Quiz 57: Pharmacotherapy of Neoplasia
Chemotherapy related nausea and vomiting is generally treated with ondansetron. The symptoms of anorexia can be managed by both the pharmacological and non-pharmacological methods. The non-pharmacological methods include the nutritional counselling and dietary counselling. Explaining the patient and his family members regarding the risk of malnutrition during the cancer therapy and the importance of maintaining good health status before the onset of actual weight loss will be helpful. Pharmacological management of anorexia: The anorexia caused due to early satiety is treated by metoclopramide. Other appetite stimulants such as cyproheptadine (antagonist at histamine and serotonin receptors), corticosteroids can also be suggested. Megestrol has a similar profile to the corticosteroids regarding the immune stimulation and weight gain, but has lesser side effects than corticosteroids.
Vaccination is an immunization procedure in which a person develops immunity, particularly against a specific pathogen. Vaccines contain live attenuated or killed organisms that are injected to the person in a series. So, our body develops antibodies to those antigens and if that organism enters into our body, they readily attack the pathogen. Vaccination is type of acquired immunity. Vaccines are not suggested for immune-compromised people such as those receiving the immunosuppressants, chemotherapy (decreases the immune response) and those suffering from HIV (human immune deficiency virus). This is because, if the body fails to produce immune response, the live organisms may cause the disease in rare cases. Thus, vaccines are contraindicated in patients receiving chemotherapy.
In chemotherapy, multidrug therapy consisting of different classes of drugs are included. This is because the multiple drugs can act on cells at different stages of development in the cell cycle, so that maximum cell death can be achieved. The dosage of each drug can also be decreased in combination therapy, which also decrease the severity of side effects or toxicity and slows the development of drug resistance. The four anti-neoplastic drugs suggested for Zack are, • Cyclophosphamide (alkylating agent) • Carboplatin (platinum coordination) • Vincristine (vinca alkaloids) • Etoposide (Topoisomerase-2 inhibitor)
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