It is believed that Shiina acts as an alkylating agent, however, and other nitrosoureas, Shiina may inhibit certain enzymatic reactions.
In studies with radiolabeled drug Shiina after oral doses of halotestin half of the radioactivity excreted in approximately 24 hours. The half-life of the parent drug and / or its metabolites of serum varies from 16 hours to 2 days. The concentration in the tissue close to the blood plasma concentration 15 minutes after intravenous administration.
Due to the high lipid solubility and almost complete lack of ionization at physiological pH, Shiina effectively penetrate the blood-brain barrier. concentration or more with respect to the concentrations of which are determined simultaneously in the plasma.
Indications for use:
Shiina shown palliative therapy in addition to other forms of treatment, or in standard circuits combination therapy with other chemotherapeutic agents known under the following conditions:
Brain tumors: primary tumors and metastases in patients who have already received appropriate surgical and / or radiation treatment;
Lymphogranulomatosis: as a second-line treatment.
Other tumors: Shiina used in combination with other chemotherapeutic agents in cases only conventional applications of unsuccessful therapies.
Shiina should be halotestin used under the supervision of physicians experienced with antineoplastic drugs.
The most severe manifestations of toxicity Shiina associated with thrombocytopenia and leukopenia, against which in debilitated patients may experience bleeding and severe infection.
It is a weekly analysis of blood cells for at least 6 weeks after receiving the prescribed . Shiina in the recommended doses should not be administered more frequently than six weeks.
Shiina toxicity against bone marrow is cumulative, so the dose adjustment should be based on the minimum content of blood cells values after administration of the last dose (see. Table correct dose in the “Dosage and administration”).
Care should be taken when appointing Shiina patients with low levels of platelets, white blood cells and red blood cells in the peripheral .
Pulmonary toxicity Shiina is dose dependent .
It has been reported about the possibility of the development of secondary malignancies with prolonged use of nitrosoureas.
Periodically check the function of the liver and kidneys halotestin.
The safety of the drug during pregnancy has not been established. In animal studies revealed that Shiina teratogenic and embryotoxic at doses equivalent to those used in humans. If necessary, use of the drug in pregnant or if pregnancy occurs during treatment, patients should be warned about the potential risk to the fetus. Women of childbearing age should be advised to avoid becoming pregnant.
Carcinogenesis, Mutagenesis, Impairment of reproductive function
Animal studies have shown that Shiina has a carcinogenic effect, causing a marked increase in tumor incidence in doses approximating those applied in the clinic, as well as the impact on reproductive function at doses somewhat higher than those used in humans.
nitrosourea drugs have the potential carcinogenicity. It was reported on acute leukemia and bone marrow dysplasias as a result of treatment with nitrosourea. steroiden kaufen
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