放線菌素D (Dactinomycin)

用途

• Antineoplastic protocols (e.g., rescue therapy for lymphomas, sarcomas)
• Lymphoma (rescue protocols), sarcomas, and carcinomas

給藥方式

可能的副作用

• Bone marrow depression (anemia, leukopenia, thrombocytopenia)
• Gastrointestinal toxicity (diarrhea, ulcerative stomatitis, GI ulceration)
• Severe tissue damage and pain (if extravasated)
• Hyperuricemia (may require allopurinol)
• Hepatotoxicity

注意事項與禁忌

• Hypersensitivity to dactinomycin
• Pregnancy (teratogenic and embryotoxic)
• **WARNING: Severe Vesicant and Highly Toxic** * **Extravasation Risk:** Can cause extensive pain and tissue damage. Must be administered via a perfectly placed IV catheter, ideally using a 'two-needle' technique and slow infusion into a running IV line. * **MDR1 Mutation:** Use with extreme caution or avoid in breeds susceptible to the MDR1-allele mutation (Collies, Australian Shepherds, Shelties, Long-haired Whippets) due to high risk of fatal toxicity. * **Organ Dysfunction:** Use with caution in patients with preexisting bone marrow depression, hepatic dysfunction, or active infections. * **Hazardous Drug:** Chronic exposure increases mutagenic, teratogenic, and carcinogenic risks for healthcare workers. Strict hazardous drug handling, preparation, and disposal protocols are required. * **Pregnancy/Nursing:** Embryotoxic and teratogenic (FDA Category C). Avoid use in pregnant or nursing animals.

藥物相互作用

• Doxorubicin: Additive cardiotoxicity may occur if used concurrently or sequentially.
• Myelosuppressive drugs (e.g., chloramphenicol, flucytosine, colchicine, other antineoplastics): May cause additive myelosuppression.
• Vitamin K: Patients may require higher dosages of vitamin K when receiving dactinomycin.

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