scholarly journals Strategies to prevent anthracycline-induced cardiotoxicity in cancer survivors

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Neha Bansal ◽  
M. Jacob Adams ◽  
Sarju Ganatra ◽  
Steven D. Colan ◽  
Sanjeev Aggarwal ◽  
...  
Keyword(s):  
The Elderly ◽  
Cancer Diagnostics ◽  
European Medicines Agency ◽  
Cardiovascular Comorbidities ◽  
Thoracic Radiation ◽  
United States Food ◽  
Short And Long Term ◽  
States Food ◽  
Anthracycline Chemotherapy

AbstractCancer diagnostics and therapies have improved steadily over the last few decades, markedly increasing life expectancy for patients at all ages. However, conventional and newer anti-neoplastic therapies can cause short- and long-term cardiotoxicity. The clinical implications of this cardiotoxicity become more important with the increasing use of cardiotoxic drugs. The implications are especially serious among patients predisposed to adverse cardiac effects, such as youth, the elderly, those with cardiovascular comorbidities, and those receiving additional chemotherapies or thoracic radiation. However, the optimal strategy for preventing and managing chemotherapy-induced cardiotoxicity remains unknown. The routine use of neurohormonal antagonists for cardioprotection is not currently justified, given the marginal benefits and associated adverse events, particularly with long-term use. The only United States Food and Drug Administration and European Medicines Agency approved treatment for preventing anthracycline-related cardiomyopathy is dexrazoxane. We advocate administering dexrazoxane during cancer treatment to limit the cardiotoxic effects of anthracycline chemotherapy.

scholarly journals Severe haematuria of lower urinary tract origin with low dose dabigatran use in three Indian elderly patients: unresolved issues in the safety of novel oral anticoagulants

2017 ◽  
Vol 9 (1) ◽  
pp. 89-91 ◽  
Author(s):  
Upinder Kaur ◽  
Sankha Shubhra Chakrabarti ◽  
Sukdev Manna ◽  
Indrajeet Singh Gambhir
Keyword(s):  
Oral Anticoagulants ◽  
The Elderly ◽  
The United States ◽  
Novel Oral Anticoagulants ◽  
Thrombin Inhibitor ◽  
European Medicines Agency ◽  
Oral Direct Thrombin Inhibitor ◽  
United States Food ◽  
States Food ◽  
Lower Urinary

Dabigatran is a newer oral direct thrombin inhibitor approved by the United States Food and Drug Administration and the European Medicines Agency (EMA). The proper dosage of the drug, the potential for adverse drug reactions and the nature of bleeds with use of this drug as with other novel oral anticoagulants (NOACs), in the elderly population are still areas of uncertainty. Despite the existence of a specific antibody, idarucizumab which is an antidote to dabigatran toxicity, management of dabigatran-induced bleeds is an undefined area especially in resource constrained settings. We report severe haematuria with dabigatran in three elderly Indian patients at the lowest recommended therapeutic dose and explore these grey zones in dabigatran therapy.

scholarly journals D-Penicillamine: The State of the Art in Humans and in Dogs from a Pharmacological and Regulatory Perspective

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 648
Author(s):  
Michela Pugliese ◽  
Vito Biondi ◽  
Enrico Gugliandolo ◽  
Patrizia Licata ◽  
Alessio Filippo Peritore ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
State Of The Art ◽  
European Medicines Agency ◽  
Therapeutic Goals ◽  
First Choice ◽  
Regulatory Perspective ◽  
The World ◽  
United States Food ◽  
States Food ◽  
Food And Drugs Administration

Chelant agents are the mainstay of treatment in copper-associated hepatitis in humans, where D-penicillamine is the chelant agent of first choice. In veterinary medicine, the use of D-penicillamine has increased with the recent recognition of copper-associated hepatopathies that occur in several breeds of dogs. Although the different regulatory authorities in the world (United States Food and Drugs Administration—U.S. FDA, European Medicines Agency—EMEA, etc.) do not approve D-penicillamine for use in dogs, it has been used to treat copper-associated hepatitis in dogs since the 1970s, and is prescribed legally by veterinarians as an extra-label drug to treat this disease and alleviate suffering. The present study aims to: (a) address the pharmacological features; (b) outline the clinical scenario underlying the increased interest in D-penicillamine by overviewing the evolution of its main therapeutic goals in humans and dogs; and finally, (c) provide a discussion on its use and prescription in veterinary medicine from a regulatory perspective.

Potassium binders

ESC CardioMed ◽  
2018 ◽  
pp. 218-221
Author(s):  
Keld P. Kjeldsen ◽  
Juan Tamargo ◽  
Thomas A. Schmidt
Keyword(s):  
United States ◽  
Clinical Pharmacology ◽  
Gastrointestinal Tract ◽  
The United States ◽  
European Medicines Agency ◽  
Sodium Polystyrene Sulfonate ◽  
United States Food ◽  
States Food ◽  
Potassium Binders ◽  
Sodium Zirconium Cyclosilicate

Potassium binders are used for the treatment of and prophylaxis against hyperkalaemia. Already in 1958, the United States Food and Drug Administration (FDA) approved sodium polystyrene sulfonate, a potassium binder exchanging sodium for potassium in the gastrointestinal tract. In 2015, the FDA approved a new potassium binder, patiromer sorbitex calcium (Veltassa®), exchanging calcium for potassium, and in 2017, it was approved by the European Medicines Agency (EMA). Furthermore, in 2018, the FDA and the EMA approved another new potassium binder, sodium zirconium cyclosilicate (Lokelma®), exchanging sodium for potassium. The clinical pharmacology aspects of potassium binders are reviewed in this chapter.

Potassium binders

ESC CardioMed ◽  
2018 ◽  
pp. 218-221
Author(s):  
Keld P. Kjeldsen ◽  
Juan Tamargo ◽  
Thomas A. Schmidt
Keyword(s):  
United States ◽  
Clinical Pharmacology ◽  
Gastrointestinal Tract ◽  
The United States ◽  
European Medicines Agency ◽  
Sodium Polystyrene Sulfonate ◽  
United States Food ◽  
States Food ◽  
Potassium Binders ◽  
Sodium Zirconium Cyclosilicate

Potassium binders are used for the treatment of and prophylaxis against hyperkalaemia. Already in 1958, the United States Food and Drug Administration (FDA) approved sodium polystyrene sulfonate, a potassium binder exchanging sodium for potassium in the gastrointestinal tract. In 2015, the FDA approved a new potassium binder, patiromer sorbitex calcium (Veltassa®), exchanging calcium for potassium, and in 2017, it was approved by the European Medicines Agency (EMA). Furthermore, in January 2018 approval by the FDA of another new potassium binder, sodium zirconium cyclosilicate (ZS-9®), exchanging sodium for potassium, is pending. The clinical pharmacology aspects of potassium binders are reviewed in this chapter.

scholarly journals Poverty, old age and gender in nineteenth-century England: the case of Hertfordshire

2005 ◽  
Vol 20 (3) ◽  
pp. 351-384 ◽  
Author(s):  
NIGEL GOOSE
Keyword(s):  
Nineteenth Century ◽  
Family Support ◽  
Elderly Women ◽  
The Elderly ◽  
Elderly Male ◽  
Age And Gender ◽  
Local Sources ◽  
Short And Long Term ◽  
And Gender

This article examines the relative incidence of poverty among the elderly in nineteenth-century Hertfordshire with special reference to gender. Both national and local sources are employed to highlight the particular difficulties experienced by the elderly, male poor under the New Poor Law, and the short and long term problems they faced as a result of seasonal unemployment and an overstocked labour market. For elderly women, the extent to which their poverty was relieved by employment in cottage industry, almshouse accommodation, the continuing receipt of out-relief and a higher incidence of family support are examined to provide an assessment of the manner in which poverty was gendered in the nineteenth century.

The Short- and Long-Term Outcomes of Pancreatic Resection for Pancreatic Adenocarcinoma in Patients Older Than 75 Years

2016 ◽  
Vol 101 (11-12) ◽  
pp. 554-561
Author(s):  
Toru Aoyama ◽  
Masaaki Murakawa ◽  
Yosuke Atsumi ◽  
Keisuke Kazama ◽  
Manabu Shiozawa ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Pancreatic Adenocarcinoma ◽  
Pancreatic Resection ◽  
The Elderly ◽  
Surgical Mortality ◽  
Long Term Outcomes ◽  
Group A ◽  
Short And Long Term ◽  
Group B

The short- and long-term outcomes of pancreatic resection for pancreatic adenocarcinoma have not been fully evaluated in elderly patients. This retrospective study selected patients who underwent curative surgery for pancreatic cancer at our institution. Patients were categorized into 2 groups: nonelderly patients (age < 75 years; group A) and elderly patients (age ≥ 75 years; group B). The surgical morbidity, surgical mortality, overall survival (OS), and recurrence-free survival (RFS) rates in the 2 groups were compared. A total of 221 patients were evaluated in the study. The overall complication rates were 44.8% in group A and 52.6% in group B. Surgical mortality was observed in 2 patients due to an abdominal abscess and cardiovascular disease in group A (1.1%) and in 1 patient due to postoperative bleeding in group B (2.6%). There were no significant differences (P = 0.379 and P = 0.456, respectively). Furthermore, the 5-year OS and RFS rates were similar between the elderly patients and nonelderly patients (18.55 versus 20.2%, P = 0.946 and 13.1% versus 16.0%, P = 0.829, respectively). The short-term outcomes and long-term survival after pancreatic resection for pancreatic adenocarcinoma were almost equal in the elderly and the nonelderly patients in this study. Therefore, it is unnecessary to avoid pancreatic resection for pancreatic adenocarcinoma in elderly patients simply because of their age.

Speech‐language pathology care and short‐ and long‐term outcomes of oropharyngeal cancer treatment in the elderly

2017 ◽  
Vol 128 (6) ◽  
pp. 1403-1411 ◽  
Author(s):  
Kimberly T. Webster ◽  
Donna Tippett ◽  
Marissa Simpson ◽  
Rina Abrams ◽  
Kristine Pietsch ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Oropharyngeal Cancer ◽  
The Elderly ◽  
Speech Language Pathology ◽  
Long Term Outcomes ◽  
Language Pathology ◽  
Short And Long Term
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