Vincristine , also known as leurocristine and marketed under the brand name Oncovin among others, is a chemotherapy drug used to treat certain types of cancer. These include acute lymphocytic leukemia, acute myeloid leukemia, Hodgkin's disease, neuroblastoma, and small cell lung cancer among others. It is given intravenously.
Most people experience some side effects from vincristine treatment. Usually it causes changes in sensation, hair loss, constipation, difficulty walking, and headaches. Serious side effects may include neuropathic pain, lung damage, or low white blood cells. It is likely to cause damage to the baby if given during pregnancy. It works by stopping the cell from splitting properly.
Vincristine was first isolated in 1961. This is a List of Essential Medicines of the World Health Organization, the most effective and safe medicines needed in the health system. Wholesale costs in developing countries are between 1.80 and 42.60 USD per dose. It is a vinca alkaloids that can be obtained from the Madagascar periwinkle Catharanthus roseus .
Video Vincristine
Medical use
Vincristine is administered by intravenous infusion for use in various types of chemotherapy regimens. Its primary use is non-Hodgkin's lymphoma as part of a CHOP chemotherapy regimen, Hodgkin lymphoma as part of the less popular MOPP, COPP, BEACOPP or Stanford V chemotherapy regimen in acute lymphoblastic leukemia (ALL), and in the treatment of nephroblastoma. It is also used to induce remission in ALL with dexamethasone and L-asparaginase, and in combination with prednisone to treat leukemia in childhood. Vincristine is sometimes used as an immunosuppressant, for example, in treating thrombotic thrombocytopenic purpura (TTP) or chronic idiopathic thrombocytopenic purpura (ITP).
Maps Vincristine
Side effects
The main side effect of vincristine is peripheral neuropathy induced by chemotherapy, hyponatremia, constipation, and hair loss.
Peripheral neuropathy induced by chemotherapy may be severe, and may be the reason for reducing or avoiding the use of vincristine. These symptoms are progressive and lasting tingling, pain and hypersensitivity to cold, starting in the hands and feet and occasionally affecting the arms and legs. One of the first symptoms of peripheral neuropathy is a drop of foot: A person with a family history of foot drop and/or Charcot-Marie-Tooth (CMT) disease should avoid taking vincristine.
Injection of vinca alkaloids into the spinal canal (intrathecal administration) is very dangerous, with mortality rates approaching 100 percent. The medical literature documents cases of increased paralysis due to massive encephalopathy and demyelination of the spinal cord, accompanied by intolerable, almost uniform pain leading to death. Some patients survived after an aggressive and immediate intervention. Rescue care consists of cerebrospinal fluid leaching and administration of protective drugs. Children may be better off following this injury. One child, who was aggressively treated at the time of the injection, recovered almost completely with only mild neurological deficits. A large series of intentional intrathecal vincristine intake occurred in China in 2007 when a number of citarabins and methotrexate (both often used intrathecally) produced by the Shanghai Hualian company were found to be contaminated with vincristine.
Excessive use of vincristine may also cause drug resistance by overexpression of the p-glycoprotein (Pgp) pump. There is an attempt to overcome resistance by adding derivatives and substituents to the vincristine molecule.
Action mechanism
Vincristine works in part by binding to the tubulin protein, stopping the cell from separating its chromosomes during metaphase; cells then experience apoptosis. The vincristine molecule inhibits leukocyte production and maturation.
Pharmacology
Vincristine was created through the semi-synthesis coupling of vagolin alkaloids and indole catarantina in vinca plants. It can now also be synthesized through a total stereocontrolled synthesis technique that maintains true stereochemistry in C18 'and C2'. The absolute stereochemistry of this carbon is responsible for vincristine anticancer activity.
Encapsulation of liposomes from vincristine increases the efficacy of vincristine drugs while lowering the neurotoxicity associated with it. Encapsulation of liposomes increases the concentration of vincristine plasma and lifelong circulation in the body, and allows the drug to enter the cell more easily.
History
It has been used as a traditional remedy for centuries, studies in the 1950s reveal that the reddish periwinkle Catharanthus roseus contains 70 alkaloids, many of which are biologically active. While the initial study for its use in diabetes mellitus was disappointing, the discovery that caused myelosuppression (decreased bone marrow activity) led to his studies in mice with leukemia, whose lifetime was extended by the use of vinca preparations. Soil mill treatment with Skelly-B inhibiting agent and benzene acid extract led to a fraction called "fraction A". The fraction is further treated with aluminum oxide, chromatography, trichloromethane, benz-dichloromethane, and pH-separating to produce vincristine.
Vincristine was approved by the United States Food and Drug Administration (FDA) in July 1963 as Oncovin. The drug was originally discovered by a team led by Dr. J.G. Armstrong, then marketed by Eli Lilly and Company. Eli Lilly needs lots of periwinkle plant leaves. They need a ton of dried leaves to produce an ounce of vincristine. Periwinkle was planted on a farm in Texas to produce vincristine for some time.
Supplier
Three generic drug makers supply vincristine in the United States - APP, Mayne, and Sicor (Teva).
Research
In 2012, the FDA approved a liposomal vincristine formulation called Marqibo. The bound version of the vincristine nano vein is under development in 2014.
References
External links
- Chemotherapy vincristine
- Vincristine and vinblastine
- Description and Natural History of Periwinkle
- Boger route to (-) - Vindoline
- US. National Drug Library: Drug Information Portal - Vincristine
Source of the article : Wikipedia
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