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硫酸长春新碱VINCRISTINE(VINCASAR GENERIC)

2012-08-14 11:45:16  作者:新特药房  来源:互联网  浏览次数:63  文字大小:【】【】【
简介:部分中文硫酸长春新碱处方资料(仅供参考)药物名称:硫酸长春新碱英文名:Vincristine Sulfate类别:抗肿瘤植物成分药药理毒理:长春新碱为夹竹桃科植物长春花中提取的有效成分。抗肿瘤作用靶点是微管,主要抑 ...
部分中文硫酸长春新碱处方资料(仅供参考)
药物名称:硫酸长春新碱
英文名:Vincristine Sulfate
类别:抗肿瘤植物成分药
药理毒理:长春新碱为夹竹桃科植物长春花中提取的有效成分。抗肿瘤作用靶点是微管,主要抑制微管蛋白的聚合而影响纺锤体微管的形成。使有丝分裂停止于中期。还可干扰蛋白质代谢及抑制RNA多聚酶的活力,并抑制细胞膜类脂质的合成和氨基酸在细胞膜上的转运。长春新碱对移植性肿瘤的抑制作用大于长春花碱且抗瘤谱广。除对长春花碱敏感的瘤株有效外,对小鼠Ridgeway成骨肉瘤、Mecca淋巴肉瘤、X-5563骨髓瘤等也有作用。长春新碱、长春花碱和长春地辛三者间无交叉耐药现象,长春新碱神经毒性在三者中最强。 
药代动力学:静注长春新碱后迅速分布于各组织,神经细胞内浓度较高,很少透过血脑屏障,脑脊液浓度是血浆浓度的1/30~1/20。蛋白结合率75%。在成人,t1/2α小于5分钟,t1/2β为50~155分钟,末梢消除相t1/2γ长达85小时。在肝内代谢,在胆汁中浓度最高,主要随胆汁排出,粪便排泄70%,尿中排泄5%~16%。长春新碱能选择性地集中在癌组织,可使增殖细胞同步化,进而使抗肿瘤药物增效。 
适应症:
①.急性白血病,尤其是儿童急性白血病,对急性淋巴细胞白血病疗效显著。
②.恶性淋巴瘤。
③.生殖细胞肿瘤。
④.小细胞肺癌,尤文肉瘤、肾母细胞瘤、神经母细胞瘤。
⑤.乳腺癌、慢性淋巴细胞白血病、消化道癌、黑色素瘤及多发性骨髓瘤等。
用法用量:成人剂量1~2mg(或1.4mg/m2)最大不大于2mg,年龄大于65岁者,最大每次1mg。儿童75μg/kg或2.0mg/m2, 每周1次静脉注射或冲入。联合化疗是连用2周为一周期。 
不良反应:
①.剂量限制性毒性是神经系统毒性,主要引起外周神经症状,如手指、神经毒性等,与累积量有关。足趾麻木、腱反射迟钝或消失,外周神经炎。腹痛、便秘,麻痹性肠梗阻偶见。运动神经、感觉神经和脑神经也可受到破环,并产生相应症状。神经毒性常发生于40岁以上者,儿童的耐受性好于成人,恶性淋巴瘤病人出现神经毒性的倾向高于其他肿瘤病人。
②.骨髓抑制和消化道反应较轻。
③.有局部组织刺激作用,药液不能外漏,否则可引起局部坏死。 ④.可见脱发,偶见血压的改变。
 
注意事项:
①.仅用于静脉注射,漏于皮下可导致组织坏死、蜂窝织炎。一旦漏出或可疑外漏,应立即停止输液,并予相应处理(参考氮芥外漏的处理)。
②.防止药液溅入眼内,一旦发生应立即用大量生理盐水冲洗,以后应用地塞米松眼膏保护)。
③.冲入静脉时避免日光直接照射。
④.肝功能异常时减量使用。
 
药物相互作用:
1.吡咯系列抗真菌剂(伊曲康唑),增加肌肉神经系统的副作用。如发现有副作用,应进行减量、暂停或停药等适当处理。伊曲康唑有阻碍肝细胞色素P-450 3A的作用,长春新碱通过肝细胞染色素P-450 3A代谢,合用可使长春新碱代谢受抑制。
2.与苯妥英钠合用,降低苯妥英钠吸收,或使代谢亢进。
3.与含铂的抗亚、恶性肿瘤剂合用,可能增强第8对脑神经障碍。
4.与L-天冬酰胺酶合用,可能增强神经系统及血液系统的障碍。为将毒性控制到最小,可将硫酸长春新碱在L-天冬酰胺酶给药前12-24小时以前使用。 
 
贮藏:遮光,密闭,在冷处保存。
Drugs
Vincristine sulfate injection
Generic Name: Vincristine sulfate
Product Name: Vincristine sulfate injection
Indication of Vincristine sulfate injection:
Vincristine is a medication that is used in chemotherapy to treat a range of cancers, including acute leukaemia, Non-Hodgkin's lymphoma, rhabdomyosarcoma of muscle, neuroblastoma, Wilm's tumour, osteogenic sarcoma, Ewing's sarcoma, squamous cell carcinoma of the cervix, breast cancer, malignant melanoma, oat-cell carcinoma of the lung and gynaecological tumours of childhood.
Action of Vincristine sulfate injection:
Vincristine slows the rate at which cancer cells divide by inactivating certain parts of the cell necessary for division to occur.
Dose advice of Vincristine sulfate injection:
Vincristine is given as an injection. Your doctor or nurse will give the injection to you. You should tell your doctor or nurse if you experience any of the following when you have been given Vincristine:
Any pain or unusual sensations
Constipation
Bleeding more than normal
Numbness or tingling sensations
Vincristine can sometimes make people more prone to infections. Your doctor will talk to you about this. If you think you may have an infection tell your doctor.
Vincristine should not be given to pregnant women (Pregnancy Category D).
Common side effects of Vincristine sulfate injection:
All medicines have side effects. Some side affects can be serious but most are mild. The following is a list of common side effects that occurred in more than 1% of people who were given Vincristine:
Hair loss - (occurs in more than 20% of people)
Constipation
Mild nausea and vomiting
Talk to your doctor if you experience any side effects.
Uncommon side effects of Vincristine sulfate injection:
The following is a list of uncommon side effects that occurred in less than 0.1% of people who were given Vincristine injection. Do not be alarmed by this list. You may not experience any side effects.
Hearing problems
Balance difficulties
Seizures
Consult your doctor if you experience any of the above symptoms, or any other unusual or abnormal symptoms that concern you.
Diseases treated by Vincristine sulfate injection:
Hodgkin's Lymphoma
Medulloblastoma / Primitive Neuroectodermal tumour (PNET)  (Medulloblastoma / Primitive Neuroectodermal tumour (PNET))
Multiple Myeloma
Neuroblastoma
Regimens that include Vincristine sulfate injection:
CHOP (Cyclophosphamide + Doxorubicin + Vincristine + Prednisolone)
CNOP (Cyclophosphamide + Mitoxantrone + Vincristine + Prednisolone)
CVD (Cyclophosphamide + Vincristine + Dacarbazine)
IVE (Ifosfamide + Vincristine + Etoposide)
LALA 94
MOPP (Meclorethamine + Vincristine + Procarbazine + Prednisolone)
PCV (Procarbazine + Lomustine + Vincristine)
R-CHOP 21 (Rituximab + Cyclophosphamide + Doxorubicin + Vincristine + Prednisolone)
VAC (Vincristine + Dactinomycin + Cyclophosphamide)

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