COP 항암화학요법 프로토콜

용도

• COP Protocol - Induction (Cyclophosphamide)
• COP Protocol - Induction (Vincristine)
• COP Protocol - Induction (Prednisolone)
• COP Protocol - Adjunct (Furosemide)
• COP Protocol - Maintenance after 6 months (Cyclophosphamide)
• COP Protocol - Maintenance after 6 months (Vincristine)
• COP Protocol - Maintenance after 6 months (Prednisolone)
• Alternative to Cyclophosphamide (Chlorambucil)

투여 방법

가능한 부작용

• Myelosuppression (neutropenia)
• Haemorrhagic cystitis (cyclophosphamide)
• Gastrointestinal toxicity (vomiting, diarrhoea, anorexia)
• Tissue necrosis if extravasated (vincristine)

주의사항 및 금기

• Severe neutropenia (< 2 x 10^9/L)
• Pre-existing haemorrhagic cystitis
• Known MDR1 mutation (requires extreme caution/dose adjustment for vincristine)
• > **Vesicant Warning:** Vincristine is a vesicant. IV catheters must be placed in all cases, and ONLY catheters placed by a clean 'first-stick' should be used. > **Myelosuppression:** Discontinue cyclophosphamide if neutrophil count decreases to < 2 x 10^9/L. Check weekly and do not resume until > 3 x 10^9/L. If neutropenia recurs, decrease dose by 10-25%. > **MDR1 Mutation:** Certain breeds (generally Collie type) are very sensitive to vincristine due to the MDR1 mutation; commercial testing is highly recommended prior to treatment. **Clinical Pearl:** GI protectants (e.g., Omeprazole 1 mg/kg q12-24h or Ranitidine with sucralfate) are recommended for the first 21 days of the protocol.

약물 상호작용

• Cimetidine: Inhibits hepatic cytochrome P450 enzyme pathway, potentially altering the metabolism and increasing toxicity of chemotherapeutics.

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