introduction,pharmakokinitics,Mechanism of action,Dosage form,Administration routes,Side effects and Precautions of Doxorubicin

2. Doxorubicin
 Trade name: Adriamycin, Rubex
 Chemotherapy drug class: antitumor antibiotics
 One of the most powerful chemotherapy drugs
invented that is used to treat a wide variety of cancers
 FDA approved for use alone or in combination with
other drugs

3. Doxorubicin
 Treats the following cancers:
 Acute lymphoblastic leukemia (ALL)
 Acute myeloid leukemia (AML)
 Breast Cancer (adjuvant therapy when it has spread to
lymph nodes after surgery
 Gastric cancer
 Hodgkin lymphoma
 Neuroblastoma
 Non-hodgkin lymphoma
 Ovarian cancer

4. Doxorubicin
 DOXIL is an anthracycline topoisomerase II inhibitor,
that is encapsulated in STEALTH® liposomes for
intravenous use.

5. Doxorubicin
 Mechanism Of Action
The mechanism of action is thought to be related to its
ability to bind DNA and inhibit nucleic acid synthesis.
Cell structure studies have demonstrated rapid cell
penetration and perinuclear chromatin binding, rapid
inhibition of mitotic activity and nucleic acid synthesis,
and induction of mutagenesis and chromosomal
aberrations.

6. Doxorubicin
 Distribution
Direct measurement of liposomal doxorubicin shows
that at least 90% of the drug remains liposome-
encapsulated during circulation.
Doxorubicin becomes available after the liposomes are
extravasated. Plasma protein binding of DOXIL has not
been determined; the plasma protein binding of
doxorubicin is approximately 70%.

7. Doxorubicin
 Metabolism
Doxorubicinol, the major metabolite of doxorubicin, was
detected at concentrations of 0.8 to 26.2 ng/mL in the
plasma of patients who received 10 or 20 mg/m² DOXIL.
 Elimination
The plasma clearance of total doxorubicin from DOXIL
was 0.041 L/h/m² at a dose of 20 mg/m² . Following
administration of doxorubicin HCl, the plasma clearance
of doxorubicin is 24 to 35 L/h/m² .

8. Doxorubicin
 Dosage forms and strengths of doxorubicin hydrochloride:
 Vials clear red solution
 10 mg/5 mL, 20 mg/10 mL, 50 mg/25 mL, 150 mg/75 mL, and 200
mg/100 mL
 Vials red-orange lyophilized powder
 10 mg, 20 mg, 50 mg, and 150 mg
 Storage
 Refrigerated 2° to 8°C (36° to 46°F)
 Protect from light
 Retain in carton until used
 Discard unused portion

9. Doxorubicin
 Therapy routine for Breast Cancer, ovary, prostate,
stomach, thyroid; small cell cancer of lung, liver; squamous
cell cancer of head and neck; multiple myeloma, Hodgkin's
disease, lymphomas, ALL, AML
 60-75 mg/m² IV q21Days OR
 60 mg/m² IV q14Days OR
 40-60 mg/m² IV q21-28Days OR
 20 mg/m²/dose qweek

10. Doxorubicin
 Limit lifetime cumulative dose to <550 mg/m² to
reduce risk of cardio toxicity (congestive heart failure
& cardiomyopathy)
 Monitor: CBC, cardiac function, LFTs (liver function
tests)

11. Doxorubicin
 Side effects:
 Nausea or vomiting
 Pain at injection site
 Temporary Low blood counts of white & red blood cells
and platelets
 Mouth sores
 Alopecia (hair loss on scalp or body)
 Eyes watering (first week of treatment)
 Urine color red, red-brown, orange, or pink in first 1-2
days after dose administered

12. Doxorubicin
 First two weeks of taking drug:
 Nail beds darken
 Skin darkens where previous radiation treatment was
administered
 Fertility issues
 Serious: can cause issue with pumping of heart that
may occur 7-8 years after treatment.
 Lifetime limit on amount patients may receive.

13. Doxorubicin
 Precautions while taking:
 Aspirin and their products should not be taken without
physician approval
 No vaccinations without physician approval
 Use contraceptives (barrier type recommended -condoms)
& do not get pregnant
 Do not breast feed
 Not to be taken by patients with congestive heart failure, if
you have already taken high doses of this drug, or have
bone marrow suppression or other blood count issues

14. Doxorubicin
 Administered:
 IV Push (syringe) in not less than 3 to 5 minutes
 IVPB (IV admixture) over 15 to 60 minutes
 Must not be given via intramuscular or subcutaneous
route

15. Doxorubicin

16. Refrences
 http://www.rxlist.com/doxil-drug.htm
 http://reference.medscape.com/drug/doxorubicin-342120
 http://doxorubicin.cancertreatment.net/
 http://www.cancer.gov/cancertopics/druginfo/doxorubicinhydrochlori
de
 http://www.cancernetwork.com/review-article/review-
docetaxeldoxorubicin-combination-metastatic-breast-
cancer#sthash.o4sOCNSV.dpuf. Retrieved from cancerNetwork.com:
http://www.cancernetwork.com/review-article/review-
docetaxeldoxorubicin-combination-metastatic-breast-cancer
 http://chemocare.com/chemotherapy/drug-
info/doxorubicin.aspx#.VIS15tLF9e8
http://www.globalrph.com/doxorubicin.htm#DOSAGE_AND_ADMIN
ISTRATION
 http://consumer.healthday.com/encyclopedia/cancer-8/mis-cancer-
news-102/chemotherapy-and-side-effects-648006.html

17. Doxorubicin
Name: Andrew Girgis
ID no: 40202