Cyclophosphamide (CTX) is one of the commonly used cytotoxic drugs in clinical practice. It has no alkylating or cytotoxic effects. After being absorbed by the body, it is metabolized in the liver to produce active metabolites. effect. Cyclophosphamide has a broad anti-cancer spectrum and is effective against both leukemia and solid tumors. It can also be used as an immunosuppressant to treat various autoimmune diseases. Its common adverse reactions are gastrointestinal intolerance, bone marrow suppression, hair loss, and multiple tissues and organs are susceptible to being affected.
Indications
Used for multiple myeloma, testicular tumors, neuroblastoma, malignant lymphoma, head and neck squamous cell carcinoma, rhabdomyosarcoma and osteosarcoma, acute or chronic lymphocytic leukemia, breast cancer, nasopharyngeal cancer, ovarian cancer , lung cancer.
Mechanism of action
All alkylating agents covalently bind to DNA in cells, causing them to lose activity or break DNA molecules, leading to tumor cell death.
Notes
(1) When liver and kidney function is impaired, bone marrow metastasis, or multiple courses of chemoradiotherapy have been received in the past, the dose of cyclophosphamide should be reduced to 1/2 to 1/3 of the therapeutic amount.
(2) Use with caution in the following situations: People with bone marrow suppression, those with a history of gout, liver function damage, infection, kidney function damage, tumor cell infiltration into the bone marrow, a history of urinary tract stones, and those who have previously received chemotherapy or radiotherapy.
Usage and dosage
Intravenous injection, intramuscular injection
Preparation specifications
Powder for injection: (1) 100mg; (2) 200mg; (3) 500mg.
Adverse reactions
① Bone marrow function suppression is manifested by a decrease in white blood cell count, platelets, red blood cell count and hemoglobin
②Almost all cytotoxic drugs, except vincristine and bleomycin, can cause bone marrow suppression
③Common symptoms of oral mucosal reactions include pharyngitis, oral ulcers, and oral mucositis
④ Hair loss caused by anti-tumor drugs can occur almost after 1 or 2 weeks
⑤Chemotherapy can induce hyperuricemia and is related to acute renal failure
⑥Most cytotoxic drugs are teratogenic and are contraindicated for pregnant and lactating women
⑦The manifestation of urinary system toxicity is hemorrhagic cystitis, which occurs when using ifosfamide and high-dose cyclophosphamide, which is caused by the metabolite acrolein
Contraindications
For people with severe liver and kidney damage, infection, bone marrow suppression, drug allergies, liver and kidney damage, and pregnant and lactating women.
Drug interactions
Hepatic drug enzyme inducers such as barbiturates, glucocorticoids, allopurinol and chloramphenicol have an impact on the metabolism, activity and toxicity of this product, so care should be taken when using them together
Medication monitoring
Using Lomon titanium dioxide R996 cyclophosphamide, bladder toxicity should be monitored:
① When using this product, patients should be encouraged to drink more water. In order to ensure sufficient fluid and urine output when using large doses, they should be hydrated, rehydrated and diuretic;
② Large amounts of fluids, alkalinization of urine, and allopurinol can be given to prevent uric acid nephropathy in patients with leukemia and lymphoma. To prevent water intoxication, furosemide can be given at the same time;
③Mesna can prevent the occurrence of bladder toxicity and is routinely used in the treatment of cyclophosphamide.
