Home Drug Guide Etoposide Phosphate

Drug Guide

Generic Name

Etoposide Phosphate

Brand Names Etopophos Preservative Free

Classification

Therapeutic: Antineoplastic agent (chemotherapy)

Pharmacological: Topoisomerase II inhibitor

FDA Approved Indications

  • Treatment of certain types of cancers such as small cell lung cancer, testicular cancer, ovarian cancer, and other malignancies as determined by the physician.

Mechanism of Action

Etoposide inhibits the enzyme topoisomerase II, leading to DNA damage and apoptosis in rapidly dividing cells, thereby exerting its anticancer effects.

Dosage and Administration

Adult: Dosage varies based on the specific indication, often given as an intravenous infusion; typical doses range from 50 to 100 mg/m² per day for 3 to 5 days per cycle.

Pediatric: Dose individualized based on body surface area and clinical condition; consult specific pediatric guidelines.

Geriatric: Use with caution; assume increased risk of toxicity due to decreased organ function and comorbidities.

Renal Impairment: Adjust dose based on renal function; specific guidelines are recommended.

Hepatic Impairment: Use with caution; no specific dosage adjustments are well established.

Pharmacokinetics

Absorption: Administered intravenously; not relevant for oral absorption.

Distribution: Widely distributed; crosses blood-brain barrier to some extent.

Metabolism: Partially metabolized in the liver to inactive metabolites.

Excretion: Primarily excreted via the urine.

Half Life: Approximate half-life ranges from 4 to 12 hours, depending on individual patient factors.

Contraindications

  • Hypersensitivity to etoposide or related compounds.
  • Patients with severe myelosuppression.

Precautions

  • Use cautiously in patients with impaired bone marrow function, infections, or who are receiving other myelosuppressive treatments.
  • Monitor blood counts regularly.
  • Pregnancy category D: risk to fetus; use contraception during treatment.

Adverse Reactions - Common

  • Myelosuppression (neutropenia, thrombocytopenia, anemia) (Common)
  • Nausea and vomiting (Common)
  • Alopecia (Common)

Adverse Reactions - Serious

  • Secondary leukemias (therapy-related AML or meningeal leukemia) (Rare)
  • Severe hypersensitivity reactions (Rare)
  • Hepatic toxicity (Rare)

Drug-Drug Interactions

  • Corticosteroids, other myelosuppressive drugs, live vaccines.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor complete blood counts regularly. Assess for signs of infection, bleeding, and adverse reactions.

Diagnoses:

  • Risk for infection, risk for bleeding, nausea related to chemotherapy.

Implementation: Administer under supervision of healthcare provider; ensure proper hydration; monitor blood counts; manage side effects.

Evaluation: Evaluate effectiveness by tumor response; monitor for adverse effects and hematologic toxicity.

Patient/Family Teaching

  • Report signs of infection, bleeding, or unusual symptoms immediately.
  • Use precautions to prevent infection. Follow specific instructions for hydration and managing side effects.
  • Avoid live vaccines during therapy.
  • Ensure adequate nutrition and rest.

Special Considerations

Black Box Warnings:

  • Secondary malignancies, including therapy-related AML or acute leukemia.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Severe bone marrow suppression, mucositis, nausea, vomiting.

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

Storage and Handling

Storage: Store at room temperature away from moisture and light.

Stability: Stable when stored properly; discard after the expiration date.

🛡️ 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.