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streptozotocin

 
Dictionary: strep·to·zot·o·cin   (strĕp'tə-zŏt'ə-sĭn) pronunciation
n.

An antibiotic, C8H15N3O7, produced by an actinomycete (Streptomyces achromogenes) and active against tumors but damaging to insulin-producing cells and now also regarded as a carcinogen.

[STREPTO- + ZO(O)- + -tocin (alteration of TOXIN).]


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Oncology Encyclopedia: Streptozocin
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Key Terms: Antineoplastic.

Definition

Streptozocin is one of the anticancer (antineoplastic) drugs called alkylating agents. It is available in the U.S. under the brand name Zanosar.

Purpose

Streptozocin is primarily used to treat cancer of the pancreas, specifically advanced islet-cell carcinoma.

Description

Streptozocin chemically interferes with the synthesis of the genetic material (DNA) of cancer cells, which prevents these cells from being able to reproduce.

Recommended Dosage

Streptozocin is given by injection. The dosage prescribed varies widely depending on the patient, the cancer being treated, and whether or not other medications are also being taken.

Precautions

Streptozocin carries a risk of renal (kidney) toxicity. While receiving streptozocin, patients are encouraged to drink extra fluids, since this can increase the amount of urine passed and help prevent kidney problems.

Streptozocin may cause an allergic reaction in some people. Patients with a prior allergic reaction to streptozocin should not take this medication.

Streptozocin also may cause serious birth defects if either the man or the woman is taking this drug at the time of conception or if the woman takes this drug during pregnancy. Streptozocin also may cause miscarriage.

It is not known whether streptozocin is passed from mother to child through breast milk. However, since many drugs are excreted in breast milk and since streptozocin has the potential to adversely affect an infant, breast feeding is not recommended while this medication is being taken.

Streptozocin suppresses the immune system (by damaging white blood cells) and interferes with the normal functioning of certain organs and tissues. For these reasons, it is important that the prescribing physician is aware of any of the following pre-existing medical conditions:

  • a current case of, or recent exposure to, chicken pox
  • diabetes mellitus
  • herpes zoster (shingles)
  • a current case, or history of, gout or kidney stones
  • all current infections
  • kidney disease
  • liver disease

Also, because streptozocin damages white blood cells and platelets, patients taking this drug must exercise extreme caution to avoid contracting any new infections or sustaining any injuries that result in bruising or bleeding.

Side Effects

The common side effects of streptozocin include:

  • fatigue
  • loss of appetite (anorexia)
  • nausea and vomiting
  • increased susceptibility to infection and bleeding
  • swelling of the feet or lower legs
  • unusual decrease in urination
  • temporary hair loss (alopecia)

Diarrhea is a less common side effect that may also occur.

Because streptozocin can damage the kidneys, liver, white blood cells, and platelets, patients taking this medication should be closely monitored for evidence of these adverse side effects. Laboratory tests, including renal function, urinalysis, complete blood count, and liver function, should be done at frequent intervals (approximately weekly) during drug therapy. If evidence of these adverse side effects is found, treatment with streptozocin may be discontinued or the dose may be decreased.

Interactions

Streptozocin should not be taken in combination with any prescription drug, over-the-counter drug, or herbal remedy without prior consultation with a physician. It is particularly important that the prescribing physician be aware of the use of any of the following drugs:

  • anti-infection drugs
  • carmustine (an anticancer drug)
  • cisplatin (an anticancer drug)
  • cyclosporine (an immunosuppressive drug)
  • deferoxamine (used to remove excess iron from the body)
  • gold salts (used for arthritis)
  • inflammation or pain medication other than narcotics
  • narcotic pain medication containing acetaminophen (Tylenol) or aspirin
  • lithium (used to treat bipolar disorder)
  • methotrexate (an anticancer drug also used for rheumatoid arthritis and psoriasis)
  • penicillamine (used to treat Wilson's disease and rheumatoid arthritis)
  • phenytoin (an anticonvulsant)
  • plicamycin (an anticancer drug)
  • tiopronin (used to prevent kidney stones)

—Paul A. Johnson, Ed.M.

Drug Info: Streptozocin
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Brand names: Zanosar®



Streptozocin injection

What is streptozocin injection?

STREPTOZOCIN (Zanosar®) is a chemotherapy used for treating cancer of the pancreas. Streptozocin interferes with the growth of rapidly dividing cells, like cancer cells, and eventually causes these cells to die. Generic streptozocin injections are available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• bleeding problems or other blood disorders
• dental disease
• diabetes
• infection (especially virus infection such as chickenpox or herpes)
• kidney disease
• liver disease
• an unusual or allergic reaction to streptozocin, other chemotherapy, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Streptozocin is for injection or infusion into a vein. It is usually administered in a hospital or clinic setting by a health care professional. The injections can be given once daily for five consecutive days or once a week. Continue to receive doses at regular intervals unless instructed otherwise by your prescriber or health care professional.

What if I miss a dose?

It is important not to miss a dose. Notify your prescriber or health care professional if you are unable to keep an appointment.

What drug(s) may interact with streptozocin?

doxorubicin
phenytoin
• vaccines
• water pills (diuretics)

Tell your prescriber or health care professional about all other medicines you are taking, including nonprescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking streptozocin?

Visit your prescriber or health care professional for checks on your progress. You will need to have regular blood checks. The side effects of streptozocin can continue after you finish your treatment; report side effects promptly. Nausea and vomiting can be severe; notify your health care professional if you experience continued or severe symptoms.

Streptozocin may make you feel generally unwell. This is not uncommon because streptozocin affects good cells as well as cancer cells. Report any side effects as above, but continue your course of medicine even though you feel ill, unless your prescriber or health care professional tells you to stop.

Streptozocin may decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick. Streptozocin may increase your risk to bruise or bleed. Call your prescriber or health care professional if you notice any unusual bleeding. Be careful not to cut, bruise or injure yourself because you may get an infection and bleed more than usual.

Streptozocin can change blood sugar levels. Symptons of low blood sugar include, anxiety, unusual hunger, dizziness or fainting, fast heartbeat, and confusion. Call your prescriber or health care professional at once if you get any of these side effects. If you are diabetic, monitor your blood sugar levels closely.

Be careful brushing and flossing your teeth or using a toothpick while receiving streptozocin because you may get an infection or bleed more easily. If you have any dental work done, tell your dentist you are received streptozocin.

Drink several glasses of water a day. This will help to reduce possible kidney and bladder problems.

Do not drive or operate machinery until you know how streptozocin may affect you.

If you are going to have surgery, tell your prescriber or health care professional that you are using streptozocin.

What side effects may I notice from receiving streptozocin?

The side effects you may experience with streptozocin therapy depend upon the dose, other types of chemotherapy or radiation therapy given, and the disease being treated. Not all of these effects occur in all patients. Discuss any concerns or questions with your prescriber or health care professional.

Side effects that you should report to your prescriber or health care professional as soon as possible:
low blood counts - rarely, streptozocin may decrease the number of white blood cells, red blood cells and platelets. You may be at increased risk for infections and bleeding.
signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
signs of decreased platelets or bleeding - bruising, pinpoint red spots on the skin, black, tarry stools, blood in the urine
signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness
• dark yellow or brown urine
• increase or decrease in the amount of urine passed
• increased thirst
• pain or difficulty passing urine
• pain, swelling, redness or irritation at the injection site
• sweating, tremor
• unusual hunger
• unusual tiredness or weakness
• vomiting
• weight loss
• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• confusion
• depression
• diarrhea
• nausea
• tiredness

Where can I keep my medicine?

This medicine is only given in a hospital or clinic setting; you will not keep this medicine at home.


Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Medical Dictionary: strep·to·zo·cin
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(strĕp'tə-zō'sĭn) or strep·to·zot·o·cin (-zŏt'ə-sĭn)
n.

An antineoplastic agent produced by an actinomycete and active against tumors but damaging to insulin-producing cells and now regarded as a carcinogen.

Wikipedia: Streptozotocin
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Streptozotocin
Systematic (IUPAC) name
2-deoxy-2-({[methyl(nitroso)amino]carbonyl}amino)-β-D-glucopyranose
Identifiers
CAS number 18883-66-4
ATC code L01AD04
PubChem 29327
DrugBank APRD00209
Chemical data
Formula C8H15N3O7 
Mol. mass 265.221 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability  ?
Metabolism  ?
Half life 5-15 minutes
Excretion  ?
Therapeutic considerations
Pregnancy cat.

?

Legal status
Routes  ?

Streptozotocin (Streptozocin, STZ, Zanosar) is a naturally occurring chemical that is particularly toxic to the insulin-producing beta cells of the pancreas in mammals. It is used in medicine for treating certain cancers of the Islets of Langerhans and used in medical research to produce an animal model for Type 1 diabetes.

Contents

Usage

Streptozotocin is approved by the U.S. Food and Drug Administration (FDA) for treating metastatic cancer of the pancreatic islet cells. Since it carries a substantial risk of toxicity and rarely cures the cancer, its use is generally limited to patients whose cancer cannot be removed by surgery. In these patients, streptozotocin can reduce the tumor size and reduce symptoms (especially hypoglycemia due to excessive insulin secretion by insulinomas).[1]

A typical dose is 500 mg/m2/day by intravenous injection, for 5 days, repeated every 4-6 weeks.

Streptozotocin is a glucosamine-nitrosourea compound. As with other alkylating agents in the nitrosourea class, it is toxic to cells by causing damage to the DNA, though other mechanisms may also contribute. Streptozotocin is similar enough to glucose to be transported into the cell by the glucose transport protein GLUT2, but is not recognized by the other glucose transporters. This explains its relative toxicity to beta cells, since these cells have relatively high levels of GLUT2.[2][3]

History

Streptozotocin was originally identified in the late 1950s as an antibiotic.[4] The drug was discovered in a strain of the soil microbe Streptomyces achromogenes by scientists at the drug company Upjohn (now part of Pfizer) in Kalamazoo, Michigan. The soil sample in which the microbe turned up had been taken from Blue Rapids, Kansas, which can therefore be considered the birthplace of streptozotocin. Upjohn filed for patent protection for the drug in August 1958 and U.S. Patent 3,027,300 was granted in March 1962.

In the mid-1960s streptozotocin was found to be selectively toxic to the beta cells of the pancreatic islets, the cells that normally regulate blood glucose levels by producing the hormone insulin. This suggested the drug's use as an animal model of type I diabetes,[5] and as a medical treatment for cancers of the beta cells.[6] In the 1960s and 1970s the National Cancer Institute investigated streptozotocin's use in cancer chemotherapy. Upjohn filed for FDA approval of streptozotocin as a treatment for pancreatic islet cell cancer in November 1976, and approval was granted in July 1982. The drug was subsequently marketed as Zanosar. Streptozotocin is now marketed by the generic drug company Sicor (Teva).

References

  1. ^ Brentjens R, Saltz L (2001). "Islet cell tumors of the pancreas: the medical oncologist's perspective". Surg Clin North Am 81 (3): 527–42. doi:10.1016/S0039-6109(05)70141-9. PMID 11459269. 
  2. ^ Wang Z, Gleichmann H (1998). "GLUT2 in pancreatic islets: crucial target molecule in diabetes induced with multiple low doses of streptozotocin in mice". Diabetes 47 (1): 50–6. doi:10.2337/diabetes.47.1.50. PMID 9421374. 
  3. ^ Schnedl WJ, Ferber S, Johnson JH, Newgard CB (1994). "STZ transport and cytotoxicity. Specific enhancement in GLUT2-expressing cells". Diabetes 43 (11): 1326–33. doi:10.2337/diabetes.43.11.1326. PMID 7926307. 
  4. ^ Vavra JJ, Deboer C, Dietz A, Hanka LJ, Sokolski WT (1959). "Streptozotocin, a new antibacterial antibiotic". Antibiot Annu 7: 230–5. PMID 13841501. 
  5. ^ Mansford KR, Opie L (1968). "Comparison of metabolic abnormalities in diabetes mellitus induced by streptozotocin or by alloxan". Lancet 1 (7544): 670–1. doi:10.1016/S0140-6736(68)92103-X. PMID 4170654. 
  6. ^ Murray-Lyon IM, Eddleston AL, Williams R, Brown M, Hogbin BM, Bennett A, Edwards JC, Taylor KW (1968). "Treatment of multiple-hormone-producing malignant islet-cell tumour with streptozotocin". Lancet 2 (7574): 895–8. doi:10.1016/S0140-6736(68)91058-1. PMID 4176152. 

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Copyrights:

Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
Oncology Encyclopedia. Gale Encyclopedia of Cancer. Copyright © 2006 by The Gale Group, Inc. All rights reserved.  Read more
Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Medical Dictionary. The American Heritage® Stedman's Medical Dictionary Copyright © 2002, 2001, 1995 by Houghton Mifflin Company Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Streptozotocin" Read more