streptozocin

Contraindicated in:

Hypersensitivity;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Renal impairment (dose ↓ recommended);
Hepatic impairment;
Active infection;
↓bone marrow reserve;
Pedi: Safety and effectiveness not established in children;
Geri: Consider ↓ body mass, age-related ↓ in renal/hepatic/cardiac function as well as concurrent illness and drug therapies in older adults.

Adv. Reactions/Side Effects ⬆ ⬇

Endo: hyperglycemia, HYPOGLYCEMIA (FIRST DOSE)

F and E: hypophosphatemia

GI: nausea, vomiting, diarrhea, duodenal ulcer, HEPATITIS

GU: nephrotoxicity, gonadal suppression, proteinuria

Hemat: anemia, eosinophilia, leukopenia, thrombocytopenia

Local: phlebitis, injection site reactions

Neuro: confusion, depression, lethargy

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

↑myelosuppression with other antineoplastics.
↑risk of nephrotoxicity with other nephrotoxic agents, including aminoglycosides.
Toxicity may be ↑ by concurrent phenytoin therapy.
May ↑ toxicity of doxorubicin.
May ↓ antibody response to live-virus vaccines and ↑ risk of adverse reactions.

Availability ⬆ ⬇

Powder for injection: 1 g/vial

Route/Dosage ⬆ ⬇

IV (Adults ): 500 mg/m²once daily for 5 days every 4–6 wk or 1 g/m²once weekly for 2 wk; then may be ↑ (not to exceed 1.5 g/m²/dose) and given once weekly for 4–6 doses.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits DNA synthesis by cross-linking DNA strands (cell-cycle phase-nonspecific).

Therapeutic effects:

Death of rapidly replicating cells, particularly malignant ones.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: antitumor antibiotics

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Rapidly distributed. High concentrations in liver, pancreas, kidneys, and intestine. Active metabolite enters the CSF.

Metabolism/Excretion: Highly metabolized in liver and kidneys. 10–20% excreted unchanged by the kidneys. Small amounts excreted in expired air (5%) and feces (1%).

Half-Life: 35–40 min.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
IV (effects on blood counts)	unknown	1–2 wk	unknown
IV (tumor response)	17 days	35 days	unknown

Patient/Family Teaching ⬆ ⬇

Instruct patient to notify nurse immediately if pain or redness develops at IV site.
Instruct patient to notify nurse immediately if symptoms of hypoglycemia occur (anxiety; chills; cold sweats; confusion; cool, pale skin; difficulty in concentration; drowsiness; excessive hunger; headache; irritability; nausea; nervousness; shakiness; unusual tiredness; or weakness).
Instruct patient to notify health care professional if ↓ urine output; swelling of lower extremities; yellowing of skin; fever; chills; sore throat; signs of infection; bleeding gums; bruising; petechiae; or blood in urine, stool, or emesis occurs. Caution patient to avoid crowds and persons with known infections. Instruct patient to use soft toothbrush and electric razor. Caution patient not to drink alcoholic beverages or take products containing aspirin or NSAIDs.
Instruct patient not to receive any vaccinations without advice of health care professional.
Rep: May cause fetal harm. Advise females of reproductive potential to use effective contraception during therapy and to avoid breastfeeding during therapy.
Advise patient of need for medical follow-up and frequent lab tests.

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Indications ⬇

Contraind./Precautions ⬆ ⬇