Nurses Compass
Drug Guide
Pipobroman
Classification
Therapeutic: Antineoplastic agent, Used in chemotherapy for certain cancers
Pharmacological: Pyrimidine analogue, Antimetabolite
FDA Approved Indications
- Treatment of myeloproliferative disorders (such as polycythemia vera)
Mechanism of Action
Pipobroman is a cytotoxic agent that inhibits DNA synthesis, leading to cell cycle arrest and apoptosis in proliferating cells, particularly affecting malignant cells.
Dosage and Administration
Adult: Dose based on condition and patient response; usually administered intravenously or orally under strict medical supervision.
Pediatric: Not typically used in pediatrics, consult specific guidelines.
Geriatric: Adjust dosage based on renal and hepatic function, and patient tolerability.
Renal Impairment: Use with caution; dose adjustment may be necessary depending on severity.
Hepatic Impairment: Use with caution; dosage adjustments may be needed.
Pharmacokinetics
Absorption: Variable, depends on formulation and route of administration.
Distribution: Widely distributed in body tissues.
Metabolism: Metabolized in the liver, specific pathways not well-defined.
Excretion: Excreted primarily via renal routes.
Half Life: Approximately 2-4 hours, but may vary based on individual factors and route.
Contraindications
- Hypersensitivity to pipobroman or related compounds.
- Bone marrow suppression.
Precautions
- Use cautiously in patients with impaired hepatic or renal function.
- Monitoring blood counts regularly during therapy.
- Pregnancy category X: contraindicated in pregnancy.
- Lactation: not recommended during treatment.
Adverse Reactions - Common
- Bone marrow suppression (neutropenia, thrombocytopenia, anemia) (Common)
- Nausea and vomiting (Common)
- Hair loss (Common)
Adverse Reactions - Serious
- Severe bone marrow aplasia (Rare)
- Secondary malignancies (Rare)
- Liver toxicity (Rare)
Drug-Drug Interactions
- Other myelosuppressive agents, including alkylating agents and other antineoplastics.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor CBC, liver function tests, renal function, and for signs of infection or bleeding.
Diagnoses:
- Risk for infection related to immunosuppression.
- Risk for bleeding related to thrombocytopenia.
Implementation: Administer medication as prescribed; monitor for adverse effects; educate patient about signs of toxicity.
Evaluation: Assess blood counts regularly; evaluate for signs of toxicity; ensure patient compliance and understanding.
Patient/Family Teaching
- Report signs of infection, unusual bleeding, or severe nausea.
- Avoid exposure to crowds or infections.
- Adhere to follow-up and laboratory testing schedules.
Special Considerations
Black Box Warnings:
- Potentially severe myelosuppression leading to increased risk of infection and bleeding.
Genetic Factors: No specific genetic tests required, but pharmacogenomic considerations are limited.
Lab Test Interference: May suppress blood cell counts, affecting lab results.
Overdose Management
Signs/Symptoms: Severe nausea, vomiting, bone marrow suppression, bleeding, infections.
Treatment: Supportive care including hematopoietic growth factors, infection prophylaxis, and symptomatic management; consult poison control for specific interventions.
Storage and Handling
Storage: Store at controlled room temperature, protect from light and moisture.
Stability: Stable under recommended storage conditions for the period specified by the manufacturer.