Info

🌱 來自: Irinotecan

FOLFIRI

• Irinotecan 180 mg/m2 IV Dilute in 500 mL D5W and administer over 90 minutes (can be administered concurrently with leucovorin via y-site connection). Day 1
• Leucovorin 400 mg/m2 IV Dilute in 250 mL D5W and administer over two hours. Day 1
• Fluorouracil (FU), bolus 400 mg/m2 IV Slow IV push over five minutes (administer immediately after leucovorin). Day 1
• FU, infusional 2400 mg/m2 IV Dilute in 500 to 1000 mL D5W¶ and administer over 46 hours. To accommodate an ambulatory pump for outpatient treatment, can be administered undiluted (50 mg/mL) or the total dose can be diluted in 100 to 150 mL NS.¶ Day 1

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Fluorouracil

• 5-FU
• (5-FU, Adrucil)
• Dosing:
  • Dose, schedule, & administration (IVB vs. IV continuous infusion) are based on malignancy.
  • Common ranges,
    • IVB: 400-600 mg/m2/dose;
    • IV continuous infusion 200-1,500 mg/m2/d.
  • No renal or hepatic dose adjustments recommended;
    • use w/ caution
• PK/PD:
  • Extensive tissue distribution;
  • saturable catabolism;
  • excretion via metabolism, lung, & urine;
  • T1/2 8-20 min after IVB
• AEs 󰒖: 💩👄🤮🩸🤞🫀👁️🖐️🦶😇🐌
• DDI: CYP2C9 substrates (↓ substrate levels),
  • cimetidine (↓ clearance of 5-FU),
  • oral anticoagulants (↑ levels of anticoagulants),
  • leucovorin (↑ tox of 5-FU)
• Clinical pearls:
  • AEs w/ DPD deficiency (prolonged clearance, ↑ tox), radiosensitizer;
  • leucovorin is → given w/ bolus administration to ↑ intracellular half-life of 5-FU (↑ cytotoxicity).
  • Uridine triacetate used as antidote in cases of overdose or DPD deficiency

Fluorouracil