Dangerous Drug: DOXOrubicin Hydrochloride



Dangerous Drug: DOXOrubicin Hydrochloride





(dox oh roo’ bi sin)

Doxil

PREGNANCY CATEGORY D


Drug Classes

Antibiotic

Antineoplastic


Therapeutic Actions

Cytotoxic: Binds to DNA and inhibits DNA synthesis in susceptible cells, causing cell death.


Indications



  • To produce regression in the following neoplasms: ALL, AML, Wilms tumor, neuroblastoma, soft tissue and bone sarcoma, breast carcinoma, ovarian carcinoma, transitional cell bladder carcinoma, thyroid carcinoma, Hodgkin and non-Hodgkin lymphomas, bronchogenic carcinoma



  • Liposomal form: Treatment of AIDS-related Kaposi sarcoma, ovarian cancer that has progressed or recurred after platinum-based chemotherapy; multiple myeloma in combination with bortezomib in patients who received prior therapy



Contraindications and Cautions



  • Contraindicated with allergy to doxorubicin hydrochloride, malignant melanoma, kidney carcinoma, large bowel carcinoma, brain tumors, CNS metastases, myelosuppression, cardiac disease (may predispose to cardiac toxicity), pregnancy, lactation.


  • Use cautiously with impaired hepatic function, previous courses of doxorubicin or daunorubicin therapy (may predispose to cardiac toxicity), prior mediastinal irradiation, concurrent cyclophosphamide therapy (predispose to cardiac toxicity).


Available Forms

Powder for injection—10, 20, 50 mg; injection (aqueous)—2 mg/mL; preservative-free injection—2 mg/mL; injection (lipid)—2 mg/mL


Dosages

Adults

60–75 mg/m2 as a single IV injection administered at 21-day intervals. Alternate schedule: 30 mg/m2 IV on each of 3 successive days, repeated every 4 wk.

Liposomal form



  • AIDS-related Kaposi sarcoma: 20 mg/m2 IV every 3 wk starting with initial rate of 1 mg/min. If no adverse effects, increase rate to complete dose in 1 hr.


  • Ovarian cancer: Initially 50 mg/m2 IV at 1 mg/min; if no adverse effects, complete infusion in 1 hr. Repeat every 4 wk.


  • Multiple myeloma: 30 mg/m2 on day 4 following bortezomib dose; start at 1 mg/min. Repeat every 3 wk.

Patients with elevated bilirubin

For serum bilirubin 1.2–3 mg/100 mL, use 50% of normal dose. For serum bilirubin exceeding 3 mg/100 mL, use 25% of normal dose.

Tags:
Jul 20, 2016 | Posted by in NURSING | Comments Off on Dangerous Drug: DOXOrubicin Hydrochloride

Full access? Get Clinical Tree
Get Clinical Tree app for offline access