Article Contents ::

Details About Generic Salt ::  Plicamyc

Main Medicine Class::    

(PLY-kae-MY-sin)
Mithracin
Powder for injection
2500 mcg per vial with 100 mg mannitol.
Class: Antitumor antibiotic

 Indications

Adult

Malignant testicular tumors, hypercalcemia and hypercalciuria associated with advanced neoplasms.

Pediatric

Hypercalcemia and hypercalciuria associated with advanced neoplasms.

 Contraindications Thrombocytopenia, thrombocytopathy, coagulation disorders, or increased susceptibility to bleeding caused by other causes; impairment of bone marrow function; pregnancy.

 Route/Dosage

Testicular Tumors

ADULTS AND PEDIATRIC: IV 25 to 30 mcg/kg/day for 8 to 10 days unless significant side effects or toxicity occurs. Do not use > 10 daily doses. Do not exceed 30 mcg/kg/day.

Hypercalcemia and Hypercalciuria Associated with Advanced Neoplasms

ADULTS AND PEDIATRIC: IV 25 mcg/kg/day for 3 or 4 days. Repeat at intervals of ³ 1 wk to achieve desired result or to maintain serum and urinary calcium excretion at normal levels.

Interactions

Calcitonin

Increased hypocalcemic effect may occur when given with calcitonin.

Lab Test Interferences Increased AST, ALT, isocritic and lactic dehydrogenases, alkaline phosphatase, serum bilirubin, ornithine carbamyl transferease, bromsulphalein retention.

 Adverse Reactions

CNS: Drowsiness, weakness, depression, headache, lethargy. DERMATOLOGIC: Rash, facial flushing. GI: Very low potential for nausea and vomiting (12 to 24 hr); elevated LFTs, anorexia, diarrhea, mucositis. HEMATOLOGIC: Bone marrow suppression, especially thrombocytopenia, nadir at 5 to 10 days, hemorrhagic diathesis, elevated bleeding time (rarely). METABOLIC: Decreased serum calcium, phosphorus, potassium. RENAL: Renal tubular necrosis with high doses, increased BUN and serum creatinine. OTHER: Proteinuria.

 Precautions

Pregnancy: Category X. Lactation: Discontinue nursing or the drug. Adults and pediatric: Dosage is based on patient’s body weight. Use ideal weight if patient has abnormal fluid retention. Extravasation risk: Local irritation or phlebitis may occur. Refer to your institution specific protocol. Hemorrhagic syndrome: Usually begins with epistaxis. It can start with hematemesis progressing to more widespread GI hemorrhage or to a more generalized bleeding tendency. It is most likely caused by abnormalities in multiple clotting factors and is dose-related. Adjustment in renal insufficiency: Use with extreme caution. Plicamycin Dosage Adjustment in Renal Dysfunction Ccr Percent of usual dose: > 60 mL/min 100 30 to 60 mL/min 75: 10 to 29 mL/min 75 < 10 mL/min 50: Adjustment in hepatic insufficiency Plicamycin may be dosed at 12.5 mcg/kg for the treatment of hypercalcemia.:

PATIENT CARE CONSIDERATIONS


 Administration/Storage

  • Refrigerate unconstituted vials at 2° to 8°C (36° to 46°F).
  • Add 4.9 mL of sterile water for injection to the vial for a final plicamycin concentration of 500 mcg/mL.
  • Dilute with 1 L of 5% Dextrose or 0.9% Sodium Chloride. Plicamycin also can be prepared as a bolus injection or diluted in smaller volumes of fluid.
  • The reconstituted solution must be prepared immediately prior to injection and any unused solution discarded. Plicamycin is stable for at least 4 to 6 hr at room temperature.
  • Administer as IV bolus or infusion.
  • Do not filter.
  • Slow IV infusion over 4 to 6 hr. Administration by IV bolus and IV infusion over 20 to 30 min, and £ 1 to 3 hr, in 100 to 250 mL of 5% Dextrose or 0.9% Sodium Chloride are also used.
  • Antiemetics may help relieve nausea and vomiting.

 Assessment/Interventions

  • Obtain platelet count, prothrombin time, and bleeding time frequently during therapy and for several days following the last dose. Discontinue therapy if thrombocytopenia or a significant prolongation of prothrombin or bleeding times occurs.
  • Use with extreme caution in patients with preexisting renal or hepatic impairment.
  • Stop therapy for leukocytes < 4000/mm3 or platelets < 150,000/mm3, PT > 4 sec greater than control, AST > 600 U/mL, LDH > 2000 U/mL, or BUN > 25 mg/dL.
  • Correct electrolyte imbalance (especially hypocalcemia, hypokalemia, and hypophosphatemia) with appropriate therapy prior to treatment.
OVERDOSAGE: SIGNS & SYMPTOMS
  Expect exaggeration of usual adverse effects.

 Patient/Family Education

  • Notify health care provider if any of the following occur: Fever; sore throat; rashes; chills; unusual bleeding or bruising; bloody nose; black tarry stools; dark urine; yellowing of skin/eyes.
  • Nausea, vomiting, and stomach upset are common. Avoid sweet, fried, or fatty foods. Eat smaller light meals several times a day. Dry foods (eg, toast, crackers) and liquids (eg, soups, unsweetened apple juice) may be more easily digested. Do not lie down after eating. If this does not help, antinausea drugs may be prescribed.
  • Contraceptive measures are recommended during treatment.
  • Calcium supplements are sometimes needed during plicamycin therapy.

Medicscientist Drug Facts

 

Drugs Class ::

(PLY-kae-MY-sin)
Mithracin
Powder for injection
2500 mcg per vial with 100 mg mannitol.
Class: Antitumor antibiotic

Indications for Drugs ::

 Indications

Adult

Malignant testicular tumors, hypercalcemia and hypercalciuria associated with advanced neoplasms.

Pediatric

Hypercalcemia and hypercalciuria associated with advanced neoplasms.

Drug Dose ::

 Route/Dosage

Testicular Tumors

ADULTS AND PEDIATRIC: IV 25 to 30 mcg/kg/day for 8 to 10 days unless significant side effects or toxicity occurs. Do not use > 10 daily doses. Do not exceed 30 mcg/kg/day.

Hypercalcemia and Hypercalciuria Associated with Advanced Neoplasms

ADULTS AND PEDIATRIC: IV 25 mcg/kg/day for 3 or 4 days. Repeat at intervals of ³ 1 wk to achieve desired result or to maintain serum and urinary calcium excretion at normal levels.

Contraindication ::

 Contraindications Thrombocytopenia, thrombocytopathy, coagulation disorders, or increased susceptibility to bleeding caused by other causes; impairment of bone marrow function; pregnancy.

Drug Precautions ::

 Precautions

Pregnancy: Category X. Lactation: Discontinue nursing or the drug. Adults and pediatric: Dosage is based on patient’s body weight. Use ideal weight if patient has abnormal fluid retention. Extravasation risk: Local irritation or phlebitis may occur. Refer to your institution specific protocol. Hemorrhagic syndrome: Usually begins with epistaxis. It can start with hematemesis progressing to more widespread GI hemorrhage or to a more generalized bleeding tendency. It is most likely caused by abnormalities in multiple clotting factors and is dose-related. Adjustment in renal insufficiency: Use with extreme caution. Plicamycin Dosage Adjustment in Renal Dysfunction Ccr Percent of usual dose: > 60 mL/min 100 30 to 60 mL/min 75: 10 to 29 mL/min 75 < 10 mL/min 50: Adjustment in hepatic insufficiency Plicamycin may be dosed at 12.5 mcg/kg for the treatment of hypercalcemia.:

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CNS: Drowsiness, weakness, depression, headache, lethargy. DERMATOLOGIC: Rash, facial flushing. GI: Very low potential for nausea and vomiting (12 to 24 hr); elevated LFTs, anorexia, diarrhea, mucositis. HEMATOLOGIC: Bone marrow suppression, especially thrombocytopenia, nadir at 5 to 10 days, hemorrhagic diathesis, elevated bleeding time (rarely). METABOLIC: Decreased serum calcium, phosphorus, potassium. RENAL: Renal tubular necrosis with high doses, increased BUN and serum creatinine. OTHER: Proteinuria.

Drug Mode of Action ::  

(PLY-kae-MY-sin)
Mithracin
Powder for injection
2500 mcg per vial with 100 mg mannitol.
Class: Antitumor antibiotic

Drug Interactions ::

Interactions

Calcitonin

Increased hypocalcemic effect may occur when given with calcitonin.

Drug Assesment ::

 Assessment/Interventions

  • Obtain platelet count, prothrombin time, and bleeding time frequently during therapy and for several days following the last dose. Discontinue therapy if thrombocytopenia or a significant prolongation of prothrombin or bleeding times occurs.
  • Use with extreme caution in patients with preexisting renal or hepatic impairment.
  • Stop therapy for leukocytes < 4000/mm3 or platelets < 150,000/mm3, PT > 4 sec greater than control, AST > 600 U/mL, LDH > 2000 U/mL, or BUN > 25 mg/dL.
  • Correct electrolyte imbalance (especially hypocalcemia, hypokalemia, and hypophosphatemia) with appropriate therapy prior to treatment.
OVERDOSAGE: SIGNS & SYMPTOMS
  Expect exaggeration of usual adverse effects.

Drug Storage/Management ::

 Administration/Storage

  • Refrigerate unconstituted vials at 2° to 8°C (36° to 46°F).
  • Add 4.9 mL of sterile water for injection to the vial for a final plicamycin concentration of 500 mcg/mL.
  • Dilute with 1 L of 5% Dextrose or 0.9% Sodium Chloride. Plicamycin also can be prepared as a bolus injection or diluted in smaller volumes of fluid.
  • The reconstituted solution must be prepared immediately prior to injection and any unused solution discarded. Plicamycin is stable for at least 4 to 6 hr at room temperature.
  • Administer as IV bolus or infusion.
  • Do not filter.
  • Slow IV infusion over 4 to 6 hr. Administration by IV bolus and IV infusion over 20 to 30 min, and £ 1 to 3 hr, in 100 to 250 mL of 5% Dextrose or 0.9% Sodium Chloride are also used.
  • Antiemetics may help relieve nausea and vomiting.

Drug Notes ::

 Patient/Family Education

  • Notify health care provider if any of the following occur: Fever; sore throat; rashes; chills; unusual bleeding or bruising; bloody nose; black tarry stools; dark urine; yellowing of skin/eyes.
  • Nausea, vomiting, and stomach upset are common. Avoid sweet, fried, or fatty foods. Eat smaller light meals several times a day. Dry foods (eg, toast, crackers) and liquids (eg, soups, unsweetened apple juice) may be more easily digested. Do not lie down after eating. If this does not help, antinausea drugs may be prescribed.
  • Contraceptive measures are recommended during treatment.
  • Calcium supplements are sometimes needed during plicamycin therapy.

Medicscientist Drug Facts

Disclaimer ::

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