Mechlorethamine toxicity

Gastrointestinal distress, myelosuppression, alopecia, and sterility are common. Mechlorethamine has marked vesicant (blister-forming) actions.The include severe nausea and vomiting (centrally mediated). [Note: These eff ects can be diminished by pretreatment with ondansetron, granisetron, or palonosetron with dexamethasone.] Severe bone marrow depression limits extensive use. Latent viral infections (for example, herpes zoster) may appear because of immunosuppression. Extravasation is a serious problem. If it occurs, the area should be infiltrated with isotonic sodium thiosulfi te to inactivate the drug.