Doxorubicin final project in Pharmaceutics 2015

introduction,pharmakokinitics,Mechanism of action,Dosage form,Administration routes,Side effects and Precautions of Doxorubicin

1. DOXIL® (doxorubicin hydrochloride liposome) Injection

2. Doxorubicin Trade name : Adriamycin, Rubex Chemotherapy drug class : antitumor antibiotics One of the most powerful chemotherapy drugs invented that is used to treat a wide variety of cancers FDA approved for use alone or in combination with other drugs

3. Doxorubicin Treats the following cancers: Acute lymphoblastic leukemia (ALL) Acute myeloid leukemia (AML) Breast Cancer (adjuvant therapy when it has spread to lymph nodes after surgery Gastric cancer Hodgkin lymphoma Neuroblastoma Non-hodgkin lymphoma Ovarian cancer

4. Doxorubicin DOXIL is an anthracycline topoisomerase II inhibitor, that is encapsulated in STEALTH® liposomes for intravenous use .

5. Doxorubicin Mechanism Of Action The mechanism of action is thought to be related to its ability to bind DNA and inhibit nucleic acid synthesis. Cell structure studies have demonstrated rapid cell penetration and perinuclear chromatin binding, rapid inhibition of mitotic activity and nucleic acid synthesis, and induction of mutagenesis and chromosomal aberrations.

6. Doxorubicin Distribution Direct measurement of liposomal doxorubicin shows that at least 90% of the drug remains liposome-encapsulated during circulation. Doxorubicin becomes available after the liposomes are extravasated . Plasma protein binding of DOXIL has not been determined; the plasma protein binding of doxorubicin is approximately 70%.

7. Doxorubicin Metabolism Doxorubicinol , the major metabolite of doxorubicin, was detected at concentrations of 0.8 to 26.2 ng /mL in the plasma of patients who received 10 or 20 mg/m² DOXIL. Elimination The plasma clearance of total doxorubicin from DOXIL was 0.041 L/h/m² at a dose of 20 mg/m² . Following administration of doxorubicin HCl , the plasma clearance of doxorubicin is 24 to 35 L/h/m² .

8. Doxorubicin Dosage forms and strengths of doxorubicin hydrochloride: Vials clear red solution 10 mg/5 mL, 20 mg/10 mL, 50 mg/25 mL, 150 mg/75 mL, and 200 mg/100 mL Vials red-orange lyophilized powder 10 mg, 20 mg, 50 mg, and 150 mg Storage Refrigerated 2° to 8°C (36° to 46°F) Protect from light Retain in carton until used Discard unused portion

9. Doxorubicin Therapy routine for Breast Cancer, ovary, prostate, stomach, thyroid; small cell cancer of lung, liver; squamous cell cancer of head and neck; multiple myeloma, Hodgkin's disease, lymphomas, ALL, AML 60-75 mg/m² IV q21Days OR 60 mg/m² IV q14Days OR 40-60 mg/m² IV q21-28Days OR 20 mg/m²/dose qweek

10. Doxorubicin Limit lifetime cumulative dose to <550 mg/m² to reduce risk of cardio toxicity (congestive heart failure & cardiomyopathy) Monitor: CBC, cardiac function, LFTs (liver function tests)

11. Doxorubicin Side effects: Nausea or vomiting Pain at injection site Temporary Low blood counts of white & red blood cells and platelets Mouth sores Alopecia (hair loss on scalp or body) Eyes watering (first week of treatment) Urine color red, red-brown, orange, or pink in first 1-2 days after dose administered

12. Doxorubicin First two weeks of taking drug: Nail beds darken Skin darkens where previous radiation treatment was administered Fertility issues Serious: can cause issue with pumping of heart that may occur 7-8 years after treatment. Lifetime limit on amount patients may receive.

13. Doxorubicin Precautions while taking: Aspirin and their products should not be taken without physician approval No vaccinations without physician approval Use contraceptives (barrier type recommended -condoms) & do not get pregnant Do not breast feed Not to be taken by patients with congestive heart failure, if you have already taken high doses of this drug, or have bone marrow suppression or other blood count issues

14. Doxorubicin Administered: IV Push (syringe) in not less than 3 to 5 minutes IVPB (IV admixture) over 15 to 60 minutes Must not be given via intramuscular or subcutaneous route

15. Doxorubicin

16. Refrences http:// www.rxlist.com/doxil-drug.htm http ://reference.medscape.com/drug/doxorubicin-342120 http ://doxorubicin.cancertreatment.net/ http ://www.cancer.gov/cancertopics/druginfo/doxorubicinhydrochloride http ://www.cancernetwork.com/review-article/review-docetaxeldoxorubicin-combination-metastatic-breast-cancer#sthash.o4sOCNSV.dpuf . Retrieved from cancerNetwork.com: http://www.cancernetwork.com/review-article/review-docetaxeldoxorubicin-combination-metastatic-breast-cancer http ://chemocare.com/chemotherapy/drug-info/doxorubicin.aspx#. VIS15tLF9e8 http ://www.globalrph.com/doxorubicin.htm#DOSAGE_AND_ADMINISTRATION http:// consumer.healthday.com/encyclopedia/cancer-8/mis-cancer-news-102/chemotherapy-and-side-effects-648006.html

17. Doxorubicin Name: Andrew Girgis ID no: 40202