Asparaginase

From Anvita Health Wiki

Contents 1 Indications 2 Contraindications 3 Dosage 4 Adverse-effects 5 Drug-interactions 6 Test-interactions 7 More General Terms 8 Internet Database 9 References

Indications

• acute lymphocytic leukemia
• lymphoma

Contraindications

• pancreatitis
• hypersensitivity to E. coli asparaginase or component

• investigational preparation from Erwinia is available

Dosage

• reconstitute lyophylized powder with sterile water or normal saline for IV use or normal saline for IM use
• shake well but not too vigorously
• use 5 um in line filter
• refrigerate reconstituted solutions: discard after 8 hours
• injection 10,000 units
• IM injections:

• use 2 sites for IM injections > 2 mL
• do not filter

• be prepared to treat anaphylaxis

• IV access should be established
• be prepared for endotracheal intubation to maintain airway
• antihistamine, epinephrine, oxygen, corticosteroids should be available Lyophylized powder: should be refrigerated

Adverse-effects

• common (> 10%)

• immediate effects: fever/ chills & nausea/vomiting in 50- 60% of patients
• hepatotoxicity
• pancreatitis
• allergic reaction
• hyperammonemia
• thrombosis

• less common (1-10%)

• hyperuricemia, mouth sores

• uncommon (1-10%)

• leg vein thrombosis, hyperthermia, seizures, leukopenia ( nadir about 14 days), hypotension, drowsiness, coma, fever, rash, pruritis, urticaria, transient diabetes mellitus, azotemia, coughing, laryngeal spasm, chills, malaise, hypersensitivity reactions

Drug-interactions

• methotrexate
• cyclophosphamide
• mercaptopurine
• vincristine
• prednisone

Test-interactions

• decreases serum thyroxine & thyroxine-binding globulin

More General Terms

• L-asparaginase
• antineoplastic agent (chemotherapeutic agent)
• bacterial protein

Internet Database

Prosite: [1]
Prosite: [2]

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Department of Veterans Affairs, VA National Formulary

asparaginase (Elspar)