mesna


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mesna

 [mes´nah]
a sulfhydryl compound given orally or intravenously together with a urotoxic antineoplastic agent such as ifosfamide or cyclophosphamide because it inactivates some of their metabolites and thus lessens damage to the bladder.

mesna

Mesnex, Uromitexan (CA) (UK)

Pharmacologic class: Detoxifying agent

Therapeutic class: Hemorrhagic cystitis inhibitor

Pregnancy risk category B

Action

Reacts in kidney with urotoxic ifosfamide metabolites (acrolein and 4-hydroxy-ifosfamide), resulting in their detoxification. Also binds to double bonds of acrolein and to other urotoxic metabolites.

Availability

Injection: 100 mg/ml in 10-ml vials

Tablets (coated): 400 mg

Indications and dosages

To prevent hemorrhagic cystitis in patients receiving ifosfamide

Adults:Combination I.V. and P.O. regimen-Single I.V. bolus dose of mesna at 20% of ifosfamide dosage, given at same time as ifosfamide, followed by two doses of mesna tablets P.O. at 40% of ifosfamide dosage given 2 and 6 hours after ifosfamide dose. I.V. regimen-I.V. bolus of mesna at 20% of ifosfamide dosage given at same time as ifosfamide, repeated 4 and 8 hours after each ifosfamide dose.

Dosage adjustment

• Children

Contraindications

• Hypersensitivity to drug or other thiol compounds

Precautions

Use cautiously in:
• autoimmune disorders
• pregnant or breastfeeding patients.

Administration

• Dilute with dextrose 5% in water, dextrose 5% in normal saline solution, dextrose 5% in 0.2% sodium chloride solution, dextrose 5% in 0.33% sodium chloride solution, dextrose 5% in 0.45% sodium chloride solution, normal saline solution, or lactated Ringer's solution for injection.
• Give I.V. bolus over at least 1 minute with ifosfamide dose and at prescribed intervals after ifosfamide doses.

Don't use multidose vial (contains benzyl alcohol) in neonates or infants. In older children, use with caution.
• If patient vomits within 2 hours of oral mesna dose, repeat oral dose or switch to I.V. route.

Adverse reactions

CNS: fatigue, malaise, irritability, headache, dizziness, drowsiness, hyperesthesia, rigors

CV: hypertension, hypotension, ST-segment elevation, tachycardia

EENT: conjunctivitis, pharyngitis, rhinitis

GI: nausea, vomiting, diarrhea, constipation, anorexia, flatulence

Hematologic: hematuria

Musculoskeletal: back pain, joint pain, myalgia

Respiratory: coughing, tachypnea, bronchospasm

Skin: flushing, rash

Other: arm or leg pain, injection site reactions, fever, flulike symptoms, allergic reactions

Interactions

Drug-diagnostic tests.Hepatic enzymes: increased levels

Urinary erythrocytes: false-positive or false-negative results

Urine tests using Ames Multistix: false-positive for ketonuria

Patient monitoring

• Monitor nutritional and hydration status.
• Monitor vital signs and ECG. Watch closely for blood pressure changes and tachycardia.
• Assess body temperature. Stay alert for fever, flulike symptoms, and EENT infections.
• Monitor respiratory status carefully. Watch closely for cough, bronchospasm, and tachypnea.

Patient teaching

• Inform patient that drug may cause significant adverse effects. Reassure him that he will be monitored closely.
• Encourage patient to request analgesics or other pain-relief measures for headache, back or joint pain, hyperesthesia, or muscle ache.

Advise patient to immediately report breathing difficulties and allergic symptoms.
• Inform patient about drug's adverse CNS effects. Explain safety measures used to prevent injury.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

mesna

/mes·na/ (mez´nah) a sulfhydryl compound given with urotoxic antineoplastic agents because it inactivates some of their urotoxic metabolites.

mesna

An agent that may act as an antioxidant, protecting the urogenital tract from toxic effects of ifosfamide and cyclophosphamide by binding them with its sulfhydryl-moieties, thereby reducing the incidence of haemorrhagic cystitis and haematuria. 

Adverse effects
Rash, itching, diarrheoa, nausea, vomiting.

mesna

Oncology A uroprotective agent that protects the urogenital tract from toxicity of ifosfamide and cyclophosphamide Adverse effects Rash, itching, diarrhea, N&V. See Cyclophosphamide, Ifosfamide.

mesna

A drug used to prevent damage to the urinary tract of people being treated with the anticancer drugs cyclophosphamide or ifosfamide. A brand name is Uromitexan.

Patient discussion about mesna

Q. my dad has msa, he has recently started seeing things, eg aliens, government consp.ext not fully reconzing lov does not reconize loved ones while having these episodes, becomes anxious and ill manered just not like my dad at all, he's so quite and polite normally.

A. Multi Systems Atrophy = MSA

Try this:
http://www.credencegroup.co.uk/Eclub/ses/sessearch.php?q=atrophy&pvdc=0
Get in touch with the credence group - they know very very much.

More discussions about mesna
References in periodicals archive ?
Trade names Generic names Dosage form Strengths Mvleran Busulphan Tablet 2mg/Tablet Leukeran Chlorambucil Tablet 2mg/Tablet Endoxan Cyclophosphamide White Powder 200mg/Vial Anhvdrous Injection Endoxan Cyclophosphamide White Powder 500mg/Vial Anhydrous Injection Endoxan Cyclophosphamide White Powder 1gm/Vial Anhydrous Injection Endoxan Cyclophosphamide Tablet 50mg/Tablet Anhydrous Holoxan Ifosfamide Injection 1gm/Vial Holoxan Ifosfamide Injection 2gm/Vial Alkeran Melphalan Tablet 2mg/Tablet Uromitexan Mesna Injection 100mg/ml.
The chemotherapy procedure included four cycles of ifosfamide, mesna, and doxorubicin (Adriamycin) (IMA) followed by radiotherapy at 200 cGy/day for a total of 6000 cGy.
The agent most often used to prevent this side-effect is mesna (2-mercaptoethane sulfonate)(Haselberger and Schwinghammer 1995; Ozcan et al.
After the operation, monthly intravenous pulse cyclophosphamide and mesna was ordered and his complaints disappeared after therapy.
Continuous 5-day infusion of ifosfamide with mesna in inoperable pancreatic cancer patients: a phase II study.
Mesna (Biochem Pharmaceutical Industries, Daman) was given along with it to prevent haemorrhagic cystitis.
Mesna to prevent HC: Ifosfamide and cyclophosphamide chemotherapy may cause HC.
We went "live" about a year ago and have since utilized CytoCare to prepare patient doses from as many as 60 different drug vials of antibiotic, chemotherapy, and/or monoclonal antibody therapies for Ampicillin, Busulfan, Carboplatin, Cisplatin, Cladribine, Cyclophosphamide, Cytarabine, Dacarbazine, Daunorubicin, Doxurubicin, Epirubicin, Etoposide, Fluororacil, Ganziclovir, Gemzar, Idarubicin, Ifosfamide, Irinotecan, Melphalan, Mesna, Methotrexate, Mitoxantrone, Oxaliplatin, Paclitaxel, Rituximab, Vinblastin, Vincristine, and Vinorelbine.
Furthermore, given the dose of cyclophosphamide that had been ordered, the pharmacist expected an accompanying order for the bladder-protective drug mesna, but there was no order for this drug.
AIM, another common chemotherapy regimen, consists of doxorubicin, ifosfamide, and mesna (12).
These include use of mesna for protection against urothelial toxicity, antifungal prophylaxis, and prophylaxis against Pneumocystis jiroveci, consideration for Staphylococcus aureus treatment, screening for cervical malignancy, counseling about infertility with CYC, screening for tuberculosis, and vaccination and assessment for osteoporosis, along with cardiovascular and thromboembolic risk assessment.