A Drug Study on Vincristine Sulfate

In Partial Fulfillment of the Requirements

in NCM – 212 RLE

CANCER/IMMUNOLOGY NURSING ROTATION

Submitted to:
Josephine Magno, RN, MN

Submitted by:
Trio M. San Luis. St.N

BSN – 3J, Group 3

October 3, 2020
GENERIC NAME: Vincristine Sulfate
BRAND NAME: Oncovin
DRUG CLASSIFICATION:
Therapeutic class: Antineoplastic
Pharmacologic class: Vinca alkaloids

MODE OF ACTION: Arrests mitosis in metaphase, blocking cell division

DOSAGE:

 Adult: 1.4mg/m² I.V weekly.

 Children weighing more than 10kg: 1.5 to 2mg/m² I.V weekly.
 Children weighing 10kg and less or with BSA less than 1m²: Initially,
0.05mg/kg I.V weekly. Titrate dosage as tolerated up to 2mg/dose.
 Adjust-a-dose: For patients with direct bilirubin level above 3mg/dL,
reduce dosage by 50%
INDICATION:
 Acute lymphoblastic and other leukemias, Hodgkin lymphoma, malignant
lymphoma, neuroblastoma, rhabdomyosarcoma, Wilms tumor

CONTRAINDICATION:

- Contraindicated in patients hypersensitive to drug and in those with

demyelinating form of Charcot-Marie-Tooth syndrome.
- Patients who are receiving radiation therapy through ports that include
the liver
- Use cautiously in patients with hepatic dysfunction. Neuromuscular
disease, or infection.
SIDE EFFECTS/ADVERSE REACTIONS:

 CNS – Loss of deep tendon reflexes, paresthesia, peripheral neuropathy,

coma, seizures, ataxia, cranial nerves palsies, fever, headache, sensory
loss
 CV – HTN, hypotension.
 EENT – Blindness, diplopia, hoarseness, optic and extraocular
neuropathy, photophobia, Ptosis, visual disturbances, vocal cord
paralysis.
 GI – Constipation, cramps, nausea, stomatitis, vomiting, intestinal
necrosis, anorexia, diarrhea, dysphagia, ileus that mimics surgical
paralytic ileus.
 GU – Dysuria, polyuria, urine retention.
 Hematologic – leukopenia, thrombocytopenia, anemia
 Metabolic – Weight loss
 Musculoskeletal – Cramps, jaw pain, muscle weakness
  Respiratory – Acute bronchospasm, Dyspnea
 Skin – Phlebitis, cellulitis at injection site, rash, reversible alopecia,
severe local reaction following extravasation.

INTERACTION:

Drug-drug –

- Digoxin: May decrease digoxin’s effects..

- Fosphenytoin, phenytoin: May reduce phenytoin level.
- HIV protease inhibitors: May increase pharmacologic effects of
vincrinstine. Monitor patient for neutropenia and severe neuropathy.
- Mitomycin: May increase frequency of bronchospasms, and acute
pulmonary reactions
- Ototoxic drugs: May potentiate loss of hearing
- Triazole antifungals: Concomitant use may increase risk of neurotoxicity
- Vaccines (inactivated): May diminish therapeutic effect of vaccines.
- Vaccines (live): May enhance adverse/toxic effect of live-virus vaccines
and diminish their therapeutic effect
- Warfarin: May increase anticoagulant effects

Drug-Herb

- Echinea, St. John’s wort: May decrease vincristine concentration.

Nursing Responsibilities:

 Educate patient about the adverse reactions of the drug and advise
patient to report all adverse reactions, especially pain or burning at
injection site during or after administration.
 Tell patient to report increased shortness of breath and evidence of
infection (fever, sore throat, fatigue) and bleeding (easy bruising,
nosebleeds, bleeding gums, tarry stools). Take temperature daily.
 Warn patient that hair loss may occur, but explain that it’s usually
temporary.
 Caution female patient to avoid becoming pregnant during therapy
and to consult prescriber before becoming pregnant.
Reference/s:

Vincristine dosing, indications, interactions, adverse effects, and more. (2020,

January 27). Retrieved September 28, 2020, from
https://reference.medscape.com/drug/oncovin-vincasar-pfs-vincristine-342097#5

Vincristine Side Effects: Common, Severe, Long Term. (2018, October 15).
Retrieved September 28, 2020, from https://www.drugs.com/sfx/vincristine-side-
effects.html

Kluwer, W. (2019). Nursing 2020 DRUG HANDBOOK 40th Anniversary (Vol. 2).

Lippincott Wiliiams & Wilkins.