McKenna's Pharmacology for Nursing, 2e

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P A R T 2  Chemotherapeutic agents

TABLE 14.3

DRUGS IN FOCUS Antineoplastic antibiotics (continued)

Drug name

Dosage/route

Usual indications

daunorubicin (generic)

0.5–1 mg/kg/day IV or 2 mg/kg q 4 days IV, or 2.5–3 mg/kg q 7–14 days

First-line treatment of advanced HIV infection and associated Kaposi’s sarcoma Special considerations: Complete alopecia is common, and GI toxicity and bone marrow suppression may also occur; severe necrosis may occur at sites of local extravasation—immediate treatment with corticosteroids, normal saline and ice may help; if ulcerations occur, a plastic surgeon should be called Treatment of a number of leukaemias and cancers; used to induce regression; available in a liposomal form for treatment of AIDS-associated Kaposi’s sarcoma Special considerations: complete alopecia is common; GI toxicity and bone suppression may occur; severe necrosis may occur at sites of local extravasation— immediate treatment with corticosteroids, normal saline and ice may help; if ulcerations occur, a plastic surgeon should be called; toxicity is dose related—an accurate record of each dose received is important in determining dose; severe pulmonary toxicity, alopecia, and injection site and GI toxicity occur Adjunctive therapy in people with evidence of axillary node tumour involvement after resection of primary breast cancer Special considerations: may cause cardiotoxicity and delayed cardiomyopathy; monitor for myelosuppression and hyperuricaemia; severe local cellulitis and tissue necrosis can occur with extravasation Combination therapy for treatment of acute myeloid leukaemia in adults Special considerations: may cause severe bone marrow suppression, which regulates dose; associated with cardiac toxicity, which can be severe; GI toxicity and local necrosis with extravasation are also common; severe necrosis may occur at sites of local extravasation—immediate treatment with corticosteroids, normal saline and ice may help; if ulcerations occur, a plastic surgeon should be called; it is essential to monitor heart and bone marrow function to protect the person from potentially fatal adverse effects Treatment of disseminated adenocarcinoma of the stomach and pancreas

60–75 mg/m 2 as a single IV dose; repeat every 21 days Liposomal form: 30–50 mg/m 2 IV over 1 hour once every 2–4 weeks

doxorubicin (Adriamycin, Caelyx)

epirubicin (Epiccord)

100–120 mg/m 2 IV given in repeated 3–4-week cycles all on day one or divided on days one and eight

idarubicin (Zavedos)

12 mg/m 2 per day IV for 3 days with cytarabine or 30 mg/m 2 /day × 3 days PO

mitomycin (Mitomycin C)

20 mg/m 2 IV as a single dose at 6–8-week intervals

Special considerations: severe pulmonary toxicity, alopecia, and injection-site and GI toxicity occur