RightAnswer Knowledge Solutions Search Results for Mitomycin

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ACUTE EXPOSURE INFORMATION

1. USES: Mitomycin is indicated for disseminated adenocarcinoma of the stomach and pancreas, in combination with other chemotherapy agents. It has also been used for other cancers, such as cervical, breast, colorectal, or head and neck cancers. Mitomycin ophthalmic topical solution is indicated as an adjunct to ab externa glaucoma surgery.

2. PHARMACOLOGY: Mitomycin ophthalmic solution is isolated from Streptomyces verticillus Yingtangensis and mitomycin solution for injection is isolated from Streptomyces caespitosus. Mitomycin is an antibiotic with antimetabolite activity. It causes cross-linking of DNA and inhibits DNA synthesis. It may also inhibit cellular RNA and protein synthesis.

3. EPIDEMIOLOGY: Overdose is rare.

4. WITH THERAPEUTIC USE
   1. INTRAVENOUS: COMMON: Nausea, vomiting, anorexia, mucositis, fever, and myelosuppression (eg, leukopenia, thrombocytopenia). Leukopenia and thrombocytopenia may occur anytime within 8 weeks after onset of therapy with an average time of 4 weeks. Recovery after cessation of therapy was within 10 weeks. Approximately 25% of leukopenia or thrombocytopenic episodes did not recover. OTHER EFFECTS: Alopecia, diarrhea, ileus, confusion, drowsiness, fatigue, lethargy, headache, syncope, weakness, skin findings (eg, extravasation, desquamation, induration, pruritus, pain on injection, paresthesias, contact dermatitis, necrosis, cellulitis, ulceration, and tissue sloughing at the injection site), renal dysfunction, thrombophlebitis, hepatotoxicity, pulmonary toxicity (eg, hemoptysis, dyspnea, cough, pneumonitis, alveolitis, and pulmonary fibrosis). Hemolytic uremic syndrome, consisting mainly of microangiopathic hemolytic anemia (hematocrit equal to or less than 25%), thrombocytopenia (equal to or less than 100,000/mm(3)), and irreversible renal failure (serum creatinine equal to or greater than 1.6 mg/dL) has been reported in patients receiving systemic mitomycin. Approximately 98% of patients with this syndrome developed microangiopathic hemolysis with fragmented red blood cells on peripheral blood smears. Congestive heart failure has rarely been reported in patients receiving mitomycin. Almost all patients with CHF had previously received doxorubicin.
   2. OPHTHALMIC: Chronic bleb leak, hypotony, hypotony maculopathy, blebitis, endophthalmitis, lenticular changes, cataract formation, corneal reactions (eg, endothelial damage, epithelial defects, anterior synechiae, superficial punctuate keratitis), and vascular reactions (eg, hyphema, central retinal vein occlusion, and retinal hemorrhage) have been reported.

5. WITH POISONING/EXPOSURE
   1. Limited data are available on mitomycin overdose. The clinical effects reported are those noted during therapeutic use of mitomycin, including high-dose therapy.

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