Drug Profile and Nursing Implications of a New Vinca Alkaloid
Janice M. Brogden and Brenda Nevidjon
Purpose/Objectives: To review the drug profile and nursing implications of a new vinca alkaloid, vinorelbine tartrate (Navelbine®, Burroughs Wellcome Co., Research Triangle Park, NC).
Data Sources: Published articles, abstracts, professional communications, drug manufacturer, and personal experience with vinorelbine clinical studies.
Data Synthesis: The U.S. Food and Drug Administration approved vinorelbine for the treatment of advanced non-small cell lung cancer (NSCLC) in December 1994. Vinorelbine has shown significant activity in a variety of malignancies, including NSCLC and breast cancer. Studies of vinorelbine used as a single agent in treating patients with NSCLC have achieved results comparable to combination therapies but with less toxicity, Like other vinca alkaloids, vinorelbine is a microtubule-inhibiting agent. The recommended dose for a single-agent IV dose is 30 mg/m2 administered weekly. Vinorelbine is a moderate vesicant and venous irritant. The most common side effects are leukopenia and granulocytopenia; others include fatigue, injection site pain or irritation, nausea, vomiting, constipation, paresthesias, and diminished reflexes.
Conclusions: Vinorelbine is a well-tolerated treatment with mostly mild to moderate side effects that are reversible following treatment discontinuation.
Implications for Nursing Practice: Nurses in diverse settings will focus on teaching and identifying and managing side effects of vinorelbine. Patient care concerns include risk for infection, potential for impaired skin integrity at injection site, altered comfort, constipation, and sensory/perceptual alterations.