2010/06/15

DAUNORUBICIN

Pharmacological action

Antitumor agents from the group of anthracycline antibiotics produced by Streptomyces coeruleorubidis. Cytotoxic effect due to the ability to inhibit the synthesis of DNA, RNA and proteins. The mechanism of action is based on the anthracycline intercalation between adjacent base pairs of the double helix of DNA, which prevents her "deploying" for further replication.


Pharmacokinetics

After i / v administration quickly distributed in the body, especially in the kidneys, spleen, liver, heart. Do not cross the BBB. Metabolised in the liver with the formation of the active metabolite daunorubitsinola.

T 1 / 2 in the initial phase of 45 min, in the final phase - to daunorubicin 18.5 h, for daunorubitsinola 26.7 h for the other metabolites of 55 hours is derived from the kidneys and bile.


Statement

Acute leukemia, lymphogranulomatosis, chorionepithelioma cancer, neuroblastoma, Ewing's tumor, Wilms' tumor, non-Hodgkin's lymphoma.


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 hemopoietic system: anemia, leukopenia, thrombocytopenia.

On the part of the digestive system: nausea, vomiting, diarrhea, stomatitis.

Since the cardiovascular system: heart failure, arrhythmias, rarely - myocarditis, pericarditis.

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

Other: alopecia, allergic reactions, headache.

Local reactions: pain at the injection site, tissue necrosis (for violation of technology introduction).


Contraindications

Leukopenia (leukocyte count below 4000/mkl), thrombocytopenia (platelet count below 120 000/mkl), chronic heart failure in the stage of decompensation, marked disturbances of liver function and / or kidneys, stomach ulcer and duodenal ulcer in acute, pregnancy, increased sensitivity to daunorubicin.


Application of pregnancy and breastfeeding

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

Women of childbearing age should use reliable methods of contraception during therapy daunorubicin.

In experimental studies found teratogenic, embryotoxic effect of daunorubicin.


Cautions

With caution to patients with impaired renal function and / or liver, heart disease (including history), gout or nephrolithiasis (including history), as well as in patients treated with or receiving at present during combination chemotherapy other antitumor drugs, providing myelotoxic action or course of radiotherapy.

Do not recommend the use of Daunorubicin in patients with chickenpox (including recent recover or after contact with sick), with herpes zoster, or other acute infectious diseases.

Before and during treatment requires monitoring of peripheral blood picture, renal function, liver, chest radiography, ECG, echocardiography, determination of the stroke volume of the heart.

The frequency of cardiotoxic side effects increases if the total course dose daunorubicin than 400 mg / m 2 in adults and 300 mg / m 2 in children. Violations of the myocardium, the symptoms of chronic heart failure and other cardiotoxic effects of daunorubicin may occur several months or even years after treatment (especially in children), so control of the functional state of the cardiovascular system should be a long time.

Does not recommend vaccination of the patient or his family.

Do not recommend the use of daunorubicin in patients who previously received complete cumulative doses of doxorubicin. If the resulting course of the cumulative dose of doxorubicin below, the total dose of daunorubicin and doxorubicin should not exceed 550 mg / m 2.

In the first few days of daunorubicin may be painted in the urine red.


Drug Interactions

With the simultaneous use of medications that have myelotoxic action may strengthen the toxic effects.

In the application of cyclophosphamide or doxorubicin increases the risk of cardiotoxic effects.

When combined therapy with methotrexate (or other drugs with hepatotoxic effect) increases the probability of hepatotoxic effects.

Application of daunorubicin with urikozuricheskimi drugs increases the risk of nephropathy.