The objectives of the program include:. Pharmacists can recommend the use of daily pill boxes to help improve patient adherence. According to a study, patient satisfaction with and preference for daily pill boxes were greater than for conventional pill bottles. Common treatment challenges in specific oncology treatment groups offer some opportunities for the pharmacist to relay possible recommendations to the patient or prescriber.
For example, a known issue with the breast cancer treatments tamoxifen and toremifene is the risk of developing thrombosis. Pharmacists can help educate patients on possible signs of DVT and caution them on medication side effects. Patients on these medications should look for pain, swelling, tenderness of legs or calves, unexplained shortness of breath, changes in vision, sudden chest pain, or coughing up blood.
There is also an increased risk for endometrial cancer in these patients, so regular gynecologic examinations should be recommended as well as a caution on menstrual irregularities, change in vaginal discharge, abnormal vaginal bleeding, or pelvic pain. Hot flashes are also a potential barrier to patient adherence.
Another valid concern is increased risk of osteoporosis; recommendations of IU of vitamin D per day and mg of calcium per day have been established. Pharmacists may be able to assess and educate the patient taking prostate cancer therapies for symptoms of jaundice, such as yellowing of the eyes or darkening of the urine. Prostate cancer regimens require close monitoring of liver function tests, so if the patient notices signs of jaundice, the prescriber should be notified immediately.
Immunomodulators, such as Revlimid Celgene and Thalomid Celgene , can cause thromboembolism, which can be helped or prevented by daily aspirin use. Patients with 2 or more risk factors eg, obesity and nonambulatory should use low—molecular weight heparin Lovenox; sanofi-aventis or warfarin with a goal of international normalized ratio of around 1.
Each drug has a specific REMS program to allow for close monitoring. The requirement of patient counseling prior to dispensing is to ensure all possible measures are taken to prevent bearing or fathering a child. Tyrosine kinase inhibitors are typically dosed once a day and recommendations to patients include to avoid smoking, avoid taking on an empty stomach, and use of loperamide to help control diarrhea.dalefpamangard.ml/map3.php
Oral Oncology: New Perspectives on the Role of Pharmacists
Be sure to inform the patient that potential adverse effects include corneal ulcerations and unexplained cough, fever, or dyspnea. The majority of patients will have dermatologic reactions that can be reduced in severity by avoiding sun exposure and moisturizing.
Hydrocortisone cream can be used for mild reactions; moderate reactions may also need metronidazole gel and doxycycline. Severe reactions often require a Medrol dose pack in addition.
Multikinase inhibitors, such as Nexavar Onyx and Bayer HealthCare and Sutent Pfizer Oncology , should be taken on an empty stomach and can cause hypertension. Patients new to therapy should have their blood pressure monitored weekly for the first 6 weeks. Sutent use should be monitored for congestive heart failure and arrhythmias; Nexavar use should be monitored for cardiac ischemia. The documents are evidence based and extensive, providing the necessary information for considerations related to formulary status.
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The Cost of Oncology Drugs: A Pharmacy Perspective, Part 2 | Federal Practitioner
This week's topics: Fireworks, milk benefits, diarrhea outbreaks, transgender care, and vaccine status of kindergartners. True or False. In , almost two-thirds of all fireworks-related injuries in the United States occurred in a 1-month period surrounding the Fourth of July. Skip to main content. Best Practices.
- Clinical Pharmacist, A Royal Pharmaceutical Society publication;
- The Skinny on Weight Loss:!
- Oral Oncology: New Perspectives on the Role of Pharmacists.
- Controlling the Cost of Oncology Drugs Within the VA: A National Perspective;
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- In This Section;
The VA Pharmacy Benefits Management Service has developed a number of tools and procedures to provide treatment guidance, increase consistency, and minimize costs across all VA facilities. Fed Pract. Author s : Bernadette B. Geraci, Bcop. Author and Disclosure Information Dr. OPEN provides education and supports the interests of oncology pharmacists and their staff. Resources on the following topics are available at OPEN :.
The Oncology Pharmacist's Role in Immuno-oncology
McBride : One of the great things is that we have seen ACCC really embrace the concept of the multidisciplinary cancer care team. The take-home point is that there is a larger role for oncology pharmacists as we see more immuno-oncology agents and combination therapies emerge. Oncology pharmacists can have a much larger role not only starting the patient on therapy and looking at the financial aspects of treatment, but also addressing the supportive measures necessary to support for continued treatment.
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In This Section. The Oncology Pharmacist's Role in Immuno-oncology. Ensuring Access to Appropriate Therapies What is the role of the oncology pharmacist today? Medication-Based Therapy Management A second role that the clinical oncology pharmacist plays concerns medication-based therapy management. As we see more immuno-oncology therapies develop, the oncology pharmacist is playing a larger role in providing treatment, changes to current treatment, and supportive care-based processes. Resources on the following topics are available at OPEN : Patient assistance and reimbursement Dispensing pharmacy Pharmacist's role Process improvement.