

The therapy is not recommended to vaccinate the patient and his family.

In the application of dactinomycin in conjunction with radiation therapy may be more frequent toxic reactions of the gastrointestinal tract and bone marrow. Special caution is required when appointing dactinomycin during two months of radiation therapy of right-sided Wilms tumor, as it marked hepatomegaly and elevated activity of AST.

Dactinomycin is also used by the method of isolated perfusion and injected alone or in combination with other antitumor drugs or as a palliative treatment or as an adjunct to surgical treatment. When you enter through perfusion in some cases dactinomycin is more effective temporary improvement than its systemic use.


Drug Interactions

With simultaneous application of dactinomycin chemotherapy, providing myelotoxic effect, possibly strengthening the toxic effect.

When combined therapy with doxorubicin may gain cardiotoxic action.

At simultaneous application with urikozuricheskimi means increased risk of nephropathy.