Astrocytoma Medication

Updated: Dec 07, 2017
  • Author: Benjamin Kennedy, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS  more...
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Medication

Medication Summary

No specific drug treatment exists for low-grade glioma. Certain conditions (eg, low-grade astrocytoma) typically require treatment. For seizures, the patient is usually started on levetiracetam, phenytoin, or carbamazepine. Levetiracetam is often used because it lacks the effects on the P450 system seen with phenytoin and carbamazepine, which can interfere with antineoplastic therapy. Steroid therapy, usually combined with a gastroprotectant, is initiated for vasogenic edema around tumor.

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Anticonvulsants

Class Summary

These agents prevent seizure recurrence and terminate clinical and electrical seizure activity.

Levetiracetam (Keppra)

Used as adjunct therapy for partial seizures and myoclonic seizures. Also indicated for primary generalized tonic-clonic seizures. Mechanism of action is unknown.

Phenytoin (Dilantin)

Effective in partial and generalized tonic-clonic seizures. Blocks sodium channel and prevents repetitive firing of action potentials.

Carbamazepine (Tegretol)

Similar to phenytoin. Effective in partial and generalized tonic-clonic seizures. Blocks sodium channel and prevents repetitive firing of action potentials.

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Corticosteroids

Class Summary

These drugs reduce edema around the tumor, frequently leading to symptomatic and objective improvement.

Dexamethasone (Decadron, AK-Dex, Alba-Dex, Dexone, Baldex)

Postulated mechanisms of action in brain tumors include reduction in vascular permeability, cytotoxic effects on tumors, inhibition of tumor formation, and decreased CSF production.

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Antineoplastic Agent, Alkylating Agent

Class Summary

These agents inhibit cell growth and proliferation.

Temozolomide (Temodar)

Oral alkylating agent converted to MTIC at physiologic pH; 100% bioavailable; approximately 35% crosses the blood-brain barrier.

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