CYCLOPHOSPHAMIDE PROTOCOL FOR RPGN
Cyclophosphamide for RPGN
- ONE HOUR PRIOR THE INFUSION HYDRATES WITH 500CC NORMAL SALINE FOR ONE HOUR.
- HALF AN HOUR PRIOR THE INFUSION GIVE :-
- ONDANSETRON 8MG TAB (ONE TAB.) STAT
- MESNA(UROMETEXAN) 200MG IN 100CC NORMAL SALINE IV OVER 30 MIN.
- CYCLOPHOSPHAMIDE(ENDOXAN) INFUSION AS FOLLOW:
1000MG + MESNA 400 MG IN 500CC NORMAL SALINE TO BE INFUSED OVER ONE HOUR.
(DOSE OF CYCLOPHOSPHAMIDE IS 0.75GM/M2 BSA ).
- FOLLOWING CYCLOPHOSPHAMIDE INFUSION, HYDRATE WITH 500CC NORMAL SALINE FOR ONE HOUR.
Cyclophosphamide is an alkylating agent that prevents cell division by cross-linking DNA strands and decreasing DNA synthesis. It is a cell cycle phase nonspecific agent. Cyclophosphamide also possesses potent immunosuppressive activity. Cyclophosphamide is a prodrug that must be metabolized to active metabolites in the liver.
Absorption: Oral: Well absorbed
Distribution: Vd: 30 to 50 L (approximates total body water); crosses into CSF (not in high enough concentrations to treat meningeal leukemia)
Protein binding: ~20%; some metabolites are bound at >60%
Metabolism: Hepatic to active metabolites acrolein, 4-aldophosphamide, 4-hydroperoxycyclophosphamide, and nor-nitrogen mustard
Half-life elimination: IV: 3 to 12 hours; Children: 4 hours; Adults: 6 to 8 hours
Time to peak: Oral: ~1 hour; IV: Metabolites: 2 to 3 hours
Excretion: Urine (10 to 20% as unchanged drug); feces (4%)