Nitrogen mustard

Nitrogen mustard

Nitrogen mustard is the first for the clinical and achieved outstanding efficacy of antitumor drugs. As the representative of bis-chloroethylamine alkylating agent, it is a highly active compounds. This product into the body, through the intramolecular ring formation, the formation of highly active ethylene imine ions, in neutral or weak base conditions quickly with a variety of organic substances nucleophilic groups (such as protein carboxyl, amino, mercapto , The amino group of the nucleic acid, and the hydroxyl group, the phosphate group), for alkylation. The most important reaction of nitrogen mustard is to covalently bind to the 7th nitrogen of guanine to produce cross-links within the double-stranded DNA or cross-links of different bases within the same strand of the DNA. G1 phase and M phase cells were the most sensitive to the cytotoxicity of nitrogen mustard, from G1 phase to S phase delay.

Indications
Mainly used for malignant lymphoma and cancerous pleura, pericardium and peritoneal effusion. Has rarely been used for other tumors, the acute leukemia is invalid. (VCR), methylcarhydrazine (PCZ) and prednisone (PDN) in the treatment of Hodgkin's disease have a higher efficacy of ovarian cancer, breast cancer, choriocarcinoma, prostate cancer, spermatogonia Neoplasms, nasopharyngeal carcinoma (hemiplegia chemotherapy), also have a certain effect; intracavitary injection for the control of malignant pleural effusion has a good effect; due to malignant lymphoma and other compression of the respiratory and superior vena cava compression syndrome caused by severe symptoms, Can make it quickly ease.

Adverse reactions

  皮肤溃疡

1. Local reaction: nitrogen mustard on the local tissue has a strong stimulating effect, repeated injection of the vein can be

Skin ulcers

Skin ulcers

Caused by phlebitis and embolic phlebitis, drug leakage in the blood vessels can cause local swelling, pain, and even tissue necrosis, ulcers.

2. Gastrointestinal reactions: loss of appetite, nausea, vomiting or diarrhea, vomiting which is more prominent, can be applied ondansetron or metoclopramide and dexamethasone antiemetic.

3. Bone marrow suppression: nitrogen mustard dose-limiting toxic reactions, can cause white blood cells, platelets decreased significantly, the lowest value in the medication 7 to 15 days, 2 to 3 weeks to recover.

4. Other: may have dizziness, fatigue, hair loss, amenorrhea, infertility and so on.

Precautions

1. injection of this drug do not leak out of blood vessels; once the leakage of blood vessels should be immediately local subcutaneous injection of 0.25% sodium thiosulfate or saline and cold 6 ~ 12h.

Secondary tumor

2. During treatment should check the white blood cells, platelets 1 or 2 times.

3. nitrogen mustard dissolved very unstable, the use of fresh preparation, dissolved in 10ml saline immediately after intravenous infusion.

4. alkylating agents have mutagenic or teratogenic effects, pregnant women with caution.

5. Have carcinogenicity, long-term application of nitrogen mustard, the risk of secondary tumors increased.

6. This product can increase blood uric acid and uric acid, plasma cholinesterase to reduce the interference diagnosis.

7. This product should be freshly prepared, used within 10min, and can not be used for subcutaneous injection, intramuscular injection and oral.