Home Drug Guide Hydroxyurea

Drug Guide

Generic Name

Hydroxyurea

Brand Names Hydrea, Droxia, Siklos, Xromi

Classification

Therapeutic: Antineoplastic agent, Hematologic Agent

Pharmacological: Ribonucleotide Reductase Inhibitor

FDA Approved Indications

  • Chronic myelogenous leukemia (CML)
  • Sickle cell disease (reduces frequency of sickling crises)
  • Other myeloproliferative disorders

Mechanism of Action

Hydroxyurea inhibits ribonucleotide reductase, leading to decreased DNA synthesis, which inhibits the proliferation of rapidly dividing cells and induces fetal hemoglobin production in sickle cell disease.

Dosage and Administration

Adult: Varies by indication; for sickle cell disease, typically 15 mg/kg/day orally, adjusted based on response and tolerability.

Pediatric: Dosage individualized based on body weight and clinical response.

Geriatric: Dose adjustments may be necessary due to comorbidities and renal function.

Renal Impairment: Use with caution; dosage adjustments may be necessary.

Hepatic Impairment: Use with caution; monitor for hepatotoxicity.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body fluids and tissues.

Metabolism: Metabolized in the liver, exact pathways not fully characterized.

Excretion: Excreted primarily in the urine.

Half Life: Approximately 3-4 hours.

Contraindications

  • Hypersensitivity to hydroxyurea.
  • Patients with severe myelosuppression.

Precautions

  • Monitor blood cell counts regularly.
  • Use with caution in pregnancy; effective contraception advised during treatment and for 6 months after.
  • Patients with hepatic or renal impairment require dose adjustments and close monitoring.

Adverse Reactions - Common

  • Myelosuppression (neutropenia, thrombocytopenia, anemia) (Common)
  • Gastrointestinal discomfort (nausea, vomiting, diarrhea) (Common)
  • Dermatologic reactions (rash, pigmentation) (Common)

Adverse Reactions - Serious

  • Secondary leukemia or other secondary malignancies (Rare)
  • Severe myelosuppression leading to infection or bleeding (Serious but less common)
  • Hepatic toxicity (Serious, monitor liver function)

Drug-Drug Interactions

  • Other myelosuppressive agents, may increase risk of hematologic toxicity.
  • Clozapine, increased risk of hematologic toxicity.

Drug-Food Interactions

  • No significant interactions noted.

Drug-Herb Interactions

  • Limited data, caution advised with herbs that affect blood counts.

Nursing Implications

Assessment: Monitor complete blood counts regularly, liver and kidney function tests.

Diagnoses:

  • Impaired tissue perfusion related to myelosuppression.
  • Risk for infection due to neutropenia.

Implementation: Administer as prescribed, monitor labs, educate patient on infection prevention.

Evaluation: Assess for side effects, efficacy in reducing sickling crises or controlling leukemia.

Patient/Family Teaching

  • Report signs of infection promptly.
  • Use effective contraception.
  • Follow-up blood tests as scheduled.
  • Avoid pregnancy during and for 6 months after therapy.

Special Considerations

Black Box Warnings:

  • Potential for secondary malignancies such as leukemia.
  • Severe myelosuppression leading to infection or bleeding.

Genetic Factors: Not specifically associated with genetic factors affecting drug metabolism.

Lab Test Interference: May alter blood counts, need to distinguish drug effects from disease progression.

Overdose Management

Signs/Symptoms: Severe myelosuppression, bleeding, infection.

Treatment: Supportive care, transfusions if necessary, colony-stimulating factors, hospitalization.

Storage and Handling

Storage: Store at controlled room temperature 20°C to 25°C (68°F to 77°F).

Stability: Stable if unopened for the duration of the shelf life as per manufacturer.

🛡️ 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.