relbovin
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VINORELBINE: Vinorelbine is a cytostatic antineoplastic durg. It is a semi-synthetic member of the cinca alkaloid family tht interferes with microtubule assembly. The vinca alkaloids are structually similar compunds comprised of two multiringed units, vindoline and cathranthine. Unlike other vinca alkaoids, the catharanthine unit is the site of structural modificaation for virnorebine. The antitumor activity or vinorelbine is though to be due primarly to inhibition of mitosis at metaphase through its interaction with fubulin. In infact tectal platesw form mouse embryos vincristine and vnblastine inhibited mitotic microtublue formation at the same concentratin (2micoM), including a blockade of cells at metaphase, Vincristine produced depolymerstation of axonal tubules at 5 microM but vinlastine and vinorebine dis not have this effect until concentratins of 30microM and 40micorM respectively. These date suggest relative selectivity of vinorelbine for mitotic microtubules. Vinoreelbine has an active metabolite, 17 deacetyivinorelbie, lowlevels of which are recovered in human; its toxicity and activity are slightly higher than those of vinorelbine.
Indications: The treatment of non small cell lung cancer (NSCLS), and the second line treatment of advanced breast cancer.
Dosage: Single agent treatment in usually given at 25-30mg/m2 weekly. In combination chemotherapy the dose may be the same and frequency of administration reduced i.e. day 1 day 8 or day 1 and 5 every 3weeks. Clinical experience has not identified differences in response between elderly and younger patients, but grater sensitivity of some older individuals cannot be ruled out.
Contra indications: Hypersensitivity to vinorlbhine neutoophil counts 1000cells/mm3, svere hepatic insufficiency pregnancy Lactation.
Special Precautions: Injection must only be administered by the intravenous route. Intrathecal administration of other vinca alkaloids has resulted in death improper amministratin of Tamozolomide may result in extracasation causing local tissue necrosis and/or thrombophlebitis should be frequently monitored for myleosupporession both during and after therapy. Neurtropenia is dose-limiting.