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Pronunciation |
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(YOOR
a sil MUS
tard) |
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Generic
Available |
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No |
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Pharmacological Index |
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Antineoplastic Agent, Alkylating Agent |
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Use |
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Palliative treatment in symptomatic chronic lymphocytic leukemia;
non-Hodgkin's lymphomas, chronic myelocytic leukemia, mycosis fungoides,
thrombocytosis, polycythemia vera, ovarian carcinoma |
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Pregnancy Risk
Factor |
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X |
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Contraindications |
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Severe leukopenia, thrombocytopenia, aplastic anemia; in patients whose bone
marrow is infiltrated with malignant cells; hypersensitivity to any component;
pregnancy |
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Warnings/Precautions |
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The U.S. Food and Drug Administration (FDA) currently recommends that
procedures for proper handling and disposal of antineoplastic agents be
considered. Impaired kidney or liver function. The drug should be discontinued
if intractable vomiting or diarrhea, precipitous falls in leukocyte or platelet
count, or myocardial ischemia occurs. Use with caution in patients who have had
high-dose pelvic radiation or previous use of alkylating agents. Patient should
be hospitalized during initial course of therapy; may impair fertility in men
and women; use with caution in patients with pre-existing marrow
suppression. |
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Adverse
Reactions |
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>10%:
Gastrointestinal: Nausea, vomiting, diarrhea
Hematologic: Myelosuppressive; leukopenia and thrombocytopenia nadir: 2-4
weeks, anemia
1% to 10%:
Central nervous system: Mental depression, nervousness
Dermatologic: Hyperpigmentation, alopecia
Endocrine & metabolic: Hyperuricemia
<1%: Pruritus, stomatitis, hepatotoxicity |
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Overdosage/Toxicology |
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Symptoms of overdose include diarrhea, vomiting, severe marrow suppression
No specific antidote to marrow toxicity is available |
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Mechanism of
Action |
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Polyfunctional alkylating agent. The basic reaction of uracil mustard, like
that of any alkylating agent, is the replacement of the hydrogen in a reacting
chemical with an alkyl group; cell cycle-phase nonspecific antineoplastic agent;
exact site of drug action within the cell is not known, but the nucleoproteins
of the cell nucleus are believed to be involved. |
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Pharmacodynamics/Kinetics |
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Absorption: Oral
Elimination: <1% detected in urine |
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Usual Dosage |
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Oral (do not administer until 2-3 weeks after maximum effect of any previous
x-ray or cytotoxic drug therapy of the bone marrow is obtained):
Adults: 0.15 mg/kg in a single weekly dose for 4 weeks
Thrombocytosis: 1-2 mg/day for 14 days |
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Mental Health: Effects
on Mental Status |
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May cause nervousness or depression |
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Mental Health:
Effects on Psychiatric
Treatment |
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Myelosuppression is common; avoid clozapine and
carbamazepine |
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Patient
Information |
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This drug may take weeks or months for effectiveness to become apparent. Do
not discontinue without consulting prescriber. Maintain adequate hydration (2-3
L/day of fluids unless instructed to restrict fluid intake). For nausea or
vomiting, loss of appetite, or dry mouth, small frequent meals, chewing gum, or
sucking lozenges may help. You may experience hair loss (reversible); diarrhea
(if persistent, consult prescriber); nervousness, irritability, shakiness,
amenorrhea, altered sperm production (usually reversible). Report persistent
nausea or vomiting, fever, sore throat, chills, unusual bleeding or bruising,
consistent feelings of tiredness or weakness, or yellowing of skin or eyes.
Pregnancy/breast-feeding precautions: Inform prescriber if you are pregnant.
Do not get pregnant during or for 1 month following therapy. Male: Do not cause
a female to become pregnant. Male/female: Consult prescriber for instruction on
appropriate barrier contraceptive measures. This drug may cause severe fetal
defects. Do not breast-feed. |
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Nursing
Implications |
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Notify physician of persistent or severe nausea, diarrhea, fever, sore
throat, chills, bleeding, or bruising |
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Dosage Forms |
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Capsule: 1 mg |
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References |
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Berry DH, Fernbach DJ, Sutow WW, et al,
"Uracil Mustard (NSC-34462) Therapy in Uncommon Malignant Neoplasms in Children,"
Cancer Chemother Rep, 1968, 52(3):441-3.
Berry DH, Sutow WW, Vietti TJ, et al,
"Evaluation of Uracil Mustard in Children With Hodgkin's Disease, Lymphosarcoma, and Soft Tissue Sarcoma,"
J Clin Pharmacol New Drugs, 1972, 12(4):169-73.
Fernbach DJ, Haddy TB, Holcomb TM, et al,
"Uracil Mustard (NSC-34462) Therapy for Children With Metastatic Neuroblastoma,"
Cancer Chemother Rep, 1968, 52(2):287-91.
Jeffrey LP, Chairman, National Study Commission on Cytotoxic Exposure.
Position Statement.
"The Handling of Cytotoxic Agents by Women Who Are Pregnant, Attempting to Conceive, or Breast-Feeding,"
January 12, 1987. |
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