{"id":1647,"date":"2023-06-25T17:29:04","date_gmt":"2023-06-25T17:29:04","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/arsenic-trioxide\/"},"modified":"2023-06-25T19:59:22","modified_gmt":"2023-06-25T19:59:22","slug":"arsenic-trioxide","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/arsenic-trioxide\/","title":{"rendered":"Arsenic trioxide"},"content":{"rendered":"

<\/p>\n

Arsenic trioxide<\/h1>\n

CLINICAL USE<\/h3>\n

Antineoplastic agent:
\nAcute promyelocytic leukaemia (APL)<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n

150 mcg\/kg daily until remission occurs
\nConsolidation: 150 mcg\/kg daily for 5 days
\nper week for 25 doses spread over up to 5
\nweeks (to start 3\u20134 weeks after completion of
\ninduction)<\/p>\n

PHARMACOKINETICS<\/h3>\n
  • Molecular weight                           :
    \n197.8<\/li>\n
  • %Protein binding                           :
    \n96% bound to
    \nhaemoglobin<\/li>\n
  • %Excreted unchanged in urine     :
    \n1\u20138<\/li>\n
  • Volume of distribution (L\/kg)       :
    \n4 litres<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :
    \n92\/Increased<\/p>\n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Reduce dose, use with caution<\/li>\n
  • 10 to 20     : Reduce dose, use with caution<\/li>\n
  • <10           :
    \nReduce dose, use with caution<\/p>\n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :
    \nUnknown dialysability. Dose as in
    \nGFR <10 mL\/min<\/li>\n
  • HD                     :
    \nDialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/
    \nmin<\/li>\n
  • HDF\/high flux   :
    \nDialysed. Dose as in GFR<\/li>\n
  • <10           : mL\/
    \nmin<\/li>\n
  • CAV\/VVHD      :
    \nUnknown dialysability. Dose as in
    \nGFR 10 to 20 mL\/min<\/p>\n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs
    \nUse with care in combination with<\/p>\n

    other drugs known to cause QT interval
    \nprolongation<\/p>\n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    IV<\/p>\n

    Rate of Administration<\/h4>\n

    Over 1\u20134 hours<\/p>\n

    Comments<\/h4>\n

    Dilute with 100\u2013250 mL glucose 5% or<\/p>\n

    sodium chloride 0.9%<\/p>\n

    OTHER INFORMATION<\/h4>\n<\/li>\n
  • Can cause QT interval prolongation andhypokalaemia<\/li>\n
  • Arsenic trioxide is under investigationfor other conditions, e.g. multiple
    \nmyeloma, acute myeloid leukaemias and
    \nmyelodysplastic syndromes<\/li>\n
  • Intensive monitoring is required<\/li>\n
  • Renal excretion is the main route ofelimination; can accumulate in renal
    \nimpairment<\/li>\n
  • Arsenic is stored mainly in liver, kidney,heart, lung, hair and nails. Trivalent forms
    \nof arsenic are methylated in humans and
    \nmostly excreted in urine. In APL patients,
    \ndaily administration of 0.15 mg\/kg\/day of
    \narsenic trioxide resulted in an approximate
    \n4-fold increase in the urinary excretion of
    \narsenic after 2 to 4 weeks of continuous
    \ndosing, when compared to baseline values<\/li>\n","protected":false},"excerpt":{"rendered":"

    Arsenic trioxide CLINICAL USE Antineoplastic agent: Acute promyelocytic leukaemia (APL)<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1647","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1647","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1647"}],"version-history":[{"count":2,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1647\/revisions"}],"predecessor-version":[{"id":2944,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1647\/revisions\/2944"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1647"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1647"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1647"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}