Deepika vegiraju at 15:11, 27 August 2022

2022-08-27T15:11:13Z

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== '''What is Pegaspargase?''' ==

* Pegaspargase ('''Oncaspar''') is '''an asparagine specific enzyme''' used with other drugs to treat [[acute lymphoblastic leukemia]] (ALL).
* It is used in patients whose cancer has not already been treated or who cannot be treated with [[asparaginase]].
* It is also being studied in the treatment of other types of cancer.
* Oncaspar is a form of the drug asparaginase that is linked to a substance called PEG, which makes the drug stay in the body longer.

[[File:Pegaspargasa.png|thumb|Pegaspargasa]]

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== '''What are the uses of this medicine?''' ==

Pegaspargase ('''Oncaspar''') is used for the treatment of pediatric and adult patients with:
* First-line [[acute lymphoblastic leukemia]]
* Acute lymphoblastic leukemia and hypersensitivity to [[asparaginase]]

== '''How does this medicine work?''' ==

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* Oncaspar is a form of the drug asparaginase that is linked to a substance called [[PEG]], which makes the drug stay in the body longer.
* Asparaginase is an enzyme that breaks down the amino acid asparagine and may block the growth of cancer cells that need asparagine to grow.
* The pharmacological effect of Oncaspar is thought to be based on the '''killing of leukemic cells due to depletion of plasma asparagine'''.
* It is a type of '''protein synthesis inhibitor'''.
* Also called PEG-asparaginase and pegaspargase.

== '''Who Should Not Use this medicine ?''' ==

This medicine cannot be used in patients with:
* History of serious [[hypersensitivity]] reactions, including [[anaphylaxis]], to Oncaspar or to any of the excipients
* History of serious [[thrombosis]] with prior L-asparaginase therapy
* History of [[pancreatitis]], including pancreatitis related to prior L-asparaginase therapy
* History of serious hemorrhagic events with prior L-asparaginase therapy

== '''What drug interactions can this medicine cause?''' ==

* Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
* Pegaspargase may increase the risk of [[glucocorticoid]]-induced toxicities.

== '''Is this medicine FDA approved?''' ==

* Pegaspargase was approved for medical use in the United States in 1994.

== '''How should this medicine be used?''' ==

Premedicate patients with acetaminophen, an H-1 receptor blocker (such as [[diphenhydramine]]), and an H-2 receptor blocker (such as [[famotidine]]) 30-60 minutes prior to administration of Oncaspar.

'''Recommended dosage:'''
'''Patients 21 Years of Age or Younger:'''
* The recommended dose of Oncaspar for patients up to and including 21 years of age is 2,500 International Units/m2 intramuscularly or intravenously no more frequently than every 14 days.

'''Patients More Than 21 Years of Age:'''
* The recommended dose of Oncaspar for adult patients more than 21 years of age is 2,000 International Units/m2 intramuscularly or intravenously no more frequently than every 14 days.

'''Administration:'''
* Administered [[intramuscularly]] or [[intravenously]] no more frequently than every 14 days.
* For intravenous administration, give over a period of 1 to 2 hours in 100 mL of 0.9% Sodium Chloride Injection, USP or 5% [[Dextrose]] Injection, USP through an infusion that is already running.
* Do not administer Oncaspar if drug has been frozen, stored at room temperature for more than 48 hours, or shaken or vigorously agitated.

== '''What are the dosage forms and brand names of this medicine?''' ==

This medicine is available in fallowing doasage form:
* '''As Injection:''' 3,750 International Units/5 mL (750 International Units/mL) solution in a single-dose vial.

This medicine is available in fallowing brand namesː
* '''Oncaspar'''

=='''What side effects can this medication cause?'''==

The most common side effects of this medicine include:
* [[hypoalbuminemia]]
* elevated [[transaminase]]
* [[febrile neutropenia]]
* [[hypertriglyceridemia]]
* [[hyperglycemia]]
* [[bilirubin]] increased
* [[pancreatitis]]
* abnormal clotting studies
* [[embolic]] and [[thrombotic]] events
* [[hypersensitivity]]

==''' What special precautions should I follow?''' ==

* [[Anaphylaxis]] and serious [[hypersensitivity]] reactions can occur in patients receiving Oncaspar. Observe patients for 1 hour after administration. Discontinue Oncaspar in patients with serious hypersensitivity reactions.
* Serious [[thrombotic]] events, including [[sagittal sinus]] [[thrombosis]] can occur in patients receiving Oncaspar. Discontinue Oncaspar in patients with serious thrombotic events.
* [[Pancreatitis]] can occur in patients receiving Oncaspar. Evaluate patients with abdominal pain for pancreatitis. Discontinue Oncaspar in patients with pancreatitis.
* [[Glucose intolerance]] can occur in patients receiving Oncaspar. Monitor serum glucose.
* Increased [[prothrombin time]], increased partial [[Thromboplastin|thromboplastin time]], and [[hypofibrinogenemia]] can occur in patients receiving Oncaspar. Discontinue Oncaspar for severe or life-threatening hemorrhage. Evaluate for etiology and treat.
* Hepatotoxicity and abnormal liver function, including elevations of [[transaminase]], [[bilirubin]] (direct and indirect), reduced serum [[albumin]], and plasma [[fibrinogen]] can occur. Monitor for toxicity through recovery from cycle. Discontinue Oncaspar for severe liver toxicity.

== '''What to do in case of emergency/overdose?''' ==

Symptoms of overdosage may include:
* increase in liver enzymes
* [[rash]]

'''Management of overdosage:'''
* There is no specific [[antidote]] for Oncaspar overdosage.
* In case of overdose, monitor patients closely for signs and symptoms of adverse reactions, and appropriately manage with symptomatic and supportive treatment.

== '''Can this medicine be used in pregnancy?''' ==

* Oncaspar can cause fetal harm when administered to a pregnant woman.
* There are no available data on Oncaspar use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.

=='''Can this medicine be used in children?'''==

* The safety and effectiveness of Oncaspar in the treatment of ALL have been established in pediatric patients.

== '''What are the active and inactive ingredients in this medicine?''' ==

'''Active ingredient:'''
* PEGASPARGASE

'''Inactive ingredients:'''
* SODIUM PHOSPHATE, MONOBASIC, DIHYDRATE
* SODIUM PHOSPHATE, DIBASIC, UNSPECIFIED FORM
* SODIUM CHLORIDE
* WATER

== '''Who manufactures and distributes this medicine?''' ==

'''Manufactured by:'''
* [[Servier Pharmaceuticals LLC]], Boston, MA

== '''What should I know about storage and disposal of this medication?''' ==

* Store Oncaspar refrigerated at 2°C to 8°C (36°F to 46°F) in the original carton to protect from light.
* Do not shake or freeze product.
* Unopened vials may be stored at room temperature (15°C to 25°C [59°F to 77°F]) for no more than 48 hours.

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[[Category:Antineoplastic drugs]]
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Pegaspargase - Revision history

Deepika vegiraju at 15:11, 27 August 2022