Multiple drugs

Multiple drugs Reactions 1704, p269 - 2 Jun 2018 Various toxicities: case report A 51-year-old woman developed mania during treatment with dexamethasone, facial acne during treatment with cetuximab, allergic reaction in the form of generalised pruritus during treatment with leuprorelin [Lupron]. Additionally, she developed nausea during chemotherapy with temozolomide [not all routes and dosages stated]. The woman, who presented to a primary care provider in the fall of 2016 (at the age of 51 years) with a 2 3 week history of severe, chronic headache, was diagnosed with a right frontal glioblastoma and underwent craniotomy. Her headaches resolved after the surgery with oral dexamethasone 2mg twice daily. However, she developed mania on dexamethasone. The woman’s dexamethasone was tapered down to 0.5mg daily, which she tolerated well. Pathological examination confirmed epidermal growth factor receptor (EGFR) amplification. A week prior to the initiation of standard chemoradiation therapy as per Stupp protocol (that included combination of radiation treatment and oral temozolomide), she received first of the three separate superselective intraarterial cerebral infusion (SIACI) of cetuximab after blood- brain barrier disruption with mannitol to the tumour site. Mannitol was infused in the A2 segment of the right anterior cerebral artery (ACA) over 2 minutes and subsequently, 120mL of cetuximab was infused at a rate 2 3 mL/minute. Mannitol was then infused into the left ACA over 2 minutes, followed by 71 mL of cetuximab. The standard chemoradiation was started within a week as per Stupp protocol that included combination of radiation treatment and oral temozolomide 75 mg/m daily. Over the next six weeks, she completed 6000cGy in 30 fractions with concurrent temozolomide. Within a month of the SIAC intiaition, she developed facial acne (a common side effect of cetuximab). She also developed vaginal bleeding secondary to fibroids and was prescribed leuprorelin, which reduced her bleeding. After receiving the second injection of leuprorelin, she developed an allergic reaction in the form of generalised pruritus. She received short-term treatment with unspecified steroids for generalised pruritus. The standard chemoradiation was completed and she was off treatment for four weeks, and then started receiving maintenance temozolomide. The second and third SIACI of cetuximab were given 3 and 6 months later, while she continued on maintenance temozolomide. She received second and third SIACI of cetuximab without any complications. Following SIACI of cetuximab after blood-brain barrier disruption using mannitol, combined with the standard chemoradiation therapy, no recurrence of the glioblastoma was noted, but she reported mild headache, which was relieved with paracetamol [Tylenol]. She was currently on maintenance temozolomide 300 mg/day for 5 days and reported grade 1 nausea with temozolomide, which was relieved by ondansetron [Zofran; not all outcomes stated]. Author comment: "She developed mania on the steroids, and was tapered down to 0.5 mg daily which she tolerated". "Within a month of the SIAC, she reported facial acne, which is a common side effect of cetuximab". "She received a second injection of Lupron which caused an allergic reaction- -generalized pruritis for which she was placed on steroids for a short term". "The patient feels well, with reports of . . .Grade 1 nausea with [temozolomide]." Kulason KO, et al. Superselective intraarterial cerebral infusion of cetuximab with blood brain barrier disruption combined with stupp protocol for newly diagnosed glioblastoma. Journal of Experimental Therapeutics and Oncology 12: 223-229, No. 3, Jan 2018 - USA 803323927 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Multiple drugs

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
Free
1 page

Loading next page...
1 Page
 
/lp/springer_journal/multiple-drugs-ZApthtYEF1
Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46912-5
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p269 - 2 Jun 2018 Various toxicities: case report A 51-year-old woman developed mania during treatment with dexamethasone, facial acne during treatment with cetuximab, allergic reaction in the form of generalised pruritus during treatment with leuprorelin [Lupron]. Additionally, she developed nausea during chemotherapy with temozolomide [not all routes and dosages stated]. The woman, who presented to a primary care provider in the fall of 2016 (at the age of 51 years) with a 2 3 week history of severe, chronic headache, was diagnosed with a right frontal glioblastoma and underwent craniotomy. Her headaches resolved after the surgery with oral dexamethasone 2mg twice daily. However, she developed mania on dexamethasone. The woman’s dexamethasone was tapered down to 0.5mg daily, which she tolerated well. Pathological examination confirmed epidermal growth factor receptor (EGFR) amplification. A week prior to the initiation of standard chemoradiation therapy as per Stupp protocol (that included combination of radiation treatment and oral temozolomide), she received first of the three separate superselective intraarterial cerebral infusion (SIACI) of cetuximab after blood- brain barrier disruption with mannitol to the tumour site. Mannitol was infused in the A2 segment of the right anterior cerebral artery (ACA) over 2 minutes and subsequently, 120mL of cetuximab was infused at a rate 2 3 mL/minute. Mannitol was then infused into the left ACA over 2 minutes, followed by 71 mL of cetuximab. The standard chemoradiation was started within a week as per Stupp protocol that included combination of radiation treatment and oral temozolomide 75 mg/m daily. Over the next six weeks, she completed 6000cGy in 30 fractions with concurrent temozolomide. Within a month of the SIAC intiaition, she developed facial acne (a common side effect of cetuximab). She also developed vaginal bleeding secondary to fibroids and was prescribed leuprorelin, which reduced her bleeding. After receiving the second injection of leuprorelin, she developed an allergic reaction in the form of generalised pruritus. She received short-term treatment with unspecified steroids for generalised pruritus. The standard chemoradiation was completed and she was off treatment for four weeks, and then started receiving maintenance temozolomide. The second and third SIACI of cetuximab were given 3 and 6 months later, while she continued on maintenance temozolomide. She received second and third SIACI of cetuximab without any complications. Following SIACI of cetuximab after blood-brain barrier disruption using mannitol, combined with the standard chemoradiation therapy, no recurrence of the glioblastoma was noted, but she reported mild headache, which was relieved with paracetamol [Tylenol]. She was currently on maintenance temozolomide 300 mg/day for 5 days and reported grade 1 nausea with temozolomide, which was relieved by ondansetron [Zofran; not all outcomes stated]. Author comment: "She developed mania on the steroids, and was tapered down to 0.5 mg daily which she tolerated". "Within a month of the SIAC, she reported facial acne, which is a common side effect of cetuximab". "She received a second injection of Lupron which caused an allergic reaction- -generalized pruritis for which she was placed on steroids for a short term". "The patient feels well, with reports of . . .Grade 1 nausea with [temozolomide]." Kulason KO, et al. Superselective intraarterial cerebral infusion of cetuximab with blood brain barrier disruption combined with stupp protocol for newly diagnosed glioblastoma. Journal of Experimental Therapeutics and Oncology 12: 223-229, No. 3, Jan 2018 - USA 803323927 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off