mesna


Also found in: Wikipedia.

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

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 ?
cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus.
Because of the well reported incidence of gross-hematuria and hemorrhagic cystitis in patients undergoing conditioning for allogeneic BMT/SCT, these patients are routinely prophylactically treated with continuous bladder irrigation (CBI), 2-mercaptoethanesulfonic acid (mesna), and hyperhydration during their myelosuppressive conditioning.
Demographic and clinical characteristics of study population and the chemotherapeutic agents n Chemotherapeutic agents Patients 28 Sex (M/F) 6/22 Age (years), 52.3[+ or -]9.6 mean[+ or -]SD Cancer related 22 Breast cancer 9 Vinorelbine, docetaxel, clodronate, ietrozole, trastuzumab, capecitabine paclitaxel, dexamethasone sodium phosphate, gemcitabine, cisplatin Colorectal cancer 7 5-FU, leucovorin oxaliplatin, cisplatin, docetaxel, bevacizumab, irinotecan Gastric cancer 2 5-FU, leucovorin, cisplatin, docetaxel Other malignancies Methotrexate, cytarabine, ifosfamide, mesna, etoposide Noncancer related 6 M, male; F, female; FU, fluorouracil.
[16] The drugs found to cause xerosis in this study were cyclophosphamide, carboplatin, ifosfamide, mesna and vincristine.
In general, it is known that the 5-year survival of patients with uterine carcinosarcomas receiving radiotherapy versus no irradiation was 41.5% and 33.2%, respectively.[7] A retrospective study assessed the efficacy and toxicity of a novel combination chemotherapy using carboplatin, ifosfamide, and mesna compared with other regimens for patients in adjuvant and palliative settings.
Protective effect of MESNA (2-mercaptoethane sulfonate) against hepaticischemia/reperfusion injury in rats.
Sodium-2-mercap-toethanesulphonate (MESNA), a sodium salt of 2-thiosulphonate anion, is now used for this purpose during otologic surgery; it provides more effective dissection because it cleaves the disulfide bonds [9].
Another study reported that these patients could undergo hematuria with increased chemotherapy toxicity because of DNA-repair defects despite the administration of the lower cyclophosphamide doses and the administration of the protective agent Mesna (Uromitexan; Eczacibasi-Baxter Medical, Istanbul, Turkey) (6).
She was well hydrated per protocol, but her cyclophosphamide regimen (3 g/[m.sup.2] of cyclophosphamide given in 1 g/[m.sup.2] doses) did not necessitate the use of mesna (10,11).
A total of 75 patients with severe scleroderma (diffuse cutaneous systemic sclerosis) underwent randomization to open-label treatment with either transplantation or intravenous cyclophosphamide at an initial dose of 500 mg/[m.sup.2] of body-surface area, followed by 11 monthly infusions of 750 mg/[m.sup.2] with mesna prophylaxis.
In the case of high risk of development of pulmonary hemorrhage, the VIP regimen (etoposide, mesna, ifosfamide, and cisplatin) could be chosen as first-line CT.