Академический Документы
Профессиональный Документы
Культура Документы
MALIGNANT DISEASE
PHMP 4162
CASE STUDY
Case Questions
1. Create a list of potential drug therapy problems in the patients medication
regimen.
To make the tumor bulk smaller through the treatment that may have
greater potential to be cured.
3. In addition to the stage of disease, what other factors are important for
determining the prognosis for breast cancer?
4. List the treatment modalities available for this patients breast cancer and
discuss their advantages and disadvantages.
Treatment Modalities
Neoadjuvant chemotherapy
Advantages
Can reduce size of tumor and
Disadvantages
Treatment delay, over-treatment,
Surgery
Radiation
conserving surgery
Only for solid tumors and cannot
improve effectiveness of
radiation
Can cure cancer, reduce
prevent re-occurrence of
Adjuvant hormonal therapy
can be as chemoprevention
under control
5. Design an appropriate plan for treating this patients breast cancer, focusing
on pharmacologic and non-pharmacologic measures. If the plan includes
chemotherapy, identify the specific regimen and provide your rationale for
selecting it.
Non-pharmacologic
Having good diets such as monounsaturated
Rationale
May suppress HER 2 cell growth, reduce risk of
Exercise
Pharmacologic
Specific regimen
Rationale
(chemotherapy)
Tamoxifen
CMF (classic) =
(cycle 28 days)
Cyclophosphamide
Methotrexate
40 mg/m2 (IV)
other organ
5-Fluorouracil
Vinorelbine
(cycle 21 days)
Monitoring parameters
Platelets count, liver profile, serum
Adverse effects
Flush, amenorrhea, altered menses
Cyclophosphamide
Methotrexate
and vomiting
Dose limiting thrombocytopenia,
5-Fluorouracil
Vinorelbine
diarrhea
Neurologic toxicity, constipation, dose
limiting thrombocytopenia
7. Since the patient has developed bone metastases, what other medication
should be added to her treatment plan? At what dose and schedule?
Drugs
Doxorubicin
Cisplatinum
Anti-emetic = 4
Infusion Time
Days
Bolus
1-3
2 Hours
1
Reference:
Systemic Therapy of Cancer Second Edition (2011), Ministry of Health and Ministry
of Higher Education, Malaysia, page 13-22