스트렙토조신

용도

• Recurrent insulinoma after surgery (investigational)
• Pancreatic islet cell tumors

투여 방법

가능한 부작용

• Serious, permanent renal toxicity
• Severe and protracted vomiting and nausea
• Mild myelosuppression
• Elevated liver enzymes
• Severe tissue necrosis if extravasated (vesicant)

주의사항 및 금기

• Patients without a confirmed histologic diagnosis of insulinoma
• Patients with completely resectable tumors
• Pregnancy (unless benefits outweigh risks; FDA Category C)
• > **CRITICAL WARNING**: Streptozocin is highly **nephrotoxic**. Aggressive IV saline diuresis is absolutely mandatory before, during, and after administration to prevent permanent renal failure. * Must be used with extreme caution in patients with decreased renal, bone marrow, or hepatic function. * **Vesicant**: Severe tissue necrosis will occur if the drug extravasates outside the vein. Ensure a perfectly placed, patent IV catheter. * **Nursing Safety**: It is unknown if it is excreted in milk. Consider using milk replacer due to the potential for serious adverse reactions in nursing offspring.

약물 상호작용

• Doxorubicin: Streptozocin may prolong the half-life of doxorubicin; dosage adjustment may be required.
• Myelosuppressive drugs (e.g., carmustine): Additive or synergistic myelosuppression may occur.
• Nephrotoxic drugs (aminoglycosides, amphotericin B, cisplatin): May cause additive nephrotoxicity when used concurrently.
• Niacinamide (nicotinamide): Can block the diabetogenic effects of streptozocin without altering its antineoplastic activity; this may be beneficial or detrimental depending on the clinical goal.

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