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Thursday, January 27, 2011

Eric Mead: The magic of the placebo | Video on TED.com

Eric Mead: The magic of the placebo | Video on TED.com

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Wednesday, January 26, 2011

San Antonio Breast Cancer Update 2010 - Video Highlights

From OncologyEducation.ca (requires registration - Free)
http://www.oncologyeducation.ca/node/1639

4 Parts:

Part 1 - Hormone Receptor Positive
Part 2 - Adjuvant Bisphosphonates
Part 3 - Adjuvant Chemotherapy
Part 4 - Targeted Therapy
(Dr. Sunil Verma)

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Tuesday, January 25, 2011

Thomas Goetz: It's time to redesign medical data | Video on TED.com

Thomas Goetz: It's time to redesign medical data | Video on TED.com

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Thursday, January 20, 2011

Anders Ynnerman: Visualizing the medical data explosion | Video on TED.com

Anders Ynnerman: Visualizing the medical data explosion | Video on TED.com

(TED = Ideas worth sharing)

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Rank Ligand - Key mediator in bone destruction

Rank Ligand
This link has been set up by Amgen Canada. It highlights Rank Ligand and its role as a key mediator in the vicious cycle of bone destruction.

The animations help explain in the link noted below.

Osteoblastic versus osteolytic bone metastases



Bone metastases are often characterized by their radiographic appearance as either osteolytic, osteoblastic, or mixed.

Most patients with breast cancer have predominantly mixed or osteolytic lesions. In contrast, patients with prostate cancer are often found to have predominantly osteoblastic lesions. However, regardless of appearance, there is significant osteolytic activity. In fact, osteolytic activity in these lesions often is comparable with, if not higher than, that typically seen in breast cancer and multiple myeloma. Such activity has been demonstrated by markedly elevated biochemical markers of bone resorption in the serum and urine of such patients. Only in multiple myeloma do purely lytic bone lesions develop.


Learn more at:

http://www.rankligand.ca/

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Tuesday, January 18, 2011

Bleomycin-Induced Flagellate Hyperpigmentation

The incidence may be as high as 20%.


Most tissues contain a cysteine proteinase capable of hydrolyzing and inactivating bleomycin.

The reduced concentration of bleomycin hydrolase in the skin and lung, as compared with other tissues, may explain the medication's adverse reaction profile.

The patient was counseled that the flagellate hyperpigmentation usually fades over a period of several months after the cessation of the medication.

During the past year, the hyperpigmentation in this patient has faded but not yet resolved.

(NEJM 363:e36December 9, 2010)

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Nilotinib & QT Prolongation

QT interval prolongation may occur, which may in turn result in torsades de pointes, leading to syncope, seizure, and/or death. Sudden deaths have been reported (0.1-1%); ventricular repolarization abnormalities may have contributed.


Prolongation is concentration-dependent. Significant prolongation may occur if taken inappropriately with food, and/or strong CYP3A4 inhibitors, and/or medicines with a known potential to prolong QT interval. The presence of hypokalemia and hypomagnesemia may further enhance this effect.

Drugs that prolong QT interval should be avoided due to the risk of potentially fatal arrhythmias.

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Pain from Vinorelbine Infusion

  • Pain in tumour-containing tissue (rare) as per BCCA.  
  • It has been hypothesized that it is caused by a ‘‘two-step’’ pathogenetic mechanism.
  • First, surgery, radiotherapy, or the tumor itself causes a neural lesion.
  • Vinorelbine administration then induces production of pain modulators at the site of the lesion.
  • It could be classified and treated as an incident pain.
  • Patients in treatment with opioids could receive one-sixth of the daily dose 15 minutes before vinorelbine administration.
  • Opioid-naïve patients could be treated with low doses of morphine. Ketorolac alone does not allow effective control of pain and we do not recommend it to treat, or to prevent, vinorelbine associated pain.
  • Finally, PO administration (?compounded) does not seem to induce vinorelbine-related pain and a switch from IV to PO vinorelbine could be proposed as a method for opioid-resistant patients.



     

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Monday, January 17, 2011

Fulvestrant Dose Approved by US FDA

On September 10, 2010, the US Food and Drug Administration (FDA) approved the use of fulvestrant (Faslodex®, AstraZeneca) injection at a dose of 500 mg intramuscularly per month for hormone receptor–positive metastatic breast cancer in postmenopausal women with disease progression following anti-estrogen therapy. The previously approved dosing regimen was 250 mg monthly.


(J Clin Oncol. 2010;28(30):4594-4600).

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Advancing the Art and Science of Prostate Cancer–Related Bone Disease Management (CME)

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Eribulin (Halaven) approved by US FDA

Sea sponge - Halichondria okadai
- new treatment option for late-stage breast cancer


- Halaven is a synthetic form of a chemotherapeutically active compound derived from the sea sponge Halichondria okadai. This injectable therapy is a microtubule inhibitor, believed to work by inhibiting cancer cell growth. Before receiving Halaven, patients should have received prior anthracycline- and taxane-based chemotherapy for early or late-stage breast cancer.

US FDA News Release Nov. 15, 2010

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Bevacizumab Status in Breast Cancer

FDA begins process to remove breast cancer indication from Avastin label Drug not shown to be safe and effective in breast cancer patients


the results of four clinical studies of Avastin in women with breast cancer and determining that the data indicate that the drug does not prolong overall survival in breast cancer patients or provide a sufficient benefit in slowing disease progression to outweigh the significant risk to patients. These risks include severe high blood pressure; bleeding and hemorrhage; the development of perforations (or “holes”) in the body, including in the nose, stomach, and intestines; and heart attack or heart failure.

FDA: Bevacizumab (marketed as Avastin) Information http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm193900.htm

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Potential tamoxifen & methadone interaction

Drug Interactions
(as per Lexicomp Online accessed Jan 6/11)

Risk Rating D: Consider therapy modification


Summary: CYP2D6 Inhibitors (Moderate) may decrease the metabolism of Tamoxifen. Specifically, CYP2D6 inhibitors may decrease the formation of highly potent active metabolites.

Severity: Major
Reliability Rating: Fair

Patient Management Moderate CYP2D6 inhibitors may reduce the clinical effectiveness of tamoxifen; consider alternative therapy with less of an effect on CYP2D6 activity when possible.

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Sunday, January 2, 2011

Cancer: HER3 pathway

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VEGF and EGFR pathways in detail: Target for new therapies against cancer

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EFALIZUMAB MOA animation

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Chemotherapy Part 1

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Understanding Radiation Therapy - part 1

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Nanotechnology for Targeted Cancer Therapy

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An Overview of LDN - Dr Tom Gilhooly Part 1

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About Onco-PRN

Welcome and thanks for visiting Onco-P.R.N. - The oncology website with a focus on all things oncology pharmacy/pain/palliative care-related. It is intended to be an information resource for those pharmacist and relevant health care professionals involved in whatever fashion with cancer and palliative care. Stay tuned for the latest and greatest links and information with respect to: oncology medications, continuing education, pharmaceutical care initiatives, pain and symptom control, supportive care topics, and whatever else that might fit into the theme.

*Note: This website is not affiliated with Alberta Health Services (AHS) or CAPhO and the opinions expressed herewithin are that of the author(s).

Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia: http://en.wikipedia.org/wiki/Pharmacy#History_of_pharmacy

Medscape Pharmacists Headlines

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