Description
Please answer all questions in the document attached
Unformatted Attachment Preview
February 28, 2024
Oncology Clinical Case Study
AB is a 45 year old male who has a BSA of 1.8m2. He has a background history of anxiety with panic
attacks, and several recent bacterial pneumonias and suffers from frequent cold sores. He has just
been diagnosed with Diffuse Large B-Cell Lymphoma (a form of Non-Hodgkin Lymphoma), Stage IVB
and requires treatment to start within the next few days. You are the Pharmacist in the Haematology
Multi-Disciplinary Team and need to advise on his drug treatment, potential side effects and lifestyle
modifications which may be needed in the next week, months and considerations for the future.
He will start multi-drug combination treatment to include the following drugs in a regimen called RCHOP, given on 21-day cycles for a planned 6 cycles:
Rituximab 375mg/m2 iv, Day 1
Doxorubicin 50mg/m2 iv bolus over 2-15mins, Day 1
Vincristine 1.5mg/m2 (max 2mg) iv infusion over 15mins, Day 1
Cyclophosphamide 750mg/m2 iv bolus over 5-10min, Day 1
Prednisolone 100mg PO, OD Days 1-5
Marks
1. For Rituximab, what is/are the:
a. mechanism of action of Rituximab in the treatment of Lymphoma?
b. the long-term (months to years) side effects of Rituximab?
5
2. For Vincristine, what is/are the:
a. drug class
b. mechanism of action
c. potential side effects during bolus infusion and in the short-term
d. measures that can be taken to reduce the side effects (if anything)
10
3. For Doxorubicin, what is/are the
a. drug class
b. mechanism of action
c. short- (including during infusion) and long-term side effects
d. measures that can be taken to reduce the side effects (if anything)
10
4. For Cyclophosphamide, what is/are the
a. drug class
b. mechanism of action
c. short- (including during infusion) and long-term side effects
d. measures that can be taken to reduce the side effects (if anything)
10
5. Regarding his previous history of anxiety and panic attacks:
a. What drug(s) in his chemotherapy regimen would concern you?
b. How might his anxiety and panic attacks be managed during therapy (medication
and non-medication)?
1
5
February 28, 2024
6. What prophylactic and supportive care medication(s) would you suggest to the clinical team
to reduce his risk of infection(s)?
5
Clinical course:
Within minutes of starting the first Rituximab infusion, he suffers from pruritus, hives and shortness
of breath, quickly followed by a feeling of his throat closing.
7. What is happening to this patient during Rituximab infusion?
1
8. What is/are the immediate treatment(s)?
2
9. Would you advise giving Rituximab again?
a. If yes, how would you advise giving it?
b. If no, why not?
2
Total Marks: 50
(x2 = 100)
When you provide answers, we will allow for maximum 1,500 words (do not aim for this much)
Please use bullet point for answers.
2
Purchase answer to see full
attachment
