Home Drug Guide Mitomycin

Drug Guide

Generic Name

Mitomycin

Brand Names Mitosol, Mutamycin, Mitozytrex, Jelmyto

Classification

Therapeutic: Antineoplastic agent

Pharmacological: Alkylating agent

FDA Approved Indications

  • Bladder cancer (Jelmyto)
  • Topical use in ophthalmic procedures (Mitosol)
  • Chemotherapy for various solid tumors (Mutamycin, Mitozytrex)

Mechanism of Action

Mitomycin is an alkylating agent that crosslinks DNA, leading to inhibition of DNA synthesis and cell death, particularly affecting rapidly dividing cancer cells.

Dosage and Administration

Adult: Dose varies based on indication; for Jelmyto, intravesical instillation is administered once weekly for six weeks.

Pediatric: Use is limited; consult specific protocols.

Geriatric: Adjust dose based on renal and hepatic function; close monitoring recommended.

Renal Impairment: Use caution; dose adjustments may be necessary.

Hepatic Impairment: Use caution; limited data available, adjust as needed.

Pharmacokinetics

Absorption: Administered locally or intravenously; systemic absorption is minimal with topical use.

Distribution: Widely distributed; large volume of distribution.

Metabolism: Metabolized in the liver.

Excretion: Primarily excreted in urine.

Half Life: Approximately 30 minutes to 2 hours, depending on administration route.

Contraindications

  • Hypersensitivity to mitomycin or other quinones.
  • Active infections.

Precautions

  • Perform complete blood counts prior to therapy.
  • Use cautiously in patients with hepatic or renal impairment.
  • Risk of myelosuppression, hemorrhage, and wound healing impairment.

Adverse Reactions - Common

  • Myelosuppression (Common)
  • Nausea and vomiting (Common)
  • Hemorrhage or bleeding (Less common)

Adverse Reactions - Serious

  • Severe myelosuppression leading to infection or bleeding (Serious)
  • Pulmonary toxicity (Less common)
  • Secondary malignancies (rare) (Rare)

Drug-Drug Interactions

  • Other myelosuppressive agents
  • Radiation therapy

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood counts, renal and hepatic function, wound healing.

Diagnoses:

  • Risk for bleeding, infection, impaired tissue integrity.

Implementation: Administer as prescribed, monitor adverse reactions, educate patient.

Evaluation: Assess for side effects, effectiveness of treatment, and lab changes.

Patient/Family Teaching

  • Report signs of infection, bleeding, or unusual fatigue.
  • Follow instructions regarding precautions during and after therapy.
  • Maintain proper communication during treatment cycles.

Special Considerations

Black Box Warnings:

  • Bone marrow suppression leading to severe or fatal myelosuppression.
  • Potential for pulmonary toxicity and secondary malignancies.

Genetic Factors: None specified.

Lab Test Interference: May cause transient changes in blood counts, liver and renal function tests.

Overdose Management

Signs/Symptoms: Severe myelosuppression, hemorrhage, signs of pulmonary toxicity.

Treatment: Supportive care, blood product transfusions, and possibly leukocyte or platelet transfusions; no specific antidote.

Storage and Handling

Storage: Store in a refrigerator (2°C to 8°C); protect from light.

Stability: Stable for specified duration, check manufacturer guidelines.

🛡️ 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.