Doxorubicin review

Doxorubicin is an anthracycline drug used for the treatment of cancer, and are also considered to be antibiotics. The main payload of the anthracyclines is to prevent the normal process of the division of cells, more specifically targeted at malignant cancer cells, whose main characteristic is a hyperactive cell division and possible metastasis to other organs in the body. The drugs specific mechanism of actions is done in two ways.

The first is through the process of intercalation of the drug into the base pairs of the DNA strands, therefore halting the normal process leading to a replication and multiplication of genetic data. This intercalation is reversible and is just a way to prevent further replication of targeted cells, among which are the cancerous cells.

The second mechanism of action is to damage the free radicals in the ribose in DNA strands found in malignant or susceptible bacterial cells. Frequently administered as a therapeutic means for leukemia, it may also be used in other forms of malignancies but under strict regimen.

The most common form of the drug is through a crystalline hydrochloric salt and administered intravenously. It is very important to know that the drug is highly photosensitive and may have its molecular structure destroyed or altered when exposed to sunlight, and therefore should be covered by aluminum or enclosed in a bag of similar material during preparation, storage, and administration.

The ideal administration of doxorubicin is for the treatment of leukemia and lymphoma, as it was earlier found out that the drug is highly effective in destroying or impeding the activity of murine tumors. Studied for its potential since the 1950's, doxorubicine has been the base component in anthracyclines alongside daunorubicin, the former that shows better effect on murine and solid tumors. The therapeutic index was also found to be much higher than daunorubicin, while maintaining its cardiotoxic levels in competitive state among others.

Usual dosage of the medication is administered through an IV drip instead of a single quick IV shot since the compound is extremely irritating to the skin as well as other tissues that come into contact with the drug. A common formula in computing for the required dose for a susceptible patient is to allocate 240 milligrams per square meter of body surface area.

Because of the high expectation of physicians and researchers to cardiotoxic effects of doxorubicin, there is a limit to the total amount of the substance to be given regardless of the cancer activity. It has been found out that the increased cardiotoxicity in the body leads to the destruction of heart cells, which may prove really fatal if the patient is subjected to the drug at more than the required dose.

Nevertheless, the symptoms for such may already be seen even at small levels and should be monitored closely.

Other than the usual cardiotoxicity, patients are expected to develop one of the following: upset stomach, nausea, drowsiness, fatigue, hair loss, skin rashes and increased impairment of skin, respiratory fatigue, chest pains, and the like.

Special precautions are given emphasis on the patient's liver as the drug is highly damaging to cells, which in turn may also prove damaging to the liver, especially during protein binding and drug synthesis. It is therefore highly discouraged to administer this drug for patients with existing liver problems.

It is also not indicated for pregnant women as it may cause undesired results, includig death of the fetus.

Doxorubicin has the following structural formula:

Chemical structure of doxorubicin

• Molecular formula of doxorubicin is C27H29NO11
• Chemical IUPAC Name is 10-(4-amino-5-hydroxy-6-methyl-oxan-2-yl)oxy-6,8,11-trihydroxy-8-(2-hydroxyacetyl)- 1-methoxy-9,10-dihydro-7H-tetracene-5,12-dione
• Molecular weight is 543.519 g/mol

Brand name(s): Adriablastin, Adriamycin, Adriblastin, Adriblastina, Caelyx, Doxil, Doxo, Doxorubicina, Doxorubicine, Doxorubicinum, Rubex

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