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μμ© κΈ°μ : Dactinomycin is a cell-cycle phase-nonspecific antineoplastic agent. * **Intercalation:** The drug intercalates into the minor groove of the DNA double helix, specifically between adjacent guanine-cytosine base pairs. * **Transcription Inhibition:** This stable dactinomycin-DNA complex physically blocks the progression of **DNA-dependent RNA polymerase** β inhibits transcription of messenger RNA (mRNA) β disrupts protein synthesis and leads to cell death. * It also possesses some immunosuppressive and hypocalcemic properties.
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- Antineoplastic protocols (e.g., rescue therapy for lymphomas, sarcomas) Β· 0.5-1 mg/m 2 (NOT mg/kg) Β· IV Β· over 20 minutes; repeated at 1-3 week intervals Β· Depending on the protocol Β· Dose is based on body surface area (m2). Consultation with a veterinary oncologist is strongly recommended.
- Lymphoma (rescue protocols), sarcomas, and carcinomas Β· 0.5-0.75 mg/m2 Β· IV Β· q2-3wk Β· Administer slowly over 20 min Β· Must be administered via a preplaced catheter due to vesicant properties.
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- Hypersensitivity to dactinomycin
- Pregnancy (teratogenic and embryotoxic)
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- Bone marrow depression (anemia, leukopenia, thrombocytopenia)
- Gastrointestinal toxicity (diarrhea, ulcerative stomatitis, GI ulceration)
- Severe tissue damage and pain (if extravasated)
- Hyperuricemia (may require allopurinol)
- Hepatotoxicity
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- Doxorubicin Β· Additive cardiotoxicity may occur if used concurrently or sequentially. Β· major
- Myelosuppressive drugs (e.g., chloramphenicol, flucytosine, colchicine, other antineoplastics) Β· May cause additive myelosuppression.
- Vitamin K Β· Patients may require higher dosages of vitamin K when receiving dactinomycin.
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- Efficacy (tumor measurement/response)
- Complete Blood Count (CBC) with differential and platelets (prior to each dose and at nadir)
- Hepatic function tests
- Oral cavity examinations (check for ulcerative stomatitis)
- IV catheter site for any signs of extravasation during administration
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Due to the extreme toxic potential of this agent, iatrogenic overdoses must be strictly avoided. Double-check all dosage calculations (ensure dosing is in **mg/m2**, not mg/kg). Overdose will result in severe, potentially fatal bone marrow suppression and gastrointestinal ulceration. Treatment is entirely symptomatic and supportive (e.g., broad-spectrum antibiotics, blood transfusions, aggressive fluid therapy, GI protectants).
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