Home Drug Guide Streptozocin

Drug Guide

Generic Name

Streptozocin

Brand Names Zanosar

Classification

Therapeutic: Antineoplastic, Alkylating agent

Pharmacological: Nitrosourea compound, Alkylating agent

FDA Approved Indications

  • Treatment of pancreatic islet cell carcinoma

Mechanism of Action

Streptozocin is a nitrosourea compound that acts as an alkylating agent, causing DNA damage in cancer cells, leading to cell death, particularly in pancreatic islet cell tumors.

Dosage and Administration

Adult: Typically 500 mg/m² IV once a day for 5 consecutive days, repeated every 4-6 weeks, adjusted based on response and tolerability.

Pediatric: Safety and efficacy not established; use with caution and under specialist supervision.

Geriatric: Adjust dosage based on renal function and tolerability.

Renal Impairment: Use cautiously; may require dose adjustment due to increased toxicity risk.

Hepatic Impairment: Use cautiously; no specific dosage recommendation available.

Pharmacokinetics

Absorption: Administered IV, so absorption is complete and rapid.

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

Metabolism: Metabolized minimally; undergoes hepatic processing.

Excretion: Primarily excreted via the kidneys.

Half Life: Approximately 15-20 minutes in plasma.

Contraindications

  • Hypersensitivity to streptozocin or other nitrosoureas.
  • Pre-existing renal or hepatic impairment.

Precautions

  • Monitor renal and hepatic function closely.
  • Risk of myelosuppression, nephrotoxicity, and neurotoxicity.
  • Use with caution in pregnant or breastfeeding women; potential teratogenicity and risk to infant.

Adverse Reactions - Common

  • Nausea and vomiting (Common)
  • Myelosuppression (anemia, leukopenia, thrombocytopenia) (Common)
  • Nephrotoxicity (Common)

Adverse Reactions - Serious

  • Neurotoxicity (including seizures, coma) (Serious)
  • Secondary malignancies (rare) (Rare)

Drug-Drug Interactions

  • Other myelosuppressive agents, nephrotoxic drugs, or hepatotoxic drugs.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood counts, renal and hepatic function regularly.

Diagnoses:

  • Risk for infection due to myelosuppression.
  • Risk for renal impairment.

Implementation: Administer IV as ordered, monitor vital signs and lab values, manage side effects, ensure hydration.

Evaluation: Assess response to therapy and toxicity; adjust treatment as necessary.

Patient/Family Teaching

  • Report signs of infection, bleeding, or unusual neuro symptoms promptly.
  • Maintain adequate hydration.
  • Avoid pregnancy.

Special Considerations

Black Box Warnings:

  • Risk of severe myelosuppression leading to infections.
  • Potential for secondary malignancies.

Genetic Factors: N/A

Lab Test Interference: May cause transient increases in serum transaminases and serum creatinine; interpret lab results with caution.

Overdose Management

Signs/Symptoms: Severe myelosuppression, neurotoxicity, nephrotoxicity.

Treatment: Supportive care, intensive monitoring, possible use of growth factors, renal support if needed.

Storage and Handling

Storage: Store at room temperature, protected from light.

Stability: Stable when stored properly, discard any unused portion after designated expiration.

🛡️ 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.