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Plicamycin (Mithramycin)

- Discussion:
    - inhibitor of RNA synthesis in osteoclasts;
    - an effective treatment for hypercalcemia;
    - given intravenously in a dose of 25 microg per kilogram over a period of four to six hours;
    - dose can be repeated several times at intervals of 24 to 48 hours, although a single dose may be sufficient to normalize the serum calcium concentration;
     - serum calcium concentration begins to decrease as early as 12 hours after the administration of the drug, and the maximal reduction occurs in 48 to 72 hours;
     - duration of normocalcemia after the administration of plicamycin ranges from a few days to several weeks, depending on the extent of ongoing bone resorption;
     - toxicity may become an issue;
           - toxic to the kidney, liver, hematopoetic system