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.