For palliative treatment of Hodgkins disease

Dermatologic -
Occassionally maculopapular skin eruptions occurs. but this may be idiosyncratic
and dose not necessary recur with subsequent courses of the drug.
Erythema multiforme, have been observed.
Herpes zoster a common complicating infection. may first appear.
Discontinue further treatment during acute phase of illness

GI -
Mechlorethamine is given preferably at night in case sedation for side efects is required.  
Nausea and vomoting usually occur 1 o 3 hours after use of the drug..
Emesis may diappear in thr firstb8 hours, but nausea may persist for 24 hours
Premedication with antiemetics in addition to sedatives may help to control severe nausea

GU-
Impaired spermatogenesis, azoospermia and total aplasia have been reported in male patients treated with alkylating agents in combination with other drugs.
Warn patients of the potential to their repoductive capacity

Haematologic-
Produces a lymphocytopenia within 24 hours after the first injection.
Significant granulocytopenia occurs within 6 o 8 days and last for 10 days to 3 weeks
Depression of the hemotopoietic system may be found up to 50 days or more after starting therapy

Miscellaneous -
Hypesensitivity reactions including anaphylaxis have been reported.

Infectious disease , previous anaphylactic reactions to mechlorethamine .

Special precautions/ Warnings-

Amyloidosis - Nitrogen mustard may contribute  to extensive and raid development of
amyloidosis.  Use it if foci of acute and acute and chronic suppurative inflammation are absent.

Tumors- tumors of bone and nervous tissue have responded poorly to therapy.

Concomittant therapy- precautions must be observed with the use of mechloethamine and x-ray therapy or chemotherapy in alternating courses.Haemopoetic  function is characterstilcally  depresssed by either form of therapy

Immunosuppression- mechloethamine has  been reported to have imunosuppressive activity.

Hyperuricemia - may develop during therapywith mechlorethamine

Hematologic - use of mechloethamine in patients with leukopenia , thrombocytopenia and anemia due to invasion of bone marrow by tumor carries a greater risk.

Pregnancy- appraise the patient  of the potenial hazard to the fetus. Advice  women
of childbearing potential tomavoid becoming pregnant

Lactation- decide whether to discontinue nursing or discontinue the drug taking into account the importance of the drug to the mother.

Children-  safety and efficacy  in pediatric patients have not been established 

Indication-

For palliative treatment of Hodgkins disease
Leukemia lymphomas, polythemia vera, Mycosa fungoides, Bronchogenic carcinoma IV only

Dosage -
Dosage of mechlorethamine varies with the clinical siuation.
A total dose of 0.4mg/kg of body weight for each course usually given as a single dose or in
divided doses of 0.2 to 0.2mg.kg/ day. Base dosage on ideal dry weight.
Presence of edema or acites must be considered so that dosage will be based on weight
inaugemented by these conditions

Pregnancy-
Appraise the patient  of the potenial hazard to the fetus. Advice  women
of childbearing potential tomavoid becoming pregnant

Lactation-
Decide whether to discontinue nursing or discontinue the drug taking into account
the importance of the drug to the mother.

Children- 
Safety and efficacy  in pediatric patients have not been established