单词 | etoposide |
释义 | etoposideetoposideetoposide[e-to-po´sīd]etoposide (VP-16-213)etoposide phosphatePharmacologic class: Podophyllotoxin derivative Therapeutic class: Antineoplastic Pregnancy risk category D ActionDamages DNA before mitosis by inhibiting topoisomerase II enzyme. This action impairs DNA synthesis and inhibits selected cancer cell growth. Cell-cycle-phase specific. AvailabilityCapsules: 50 mg Injection: 20 mg/ml Powder for injection (phosphate): 100 mg in single-dose vials Indications and dosages➣ Testicular cancer Adults: 50 to 100 mg/m2 I.V. daily for 5 days. Or 100 mg/m2 I.V. on days 1,3, and 5, with course repeated q 3 to 4 weeks. ➣ Small-cell carcinoma of lung Adults: 70 mg/m2 (rounded up or down to nearest 50 mg) P.O. daily for 4 days, then a maximum of 100 mg/m2 (rounded up or down to nearest 50 mg) P.O. daily for 5 days every 3 to 4 weeks. Alternatively, 35 mg/m2 I.V. daily for 4 days, then a maximum of 50 mg/m2 I.V. daily for 5 days q 3 to 4 weeks. Dosage adjustment• Renal impairment Off-label uses• AIDS-related Kaposi's sarcoma • Wilms' tumor • Neuroblastoma • Malignant lymphoma • Hodgkin's disease • Ovarian neoplasms Contraindications• Hypersensitivity to drug or its components PrecautionsUse cautiously in: • active infections, decreased bone marrow reserve, renal or hepatic impairment • pregnant patients and patients with childbearing potential • breastfeeding patients • children (safety and efficacy not established). Administration• For I.V. concentrations above 0.4 mg/ml, mix each 100 mg with 250 to 500 ml of dextrose 5% in water or normal saline solution, to help prevent crystallization. • Give I.V. infusion over 30 to 60 minutes. Don't use in-line filter. See Avoid rapid infusion, which may cause severe hypotension and bronchospasm. • Administer with antiemetics, as prescribed. • Wear disposable gloves when handling. If drug comes into contact with skin, wash thoroughly with soap and water. • Be aware that drug is given with other chemotherapeutic agents. ![]() Adverse reactionsCNS: drowsiness, fatigue, headache, vertigo, peripheral neuropathy CV: hypotension (with I.V. use), heart failure, myocardial infarction GI: nausea, vomiting, stomatitis GU: sterility Hematologic: anemia, leukopenia, thrombocytopenia, bone marrow depression Hepatic: hepatotoxicity Metabolic: hyperuricemia Musculoskeletal: muscle cramps Respiratory: pulmonary edema, bronchospasm Other: alopecia, fever, phlebitis at I.V. site, allergic reactions including anaphylaxis InteractionsDrug-drug. Live-virus vaccines: increased risk of adverse reactions Other antineoplastics: additive bone marrow depression Drug-diagnostic tests. Hemoglobin, neutrophils, platelets, red blood cells, white blood cells: decreased values Uric acid: increased level Patient monitoringSee Monitor blood pressure during and after infusion. Stop infusion if severe hypotension occurs. • With I.V. use, monitor infusion rate closely to prevent infusion reactions. • Throughout infusion, check I.V. site for extravasation, which may cause thrombophlebitis. See Keep diphenhydramine, hydrocortisone, epinephrine, and artificial airway at hand in case anaphylaxis occurs. • Assess for CNS adverse effects. Assist patient during ambulation as needed. See Monitor for signs and symptoms of bone marrow depression. • Monitor CBC, liver function tests, and blood urea nitrogen and creatinine levels. Report platelet count below 50,000/mm3 or neutrophil count below 500/mm3. Patient teaching• Instruct patient to inspect mouth daily for ulcers and bleeding gums. See Tell patient to immediately report difficulty breathing or signs and symptoms of allergic reaction. See Caution female of childbearing age to avoid pregnancy and breastfeeding during drug therapy. • Instruct patient to move slowly when sitting up or standing, to avoid lightheadedness or dizziness from sudden blood pressure decrease. • Tell patient drug may cause hair loss. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above. etoposide(ē′tə-pō′sīd′)etoposideOncology A chemotherapeutic active against monocytic leukemia, CNS lymphoma, refractory small cell carcinoma, testicular CA, and KS, which may be co-administered with cyclophosphamide and doxorubicin Adverse effects BM toxicity, hair loss, nausea, incoordination, stomatitis, dyspnea, anorexia. See AIDS, ALL.etoposideAn anticancer drug derived from a plant poison epipodophyllotoxin. It is used chiefly in the maintenance treatment of acute leukaemia after remission has been achieved and the bone marrow has recovered. It has been given by mouth to treat lung cancer. The drug is on the WHO official list. A brand name is Vepeside.See VP-16 |
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