Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners
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J Oncol Pharm Pract · Jun 2020
Olanzapine as a rescue antiemetic in hematopoietic stem cell transplant.
Chemotherapy-induced nausea and vomiting occurs in up to 80% of patients undergoing chemotherapy treatment and is associated with a deterioration in quality of life. Olanzapine is an atypical antipsychotic antagonist blocking a variety of neurotransmitters in the nausea and vomiting pathophysiology. ⋯ Olanzapine was associated with significant improvements in breakthrough nausea and vomiting control while reducing the number of emesis episodes and required antiemetic doses in the hematopoietic stem cell transplant population. Olanzapine may be beneficial in optimizing antiemetic regimens for breakthrough chemotherapy-induced nausea and vomiting control in patients undergoing hematopoietic stem cell transplant.
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J Oncol Pharm Pract · Jun 2020
Case ReportsRuxolitinib for the treatment of lymphoma-associated hemophagocytic lymphohistiocytosis: A cautionary tale.
Hemophagocytic lymphohistiocytosis is a hyperinflammatory syndrome characterized by fever, hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, and pancytopenia. Three publications reported success with ruxolitinib, a Janus-associated kinase (JAK1/2) inhibitor. This therapy interrupts the production of cytokines associated with hemophagocytic lymphohistiocytosis, namely interferon-γ and interleukins 2, 6, and 10. ⋯ While treating the underlying lymphoma is a clear priority, the cytopenias and other symptoms of hemophagocytic lymphohistiocytosis complicate the delivery of this therapy. Hence, the use of ruxolitinib as a bridge to definitive therapy was appealing. However, we are concerned about the progression of lymphoma while these patients were taking ruxolitinib. Ruxolitinib may be controlling cytokine storm associated with hemophagocytic lymphohistiocytosis, while other aspects of the condition are progressing. Therefore, we would advise caution in its use in lymphoma-associated-hemophagocytic lymphohistiocytosis until more data are available.
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J Oncol Pharm Pract · Jun 2020
Impact of an electronic health record transition on chemotherapy error reporting.
Incident reporting systems allow for frontline employees to report errors and are a critical component of healthcare patient safety programs. Although incident reporting systems cannot quantify total errors, organizations can utilize incident reporting systems to help identify risks and trends to act upon. The objective of this article is to utilize incident reporting systems to evaluate trends in medication error reporting before and after implementation of a new electronic health record system. ⋯ Analyzing data from incident reporting system reports allowed our institution to understand different trends of reporting in the cancer hospital following electronic health record adoption. Utilization of incident reporting systems must be combined with proactive risk identification approaches to enable systems-focused improvements to improve patient safety.