dacarbazine


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Related to dacarbazine: doxorubicin, bleomycin, Temozolomide

dacarbazine

 [dah-kahr´-bah-zēn]
a cytotoxic alkylating agent, used in antineoplastic therapy primarily for treatment of malignant melanoma and in combination chemotherapy for Hodgkin's disease and sarcomas. Unlike other alkylating agents, its primary target is not DNA; its major effect is inhibition of RNA and protein synthesis. Called also DTIC.

dacarbazine

FDA Box Warning

Give under supervision of physician experienced in cancer chemotherapy.

Hematopoietic depression is most common toxicity; hepatic necrosis has also occurred.

Drug is carcinogenic and teratogenic in animals.

Prescriber must weigh potential benefit against toxicity risk.

Action

Unclear. Thought to inhibit DNA synthesis by acting as purine analog. Also causes alkylation and may interact with sulfhydryl groups.

Availability

Injection: 100-mg and 200-mg vials

Indications and dosages

Hodgkin's disease

Adults: 150 mg/m2 I.V. daily for 5 days in combination with other drugs, repeated q 4 weeks. Or 375 mg/m2 I.V. on first day of combination therapy, repeated q 15 days.

Metastatic malignant melanoma

Adults: 2 to 4.5 mg/kg I.V. daily for 10 days, repeated q 4 weeks. Or 250 mg/m2 I.V. daily for 5 days, repeated q 3 weeks.

Off-label uses

• Malignant pheochromocytoma

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• hepatic dysfunction, impaired bone marrow function
• pregnant or breastfeeding patients
• children.

Administration

• Follow facility procedures for safe handling, administration, and disposal of chemotherapeutic drugs.
• Reconstitute with sterile water for injection according to manufacturer's directions.
• Further dilute reconstituted drug with 5% dextrose in water or normal saline solution.

Administer over 30 to 60 minutes by I.V. infusion only.

Take steps to prevent extravasation, which may cause tissue damage and severe pain.

Adverse reactions

CNS: malaise, paresthesia

GI: nausea, vomiting, dyspepsia, anorexia

Hematologic: anemia, leukopenia, thrombocytopenia, bone marrow depression

Musculoskeletal: myalgia

Skin: dermatitis, erythematous or urticarial rash, alopecia, flushing, photosensitivity

Others: flulike symptoms, fever, hypersensitivity reactions including anaphylaxis

Interactions

Drug-diagnostic tests.Platelets, red blood cells, white blood cells: decreased counts

Drug-behaviors.Sun exposure: photosensitivity reaction

Patient monitoring

Frequently monitor CBC with white cell differential and platelet count. Know that hematopoietic depression is the most common toxicity and can be fatal.
• Assess infusion site closely for extravasation.

Patient teaching

Instruct patient to immediately report pain, burning, or swelling at infusion site; numbness in arms or legs; gait changes; respiratory distress; difficulty breathing; rash; or easy bruising or bleeding.
• Advise patient to minimize GI distress by eating small, frequent servings of healthy food and drinking plenty of fluids.
• Tell patient he'll undergo regular blood testing during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests and behaviors mentioned above.


dalfampridine

Ampyra


Pharmacologic class: Potassium channel blocker

Therapeutic class: Multiple sclerosis agent

Pregnancy risk category C

 

Action

Unknown. May increase conduction of action potentials in demyelinated axons through inhibition of potassium channels.

Availability

Tablets (extended release): 10 mg

Indications and dosages

To improve walking in patients with multiple sclerosis

Adults: 10 mg P.O. q 12 hours

Dosage adjustments

• Mild renal impairment

Contraindications

• History of seizures
• Moderate or severe renal impairment

Precautions

Use cautiously in:
• mild renal impairment
• pregnant or breastfeeding patients
• children younger than age 18 (safety and efficacy not established).

Administration

• Check creatinine clearance before starting drug.
• Administer with or without food.

Adverse reactions

CNS: insomnia, dizziness, headache, asthenia, balance disorder, paresthesia, seizures

EENT: nasopharyngitis, pharyngolaryngeal pain

GI: nausea, constipation, dyspepsia

GU: urinary tract infection

Musculoskeletal: back pain

Other: multiple sclerosis relapse

Interactions

None

Patient monitoring

Discontinue drug if seizure occurs.
• Monitor renal function tests regularly (especially creatinine clearance).

Patient teaching

• Instruct patient to take drug with or without food.
• Instruct patient to swallow tablet whole and not to break, crush, chew, or dissolve it.

Advise patient to discontinue drug and immediately report to prescriber if seizures occur.
• Instruct patient to promptly report urinary tract problems.
• As appropriate, review all other significant and life-threatening adverse reactions.

dacarbazine

/da·car·ba·zine/ (dah-kahr´bah-zēn) a cytotoxic alkylating agent used as an antineoplastic primarily for treatment of malignant melanoma and in combination chemotherapy for Hodgkin's disease and sarcomas.

dacarbazine

(dă-kär′bə-zēn′, dā-)
n.
An antineoplastic agent used in the treatment of malignant melanoma and Hodgkin lymphoma.

dacarbazine

[dekär′bəzēn]
an alkylating agent used as an antineoplastic.
indications It is prescribed primarily in the treatment of malignant melanoma and Hodgkin's disease.
adverse effects Among the more serious adverse reactions are bone marrow depression, GI symptoms, kidney and liver impairment, alopecia, and fever.

ABDIC

A "salvage" chemotherapy regimen used for patients who have a disease—e.g., lymphoma—relapse after radiation therapy or chemotherapy.

dacarbazine

Oncology An alkylating chemotherapeutic used for lymphoma and metastatic melanoma Adverse effects BM suppression, pain on administration, vomiting

dacarbazine

An alkylating cytotoxic anti-cancer drug. The drug is on the WHO official list. A brand name is DTIC-Dome.

dacarbazine

an alkylating and antimetabolite, cell-cycle nonspecific antineoplastic agent. Abbreviated DTIC.
References in periodicals archive ?
Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma.
Conducted primarily in Europe and the United States, Study 309 was a multicenter, open-label, randomized Phase III study comparing the efficacy and safety of Halaven versus dacarbazine in 452 patients (aged 18 or over) with locally advanced, recurrent or metastatic soft tissue sarcoma (liposarcoma or leiomyosarcoma) who had disease progression following standard therapies which must have included an anthracycline and at least one other additional regimen.
Conclusion: These results revealed that the saponin extracted from sea cucumber as a natural anti-cancer compound may be a new treatment modality for metastatic melanoma and the application of sea cucumber saponin in combination with dacarbazine demonstrated the strongest anti-cancer activity as compared with the drug alone.
Group4 treated with a combination of Propolis at a dose of 50mg/kg and Dacarbazine at a dose of 3.
Phase Ill randomized, open-label, multicenter trial (BRIM3) comparing BRAF inhibitor vemurafenib with dacarbazine (DTIC) in patients with V600EBRAF-mutated melanoma.
Metastatic melanoma has been an "incredibly frustrating disease," with only one treatment--high dose interleukin-2--approved since dacarbazine was approved in 1975, Dr.
The toxicity associated with FDA-approved treatments such as dacarbazine or interleukin-2 is often significant, resulting in serious or life-threatening side effects in many of the patients treated.
Genasense is being made available for use in combination with dacarbazine at certain clinical sites throughout the United States for eligible patients with Stage IV and unresectable Stage III melanoma who have not been previously treated with dacarbazine or temozolomide-containing chemotherapy regimens.
According to the company, the NEMO study found binimetinib significantly extended median progression-free survival (PFS), the study's primary endpoint, as compared with dacarbazine.
14] followed by initiation of an adjuvant chemotherapy with Dacarbazine (DTIC), Nimustine (ACNU) or Vincristine (VCR).
OS was the primary endpoint in the CheckMate 066 trial, which compared treatment with nivolumab (3mg/kg administered intravenously every 2 weeks) to dacarbazine (1,000 mg/[m.
The patient began an intensive five-month regimen of chemotherapy, which consisted of dacarbazine, temozolomide, and vinblastine every three weeks.