Home Drug Guide Altretamine

Drug Guide

Generic Name

Altretamine

Brand Names Hexalen

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Alkylating agent

FDA Approved Indications

  • Ovarian cancer, persistent or recurrent

Mechanism of Action

Altretamine is an alkylating agent that interferes with DNA synthesis by forming cross-links, leading to cell death, particularly in ovarian cancer cells.

Dosage and Administration

Adult: Initially, 5 mg orally 4 times daily for 14 days, then 2-week rest, repeating cycles.

Pediatric: Not typically used in pediatric patients.

Geriatric: No specific dose adjustment; monitor for toxicity.

Renal Impairment: Use with caution; no specific adjustments provided.

Hepatic Impairment: Use with caution; no specific adjustments provided.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Hepatic, primarily via demethylation.

Excretion: Renal, mainly as metabolites.

Half Life: Approximately 8 hours.

Contraindications

  • Known hypersensitivity

Precautions

  • Monitor blood counts regularly, as myelosuppression is common.
  • Use with caution in hepatic impairment.
  • Potential for neurotoxicity and other adverse effects; adjust dose or discontinue as needed.

Adverse Reactions - Common

  • Nausea, vomiting (Common)
  • Myelosuppression (Common)
  • Alopecia (Less common)

Adverse Reactions - Serious

  • Bone marrow suppression leading to anemia, leukopenia, thrombocytopenia (Serious)
  • Neurotoxicity (peripheral neuropathy) (Less common)
  • Hemorrhagic cystitis (Less common)

Drug-Drug Interactions

  • CNS depressants, other myelosuppressive agents

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor CBC regularly, assess for signs of neurotoxicity and other adverse effects.

Diagnoses:

  • Risk for infection related to myelosuppression.
  • Risk for tissue injury related to hemorrhagic cystitis.

Implementation: Administer as prescribed, monitor blood counts, provide supportive care.

Evaluation: Assess for response to therapy and adverse effects, adjust treatment plan accordingly.

Patient/Family Teaching

  • Report signs of infection, bleeding, or unusual neurological symptoms.
  • Use effective contraception during therapy and for at least 6 months after.
  • Avoid alcohol and hepatotoxic drugs.
  • Attend regular blood tests as scheduled.

Special Considerations

Black Box Warnings:

  • Potentially severe myelosuppression, including leukopenia and thrombocytopenia, which can be life-threatening.

Genetic Factors: None specified.

Lab Test Interference: May affect hepatic and hematologic laboratory tests.

Overdose Management

Signs/Symptoms: Severe myelosuppression, neurological symptoms.

Treatment: Supportive care including growth factors, transfusions, and symptomatic management; no specific antidote.

Storage and Handling

Storage: Store at room temperature, protected from light and moisture.

Stability: Stable when stored properly, check expiration date regularly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.