Pegaspargaza covalent bonding is the result of the native L-asparaginase, synthesized by a microorganism E.Coli, with monomethoxy. Pegaspargazy mechanism of action is different from that of the native L-asparaginase and consists in enzymatic destruction of the amino acids L-asparagine located in the blood plasma. It is dianabol side effects believed that tumor lymphoblasts, in contrast to healthy cells, this is an essential amino acid, since they are not able to synthesize L-asparagine, necessary for normal activity. Destruction pegaspargazoy amino acid L-asparagine plasma leads to deficiency in L-asparagine tumor lymphoblasts, disturbs protein synthesis and death of tumor cells.
Peak pegaspargazy concentration in blood plasma after intravenous administration is correlated with administered dose. The volume of distribution is equivalent to the volume of plasma. After hour intravenous infusion pegaspargazy amino acid L-asparagine in plasma not detectable, thus available to determine the value of L-asparaginase retained in the plasma for at least 15 days after the first injection pegaspargazy.
Onkaspar used in combination with other anticancer drugs for reinduktsionnoy treatment of acute lymphoblastic leukemia in children and adults in the development of their hypersensitivity to native forms of L-asparaginase.
- Pancreatitis at the start of treatment or history.
- Serious hemorrhagic complications associated with therapy L-asparaginase in history.
- Severe allergic reactions in the anamnesis (generalized urticaria, bronchospasm, laryngeal edema, decreased blood pressure) or serious adverse reactions to Onkaspar.
- Pregnancy and lactation.
Dosing and Administration
Usually Onkaspar used in combination with other cytotoxic drugs. In monotherapy Onkaspar only used when it is impossible for any reason to use other drugs included in the combined regimen.
Onkaspar can be used as part of the induction, consolidation and maintenance therapy.
In the selection of individual dose should be guided by the data of the medical literature.
The recommended dose dianabol side effectsbody surface every 14 days.
Children with body surface of 0.6 m² administered 2500 IU / m² every 14 days.
Babies with the body surface less than 0.6 m² introduced 82.5 IU / kg body weight.
The drug is administered intramuscularly or intravenously.
Preferably intramuscular injection due to lower risk of hepatotoxicity, bleeding disorders, renal and gastrointestinal disorders compared with intravenous administration.
in intravenous administration should be administered Onkaspar infusion over 1-2 hours in 100 ml of 0.9% sodium chloride or 5% dextrose .
intramuscular injection volume simultaneously appointing Onkaspara should not exceed 2 ml for children and 3 ml for adults. If necessary, the introduction of a greater volume of its preparation should be introduced by means of several injections in different places.
When the solution becomes cloudy or there is Onkaspar sludge can not be used.
Do not shake!
Side effects: Hypersensitivity reactions: there are about 5% of patients; may be acute, delayed wearing character; manifested as local erythema, urticaria elements, itching, swelling, pain and inflammation at the injection site, fever, myalgia, respiratory difficulties, bronchospasm, tachycardia, rash, decrease in blood pressure, up to anaphylactic shock. Conducted intradermal tests do not rule out the risk of anaphylactic reactions. On the part of the gastrointestinal tract: in about half of patients have decreased appetite, nausea, vomiting, constipation, diarrhea, flatulence, abdominal pain, inflammation of the mucous membranes of the gastrointestinal tract. On the part of the pancreas : in rare cases may occur acute pancreatitis, increased levels of amylase and lipase in blood serum; very rarely – hemorrhagic pancreatitis or necrotizing pancreatitis, in some cases fatal. There are some reports about the formation of pseudocysts of the pancreas (up to 4 months after the end of treatment). We describe a case of a combination of acute pancreatitis with mumps. Violation of the endocrine function of the pancreas may be manifested mainly in violation of glucose metabolism. Cases of diabetic ketoacidosis and hyperosmolar hyperglycemia, which in most cases cropped administration of exogenous insulin. Liver function: the most common – increasing levels of alkaline phosphatase, ALT, ACT, LDH and bilirubin.There are some reports about the development of cholestasis, jaundice, fatty degeneration of the liver and hepatocellular necrosis. Dose-dependent decrease in albumin is found in the majority of patients during treatment pegaspargazoy. Hypoalbuminemia can cause peripheral edema. From the hematopoietic system: moderate myelosuppression (leukopenia, thrombocytopenia, anemia). These changes usually do not affect the holding therapy.
Described isolated cases of autoimmune anemia during treatment pegaspargazoy. From the blood coagulation system: gipofibrinogenemia, prolonged prothrombin time, partial thromboplastin time, elongation and reduction of antithrombin III level. There were also thrombosis of superficial and deep venous thrombosis of the sagittal sinus thrombosis, arterial thrombosis and venous catheters, DIC. Also aware of symptomatic hemorrhagic syndrome, sometimes fatal, increased bleeding and ecchymosis. From dianabol side effects the nervous system: headache, dizziness, cramps, weakness, paresthesias, agitation, depression, hallucinations, confusion, increased drowsiness that can progress to coma. Rarely – Parkinson’s syndrome (tremor and progressive increase in muscle tone). illegal steroids for sale online buy testosterone cypionate uk where to buy steroid pills