다카르바진

항종양제 - 알킬화제

다카르바진(흔히 **DTIC**로 불림)은 수의 종양학에서 주로 개의 재발성 림프종, 연조직 육종 및 흑색종 치료에 사용되는 주사용 **항종양제**입니다. **임상 요점:** * 다카르바진은 세포독성 효과를 발휘하기 위해 간에서 활성화되어야 하는 **전구약물(prodrug)**입니다. * 고양이의 간이 이 약물을 활성 형태로 충분히 대사할 수 있는지 알려져 있지 않기 때문에 **고양이에게는 사용이 권장되지 않습니다**. 고양이에서의 효능과 안전성은 예측하기 매우 어렵습니다. * 강력한 **발포제(vesicant)**입니다. 혈관 외 유출 시 심각한 조직 괴사를 유발할 수 있습니다. 완벽하게 장착된 정맥 카테터를 통해 투여해야 하며, 일반적으로 희석하여 천천히 주입하는 것이 권장됩니다.

작용 기전: Dacarbazine is a prodrug that undergoes hepatic N-demethylation (likely via **cytochrome P450** enzymes) to form an active intermediate, which then degrades to form **reactive carbonium ions**. * **Alkylating Activity:** These carbonium ions act as alkylating agents → cross-link DNA strands → interfere with DNA transcription and replication. * **Antimetabolite Activity:** It also inhibits the incorporation of purine nucleosides into DNA. * It possesses minimal immunosuppressant activity and is generally considered **cell cycle-phase nonspecific**.

동물 종별 용량

Dogs

Relapsed lymphoma, soft tissue sarcomas, melanoma · 800-1000 mg/m2 · IV · every 2-3 weeks · over 5-8 hours · NOT mg/kg. Depending on the protocol used.
Relapsed Lymphoma (Rescue Protocol) · 800-1000 mg/m2 · IV · every 3 weeks · as determined by oncologist · Administer as a slow IV infusion (over several hours) to minimize adverse effects. Pre-medicate with antiemetics.
Relapsed Lymphoma (Alternative schedule) · 200 mg/m2 · IV · sid · for 5 consecutive days · Repeat cycle every 3 weeks.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

Cats (due to unknown hepatic metabolism capabilities)
Patients with known hypersensitivity to the drug
Pregnancy (teratogenic)
Pre-existing severe myelosuppression
Severe hepatic dysfunction
Pregnancy and lactation
Known hypersensitivity

이상반응

Severe gastrointestinal toxicity (vomiting, anorexia, diarrhea) - often dose-limiting
Bone marrow suppression (leukopenia, thrombocytopenia) - nadir occurs several weeks post-treatment
Severe tissue damage and pain (if extravasated)
Venous spasm and phlebitis during IV administration
Alopecia (rare)
Hepatotoxicity (rare)
Renal impairment (rare)
Photosensitivity (rare)
Severe nausea and vomiting
Myelosuppression (neutropenia, thrombocytopenia)
Tissue necrosis if extravasated
Hepatotoxicity
Lethargy
Anorexia

약물 상호작용

Myelosuppressive drugs (e.g., other antineoplastics, chloramphenicol, flucytosine, colchicine) · May cause additive myelosuppression when used concurrently with DTIC.
Rifampin · May increase the hepatic metabolism of DTIC.
Phenobarbital · May increase the hepatic metabolism of DTIC. · moderate
Phenytoin · May increase the hepatic metabolism of DTIC.
Other myelosuppressive agents · Additive bone marrow suppression · major

모니터링

Efficacy (tumor response)
CBC with differential and platelets (monitor for myelosuppression)
Renal function tests
Hepatic function tests
IV catheter site for signs of extravasation during infusion
Complete Blood Count (CBC) prior to each dose and at nadir (typically 7-14 days post-treatment)
Liver function tests (ALT, AST, Bilirubin)
Renal function
IV catheter site for signs of extravasation
Gastrointestinal signs (vomiting, diarrhea)

과용량

Because of the severe toxic potential of this agent, iatrogenic overdoses must be strictly avoided. Recheck all dosage calculations carefully (ensure dosing is based on body surface area in mg/m2, not mg/kg). Overdose will likely result in profound, life-threatening bone marrow suppression and severe gastrointestinal toxicity. Treatment is supportive.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.