mitomycin

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mitomycin

 [mi″to-mi´sin]
1. any of a group of antitumor antibiotics (e.g., mitomycin A, B, C) produced by Streptomyces caespitosus.
2. mitomycin C, which inhibits DNA and RNA synthesis by causing cross-linking of DNA. It is effective against cancers of the breast, lung, cervix, bladder, and gastrointestinal tract but because of its toxicity is mainly used for palliative treatment of patients who have not responded to other treatment. Administered intravenously.

mitomycin

Mutamycin

Pharmacologic class: Antitumor antibiotic

Therapeutic class: Antineoplastic

Pregnancy risk category C

FDA Box Warning

• Give under supervision of physician experienced in cancer chemotherapy, in facility with adequate diagnostic and treatment resources.

• Most common and severe toxic effect is bone marrow suppression.

• Some patients receiving systemic drug have experienced hemolytic uremic syndrome, a serious complication consisting primarily of microangiopathic hemolytic anemia, thrombocytopenia, and irreversible renal failure. Syndrome may arise at any time during systemic therapy, but most cases occur at doses of 60 mg or higher. Blood product transfusion may exacerbate symptoms.

Action

Selectively inhibits DNA synthesis by causing cross-linking of DNA strands and suppressing RNA and protein synthesis, resulting in cell death

Availability

Injection: 5-mg, 20-mg, and 40-mg vials

Indications and dosages

Disseminated adenocarcinoma of stomach or pancreas (given with other chemotherapeutic agents); palliative treatment when other therapies fail

Adults: 20 mg/m2 I.V. as a single dose. Repeat cycle q 6 to 8 weeks, adjusting dosage if necessary.

Dosage adjustment

• Reduced white blood cell or platelet count

Contraindications

• Hypersensitivity to drug

• Thrombocytopenia, coagulation disorders, increased bleeding tendency

Precautions

Use cautiously in:

• active infections, decreased bone marrow reserve, impaired hepatic function

• history of pulmonary disorders

• elderly patients

• pregnant or breastfeeding patients.

Administration

Follow facility policy for handling, administering, and disposing of mutagenic, teratogenic, and carcinogenic drugs.

• Reconstitute 5-mg vial with 10 ml of sterile water. Shake, let mixture stand, and administer by direct I.V. injection through Y-tube or three-way stopcock. Infuse over 5 to 10 minutes through line with running infusion of normal saline solution or dextrose 5% in water.

Avoid extravasation and contact with skin, mucous membranes, and eyes.

Adverse reactions

GI: nausea, vomiting, anorexia, mouth ulcers, stomatitis

GU: renal failure, hemolytic uremic syndrome

Hematologic: anemia, leukopenia, thrombocytopenia

Respiratory: pulmonary toxicity, interstitial pneumonitis

Skin: reversible alopecia; pruritus; desquamation; phlebitis, necrosis, and sloughing with I.V. site extravasation

Other: fever

Interactions

Drug-drug. Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions

Other antineoplastics: additive bone marrow depression

Vinca alkaloids: respiratory toxicity

Patient monitoring

Closely monitor CBC with white cell differential and platelet count. Stay alert for evidence of blood dyscrasias.

• Assess kidney function tests. Measure fluid intake and output and evaluate fluid balance.

Watch for signs and symptoms of hemolytic uremic syndrome (irritability, fatigue, pallor, and decreased urinary output).

Closely monitor I.V. site and skin integrity to prevent extravasation.

Assess respiratory status carefully to detect severe pulmonary problems.

Patient teaching

Teach patient to recognize and immediately report signs and symptoms of hemolytic uremic syndrome, blood dyscrasias, and renal failure.

Instruct patient to report cough or shortness of breath, even if it occurs several months after therapy ends.

• Advise patient to limit exposure to infections and to avoid live vaccines.

• Tell patient drug may cause hair loss. Discuss options for dealing with this problem.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above.

mi·to·my·cin

(mī'tō-mī'sin),
Antibiotic produced by Streptomyces caespitosus, variants of which are designated mitomycin A, mitomycin B, etc.; mitomycin C is an antineoplastic agent and a bacteriocide; inhibits DNA synthesis.

mitomycin

(mī′tə-mī′sĭn)
n.
Any of a group of antibiotics produced by the soil actinomycete Streptomyces caespitosus that inhibit DNA synthesis and are used against bacteria and cancerous tumor cells.

mitomycin

Oncology An antineoplastic antibiotic produced from Streptomyces caespitosus, which acts as an alkylating agent and cross-links DNA, thereby inhibiting DNA synthesis Indications Leukemia

mi·to·my·cin

(mī'tō-mī'sin)
Antibiotic produced by Streptomyces caespitosus, variants of which are designated mitomycin A, mitomycin B, C, which is an antineoplastic agent and a bacteriocide; inhibits DNA synthesis.
References in periodicals archive ?
Dermatitis due to intravesical mitomycin C: a delayed-type hypersensitivity reaction?
Reichelderfer, "Intralesional mitomycin C: successful treatment for benign recalcitrant esophageal stricture," Gastrointestinal Endoscopy, vol.
The possibility of cardiotoxicity in the form of perimyocarditis occurring in association with intravesical mitomycin C instillation following TURBT has not been studied and with no documented case reports in existing literature and only one instance of pericarditis attributed to intravesical MMC instillation in a retrospective analysis [16].
Outcome of recurrent pterygium with intraoperative 0.02% mitomycin C and free flap limbal conjunctival autograft.
Duman, "Comparison of three methods for the treatment of pterygium: amniotic membrane graft, conjunctival autograft and conjunctival autograft plus mitomycin C," Orbit, vol.
Diakonis et al in 2013 on the Allegretto laser platform 200hz using Mitomycin C, mean Log MAR UCVA 44 months after surgery was reported as 0.040.12 that is close to our study.12 In this study meanLog MAR BCVA five year after operation was 0.0080.044 and there was no significant difference in men and women groups as well as the age group less than and equal to25 years and more than 25 years and two groups with or without astigmatism before the operation.
The influence of mitomycin C and paclitaxel on the proliferation and apoptosis of human pulmonary fibroblast (in Chinese).
Splenocyte suspensions ([10.sup.6] cell/mL) were treated with mitomycin C or vehicle for 1 h at 37[degrees]C.
Intraoperative topical administration of mitomycin C, in different concentrations, on the cicatrization of mioplasties of the dorsal rectus of rabbits
Surgical excision with a C[O.sub.2] laser and cold steel instruments had both been attempted, as had intralesional steroid injection and application of mitomycin C.