From the Guidelines
Busulfan typically takes 2-4 weeks to reach its full therapeutic effect in the body. When considering the treatment of polycythemia vera (PV), it's essential to weigh the benefits and risks of various therapeutic agents. According to a study published in the Mayo Clinic Proceedings 1, busulfan has been shown to be a valuable treatment agent for PV, with a median survival of 11.1 years in 65 busulfan-treated patients. The study also reported that only 2 patients (3%) treated with busulfan alone developed acute leukemia.
- Key points to consider when using busulfan include:
- Its mechanism of action, which involves damaging the DNA of rapidly dividing cells, particularly affecting bone marrow stem cells
- The gradual onset of its therapeutic effects, which can take several weeks to months to become apparent
- The importance of continued adherence to the prescribed treatment regimen, despite the lack of immediate effects
- The need for close monitoring of blood cell counts and prompt reporting of any unusual bleeding, bruising, or signs of infection to the healthcare provider. In the context of PV treatment, busulfan may be considered an alternative to hydroxyurea, especially in patients who are at high risk of thrombotic complications or have contraindications to other cytoreductive agents 1. However, the choice of treatment should be individualized, taking into account the patient's specific clinical characteristics, comorbidities, and preferences.
From the Research
Buspirone Absorption and Elimination
- Buspirone is rapidly absorbed after oral administration, with a mean bioavailability of 3.9% 2
- The mean elimination half-life of buspirone is 2.1 hours 2
- Buspirone is mainly bound to albumin and alpha 1-acid glycoprotein 2
- It is metabolized to an active metabolite 1-(2-pyrimidinyl) piperazine (1-PP), with a mean elimination half-life of 6.1 hours 2
Onset of Action
- Buspirone has a gradual onset of action 3
- Patients need to be informed about the gradual onset of action and absence of euphoria and immediate sedation 3
Pharmacological Profile
- Buspirone is an azaspirodecanedione anxiolytic agent with a unique pharmacological profile 2
- Its mechanism of action is mediated by the 5-HT1A receptors, with some affinity for DA2 autoreceptors and 5-HT2 receptors 2, 4
- Buspirone lacks anticonvulsant and muscle-relaxant properties, and causes only minimal sedation 2, 5