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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
doxorubicin
(Adriamycin, Caelyx)
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
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
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
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
idarubicin (Zavedos)
12 mg/m
2
per day IV for 3 days with cytarabine
or 30 mg/m
2
/day × 3 days PO
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
mitomycin (Mitomycin C)
20 mg/m
2
IV as a single dose at 6–8-week
intervals
Treatment of disseminated
adenocarcinoma of the stomach and
pancreas
Special considerations:
severe
pulmonary toxicity, alopecia, and
injection-site and GI toxicity occur
