Home Drug Guide Floxuridine

Drug Guide

Generic Name

Floxuridine

Brand Names FUDR

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Antimetabolite (Thymidylate synthase inhibitor)

FDA Approved Indications

  • Adjunctive therapy for gastrointestinal carcinomas (primarily colorectal cancer)

Mechanism of Action

Floxuridine is a pyrimidine analog of deoxyribonucleoside that inhibits DNA synthesis by interfering with thymidylate synthase, leading to subsequent inhibition of DNA replication and cell proliferation.

Dosage and Administration

Adult: Typically, 370-550 mcg/m2 administered intra-arterially or intravenously daily for 5 consecutive days, repeated every 4 weeks, as per treatment protocol.

Pediatric: Data is limited; use is generally off-label and based on specific clinical protocols, with careful dosing adjustments.

Geriatric: No specific dosage adjustment required, but caution and close monitoring are advised due to possible decreased renal or hepatic function.

Renal Impairment: Dose adjustment may be necessary; consult specific protocols.

Hepatic Impairment: Use cautiously; no specific adjustments established.

Pharmacokinetics

Absorption: Variable, depends on administration route; intra-arterial infusion provides high local concentrations.

Distribution: Widely distributed, including crossing the blood-brain barrier in some cases.

Metabolism: Metabolized in the liver to inactive metabolites.

Excretion: Primarily excreted through the kidneys.

Half Life: Approximately 15-30 minutes in plasma.

Contraindications

  • Hypersensitivity to floxuridine or other pyrimidine analogs.

Precautions

  • Use with caution in patients with hepatic or renal impairment, pregnancy, or lactation. Monitor for hypersensitivity reactions, myelosuppression, and hepatic toxicity.

Adverse Reactions - Common

  • Myelosuppression (Common)
  • Stomatitis (Common)
  • Nausea and vomiting (Common)
  • Elevated liver enzymes (Common)

Adverse Reactions - Serious

  • Myelodysplastic syndrome or secondary leukemia (Rare)
  • Severe hepatotoxicity (Rare)
  • Anaphylactic reactions (Rare)

Drug-Drug Interactions

  • Other myelosuppressive agents, live vaccines, hepatotoxic drugs.

Drug-Food Interactions

  • No significant food interactions reported.

Drug-Herb Interactions

  • Limited data; caution with herbal products affecting hepatic or hematologic function.

Nursing Implications

Assessment: Monitor complete blood count (CBC), liver function tests, renal function, and signs of toxicity.

Diagnoses:

  • Risk for infection related to myelosuppression.
  • Impaired oral mucous membrane related to stomatitis.

Implementation: Administer as prescribed, monitor laboratory values, assess for signs of toxicity, provide supportive care.

Evaluation: Efficacy of tumor response, tolerance to medication, and absence of toxicities.

Patient/Family Teaching

  • Report any signs of infection, bleeding, unusual fatigue.
  • Maintain good oral hygiene, report mouth sores.
  • Follow administration schedule strictly.
  • Avoid live vaccines during treatment.

Special Considerations

Black Box Warnings:

  • Potential for severe myelosuppression leading to infections or bleeding, which can be life-threatening.

Genetic Factors: Not well established.

Lab Test Interference: May cause elevated liver enzymes or altered blood counts, which can interfere with other diagnostic labs.

Overdose Management

Signs/Symptoms: Severe myelosuppression, hepatotoxicity, gastrointestinal toxicity.

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

Storage and Handling

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

Stability: Stable under recommended storage conditions until 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.