Description of the medicine: Sarcolysin (Sarcolysinum)
D, L-a-amino-b- [para-bis- (b-chloro-ethyl) -aminophenyl] propionic acid hydrochloride.
Synonyms: Racemelphalanum, Sarcoclorin (The foreign drug Melphalan is the left isomer corresponding to sarcolysin [L-parabis- (b-chloroethyl) -aminophenylamine]).
White or slightly yellowish powder. Easily soluble in water when heated, soluble in dilute acids and alkalis.
Sarcolysin is a derivative of bis (b-chloroethyl) -amine and the amino acid phenylalanine. Like other drugs of this kind, sarcolysin has alkylating properties and inhibits the development of hyperplastic tissues.
They are used to treat testicular seminomas (especially in the presence of metastases), reticulosarcoma, malignant angioendothelioma, Ewing's tumor, myeloma.
In combination with colchamine (see), sarcolysin is sometimes also used for cancer of the esophagus and stomach.
The drug is prescribed orally (after eating) and intravenously, also administered in the cavity.
Release for oral administration in tablets of 0.01 g (10 mg), for injection - in dry form in hermetically sealed vials containing 0.02 and 0.04 g (20 and 40 mg) of the drug. To obtain a solution, 10 to 20 ml of an isotonic sodium chloride solution is introduced into the vial; to accelerate dissolution, the bottle is heated in water to + 60 - 70 C.
Inside or intravenously, the drug is prescribed once a week. A single dose for an adult with a body weight of 60 - 70 kg is 40 - 50 mg; for patients with a body weight of 50 kg or less - at the rate of 0.5 - 0.7 mg / kg. In the first two doses give 50 mg, then - 30 mg. Children are also prescribed at a rate of 0.5 - 0.7 mg / kg.
The course of treatment lasts 4 to 7 weeks. With tumor metastases in the serous membranes with effusion in the abdominal or pleural cavity, you can enter a solution of sarcolysin in the cavity.
From 40 to 100 mg, dissolved in 20 - 50 ml of an isotonic solution of sodium chloride, is introduced into the abdominal cavity once a week; in the pleural cavity - 20 - 80 mg, dissolved in 10 - 20 ml of isotonic sodium chloride solution, also 1 time per week.
Before the solution of sarcolysin is introduced into the cavity, exudate is removed, then 60 - 70 ml of 1% novocaine solution is injected for anesthesia, after which the trocar is not removed from the abdominal cavity or needle from the pleural cavity, the patient is placed in a lying position and after 10 minutes a freshly prepared sarcolysin solution is administered. The course of treatment is usually 4 to 5 injections.
Often, after 2 to 3 injections, resorption or a decrease in the amount of exudate occurs; injections however, continue. A solution of sarcolysin is introduced through a needle with a diameter of 0.3 - 0.5 ml; preliminary (in 10 minutes) 100 - 120 ml of a 1% solution of novocaine are administered. In total, 0.16 - 0.2 g (160 - 200 mg) of sarcolysin is used for the course.
Sarcolysin can also be used for regional chemotherapy; when perfusion of limb tumors using extracorporeal circulation, the drug is used in a dose of 25-40 mg per 1 cm of tissue in the perfused area.