Cytarabine and Its Neurological Side Effects

Name of the Drug

Cytarabine, also known as Ara-C and Arabinosylcytosine.

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Type of the Drug

It is an antineoplastic, cytotoxic (anti-cancer) medicine.

Medical Use

Its primary purpose is treatment of leukemia and its different forms, which include acute lymphocitic leukemia, and acute and chronic forms of myelogenous leukemia. The drug is also used on forms of cancer found in the in the brain and spinal cord (ordinary and meningeal lymphoma, as well as meningeal leukemia).

Finally, Cytarabine has antiviral effects, but its usefulness in this area is limited by its lack of selectiveness.

Methods of Application

It is applied to the patient by an intravenous or IV infusion, injection into the subcutaneous tissues (separating the skin and the muscle), and by intranthecal or intraventricular infusion, when the medicine needs to be applied to the cerebrospinal fluid around the brain and the spinal cord.

Relevance

This drug is on the World Health Organization’s List of Essential Medicines, because of its effectiveness in cancer treatment. High doses of Cytarabine have demonstrated very impressive results in the cancer treatment in patients who are resistant to conventional doses. It has few alternatives, and yet side effects are very dangerous, and warrant concern and study.

Side Effects

Between 7% to 28% of patients have reported severe cerebellar and cerebral dysfunction side effects associated with the high-dose consumption of the drug. The effects of neurologic toxicity are very serious and can lead to life-threatening complications.

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These complications were observed by Kerry Nichols in Billings Clinic Hospital, who estimated that high-dose of the drug was administered to 20-25 patients annually. She observed one of the patients develop symptoms such as unsteady walk and shaking hands, and continuous functional decline, to the point of full functional dependency (Dantoni, 2013).

Handling risks

To prevent serious complications and manage toxicity levels, Nichols developed a number of procedures. The first of these was the neurologic assessment tool, which combined a variety of tests designed to assess cerebellar toxicity. These were supported with a double-check system, upheld by two Rheumatology Nurses certified for chemotherapy.

References

Dantoni, T. (2013). High Dose Cytarabine Neurological Assessment Guide Streamlines Symptom Documentation. Web.

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