Drug information of Streptozocin
Mechanism of effect
Streptozocin inhibits DNA synthesis without significantly affecting RNA or protein synthesis in bacterial and mammalian cells. The biochemical mechanism leading to mammalian cell death has not been established but is at least partially caused by DNA alkylation causing intrastrand crosslinks.
Streptozocin is a naturally occurring nitrosourea that contains a glucose moiety not present in the other compounds. The glucose moiety is believed to contribute to reduced myelotoxicity
After rapid IV injection, unchanged drug is rapidly cleared from the plasma (half-life, 35 min).Streptozocin disappears from blood very quickly. Streptozocin concentrates in liver and kidneys.
As much as 20% of the drug (or metabolites containing an N-nitrosourea group) is metabolized and/or excreted by the kidney.
Drug indicationsPancreatic Islet Cell Carcinoma
Usual Adult Dose for Pancreatic Cancer
This drug can be given on a daily or weekly basis.
-Recommended Dose: 500 mg/m2 BSA IV by rapid injection or short/prolonged infusion once a day for 5 consecutive days every 6 weeks.
-Dose escalation is not recommended.
-Duration of Therapy: Until maximum benefit or until treatment-limiting toxicity occurs. WEEKLY SCHEDULE:
-Initial Dose: 1000 mg/m2 BSA IV by rapid injection or short/prolonged infusion at weekly intervals for first 2 courses.
-Maintenance Dose: After the first 2 courses, doses may be escalated in patients who have not achieved a therapeutic response and who have not experienced significant toxicity with the previous treatment course.
-Maximum Dose: Single dose of 1500 mg/m2 BSA
Drug contraindicationshypersensitivity to drug or its components.
Side effectsnausea , vomiting , Depression , Diarrhea , confusion , jaundice , renal failure , Hypoglycemia , lethargy
Interactionspimecrolimus , Natalizumab , Clozapine , denosumab , Trastuzumab , Vitamin A , Vitamin E , Meglumine Compound , Cidofovir , thiotepa , Ioxaglate , Iothalamate Meglumine , Meningococcal conjugate vaccine , sirukumab
1- Nausea and vomiting usually begin 1 to 4 hr after administration and last for 24 hr; occasionally requiring discontinuation of drug therapy.
2- Liver dysfunction, hematological changes Have been observed.
3- Renal toxicity occurs in up to 2/ 3 of all patients treated with streptozocin, as evidenced by azotemia, anuria, hypophosphatemia, glycosuria, and renal tubular acidosis. Such toxicity is dose-related and cumulative and may be severe or fatal.
Points of recommendation
1- Advise patient, family, or caregiver to immediately report any of the following to the health care provider: decreased urination; fever, chills, or other signs of infection; unusual bleeding or bruising; pain, redness, or swelling at injection site.
2- Advise patient, family, or caregiver to report any of the following to the health care provider: persistent nausea, vomiting, diarrhea, or appetite loss; persistent or worsening general body weakness.
3-Caution patient that medication may cause confusion, drowsiness, and depression and to use caution when driving or performing other tasks that require mental alertness or coordination.
4-Caution women of childbearing potential to avoid becoming pregnant during therapy.