Which of the following can be given orally aEUR'
Mesna MESNA is given alongwith alkylating agents to prevent nephrotoxicity due to cyclophosphanzide. Cyclophosphamide and Ifosfamide are alkylating agents that release a nephrotoxic and urotoxic metabolite -> Acrolein. Acrolein causes severe hemorrhagic cystitis. MESNA is administered to prevent hemorrhagic cystitis. MESNA conjugates with Acrolein and forms a nontoxic compound. It can be administered intravenously or orally. Mesnex injection is given as intravenous bolus injection in a dosage equal to 20% of the ifosfamide dosage at the time of ifosfamide administration whereas Mesnex tablets are given orally in a dose equal to 40% of the Ifosfamide dose 2 and 6 hours after each dose of Ifosfamide. The total daily dose of mesna is 100% of the ifosfamide dose. Cytarabine Cytarabine (Ara C) is degraded by the enzyme cytidine deaminase. Cytidine deaminase is present in high concentrations in g.i. tract therefore only about 20% of the drug reaches the circulation after oral Ara-C administration. Thus the drug must be given intravenously. Dactinomycin or Actinomycin D It is administered by intravenous route. Doxorubicin It is administered intravenously and are cleared by complex pattern of hepatic metabolism and biliary excretion.
Cytosine ara
Actinomycin D
Doxorubicin
Mesna