Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners
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J Oncol Pharm Pract · Sep 2011
Case Reports'Flooding' of the lungs and severe dyspnea in a patient with bronchoalveolar carcinoma.
In this case report, we describe a patient with bronchoalveolar carcinoma that experienced severe bronchorrhea and dyspnea after inhalation of N-acetylcysteine. The adverse reactions occurred both after oral and nebulized administration of N-acetylcysteine, resulting in severe dyspnea and the feeling of 'drowning'. ⋯ We strongly suspect the administration of N-acetylcysteine to be implicated, as the complications occurred immediately after administration of this drug. As the patient suffered from hyperhomocysteinemia, we speculate that an additive or synergistic interaction with homocysteine may have been involved as well.
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J Oncol Pharm Pract · Sep 2011
ReviewAlternative dosing schedules and administration updates for ixabepilone.
Ixabepilone 40 mg/m(2) (every 3 weeks) is approved for use in metastatic breast cancer as monotherapy as early as third line and in combination with capecitabine as early as first line in tumors that are resistant or refractory to anthracyclines and taxanes. This article seeks to familiarize oncology pharmacists with the options at their disposal to aid in management of ixabepilone therapy. Toxicity with ixabepilone is reversible and responsive to dose reduction or delay, and the 40 mg/m(2) dose may be reduced to 32 mg/m(2) and subsequently to 25 mg/m(2) should toxicities arise. ⋯ The regimen appears to be effective and well-tolerated in metastatic breast cancer and other tumor types, although data from definitive head-to-head studies with the approved regimen are not yet available. Moreover, a recent label change now incorporates alternative infusion liquids to Lactated Ringer's Solution into the approved dilution protocol for ixabepilone, and similarities and differences from taxane administration are discussed. It is hoped that the influx of new data regarding dosing, scheduling, and administration options for ixabepilone will continue to increase the pharmacist's ability to optimize treatment outcomes for breast cancer patients.
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J Oncol Pharm Pract · Sep 2011
Comparative StudyComparison of healthcare resource use between patients receiving ondansetron or palonosetron as prophylaxis for chemotherapy-induced nausea and vomiting.
To analyze the differences between ondansetron and palonosetron in healthcare resource use (i.e., inpatient/ outpatient encounters) among patients receiving intraperitoneal cisplatin. ⋯ Palonosetron was associated with a trend to a lower risk of CINV-related hospital readmission than ondansetron in patients receiving intraperitoneal cisplatin for gynecological cancers, although not statistically significant. The duration of ondansetron therapy might be suboptimal with 27% of patients receiving only 1 day of therapy during hospital stay. These findings need to be confirmed in future studies.