II. Indications

III. Mechanism

  1. See Antibiotic Chemotherapy
  2. Idarubicin is a anthracycline Aminoglycoside antineoplastic
    1. Semisynthetic 4-demethoxy analog of Daunorubicin
  3. Idarubicin inserts between adjacent DNA base pairs
    1. Blocks DNA Transcription by RNA Polymerase
  4. Idarubicin also inhibits Topoisomerase 2
    1. Inhibits normal Nucleotide strand ligation during DNA Replication
  5. Idarubicin is highly lipophilic
    1. Allows Idarubicin to more easily cross cell membranes (more than other Anthracyclines)

IV. Medications

  1. Idarubicin IV Solution: 1 mg/ml in 10 and 20 ml vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Severe skin and soft tissue necrosis on extravasation
    1. Idarubicin is a strong Vesicant (causes Blistering)
  2. Cardiotoxicity (esp. children)
    1. Risk of Congestive Heart Failure (esp. with multiple doses)
  3. Myelosuppression
  4. Hyperuricemia
  5. Alopecia

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests
    3. Renal Function Tests
    4. Serum Uric Acid
    5. Echocardiogram with ejection fraction

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