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Degu A, Karimi PN, Opanga SA, Nyamu DG. Drug-related problems among esophageal, gastric and colorectal cancer patients at the National and referral hospital in Kenya. J Oncol Pharm Pract 2024; 30:493-506. [PMID: 37272031 DOI: 10.1177/10781552231178297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Cancer therapy has remarkable potential for drug-related problems due to the high cytotoxicity and narrow therapeutic index of most anti-neoplastic regimens. However, there is a lack of comprehensive studies on drug-related problems in patients with gastrointestinal cancer in Kenya. Therefore, the present study aimed to investigate the prevalence, types and predictors of drug-related problems among gastrointestinal cancer patients at Kenyatta National Hospital. METHODS A cross-sectional study was used to assess the prevalence of drug-related problems among a random sample of 160 esophageal, 103 gastric, and 96 colorectal cancer patients. Data were collected using a researcher-administered questionnaire and data abstraction tool after training the data collectors. Patient-specific details such as socio-demographic features, histological cancer types, cancer stage, comorbidity types, and treatment regimen were recorded after the review of medical records and patient interviews. The potential of drug-related problems was determined as per the standard guidelines. The data were entered and analysed using version 26.0 SPSS statistical software. RESULTS Most esophageal (51.9%), gastric (59.2%), and colorectal (62.5%) cancer patients had a high prevalence of drug-related problems. The need for additional drug therapy and adverse drug reactions were the predominant categories of drug-related problems. Most adverse drug reactions identified had possible categories of causality score, mild severity levels, and definitely preventable types of adverse drug reactions among all gastrointestinal cancer patients. Comorbidity and advanced-stage disease were significant predictors of drug-related problems. CONCLUSIONS Drug-related problems were prevalent among gastrointestinal cancer patients in our setting. Comorbidity and advanced stages of disease were significant predictors of drug-related problems.
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Affiliation(s)
- Amsalu Degu
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy and Health Sciences, United States International University-Africa, Nairobi, Kenya
- Department of Pharmacy, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Peter N Karimi
- Department of Pharmacy, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Sylvia A Opanga
- Department of Pharmacy, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - David G Nyamu
- Department of Pharmacy, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
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Shaikh SP, Nerurkar R. Adverse Drug Reaction Profile of Anticancer Agents in a Tertiary Care Hospital: An Observational Study. Curr Drug Saf 2021; 17:136-142. [PMID: 34433404 DOI: 10.2174/1574886316666210825122152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/22/2021] [Accepted: 04/26/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anti-cancer agents are known to be toxic, leading to a number of adverse drug reactions (ADRs). ADRs not only increase the financial burden on patient/healthcare system but also decrease quality of life. Understanding the burden of ADR will help strengthen the knowledge on patient safety and thereby in implementing intervention strategies to reduce it. OBJECTIVES 1. To study the pattern of Adverse drug reaction of anticancer agents of patients admitted in the oncology ward. 2. To assess the causality, severity, and preventability of the adverse drug reactions observed. METHODS This was a cross-sectional, observational study carried out in 200 adult patients in the daycare center for chemotherapy. Details of ADRs noted in the previous and current cycles were noted. Causality assessment was done using Naranjo and WHO scale. For severity and preventability assessment Hartwig Siegel and Modified Schumock Thorton scale were used respectively. RESULTS Out of the total 732 ADRs encountered, alopecia was the most common ADR. The average number of ADRs observed per patient was 3.66 + 1.59(mean + SD). The maximum number of ADRs were seen in Paclitaxel-carboplatin 3 weekly regimen. Nausea and alopecia were the most common ADRs reported with most regimens. On causality assessment, 95(12.97%) were definitely related according to Naranjo's Causality scale, while 15.71% were certainly related according to WHO scale. Of all the ADRs recorded,47.81% were of moderate-intensity while 52.18% were of mild intensity. The majority of ADRs were not preventable, 87.59%. CONCLUSION Alopecia was the most common ADR reported. Most of the ADRs could be causally related to drugs. These ADRs were mild to moderate in severity and were not preventable. There is need to identify the underlying factors that predispose patients to these ADRs and target them in future research.
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Affiliation(s)
- Sana Parveen Shaikh
- Department of Pharmacology, Topiwala National Medical College, Mumbai. India
| | - Rajan Nerurkar
- Department of Pharmacology, Topiwala National Medical College, Mumbai. India
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Wu Y, Li W, Stephenson M, Cong W, Zhou C. Pre-treatment assessment for patients with breast cancer undergoing chemotherapy: a best practice implementation project. JBI Evid Synth 2021; 18:212-223. [PMID: 31972683 DOI: 10.11124/jbisrir-d-19-00163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES This project aimed to conduct an audit of pre-treatment assessment for patients with breast cancer undergoing chemotherapy and to assess the impact of these changes in improving the compliance with evidence-based best practice criteria in a large tertiary hospital. INTRODUCTION Pre-treatment assessment before cancer chemotherapy is paramount in order for patients to receive effective and safe treatment. Numerous guidelines and consensus-based standards for safe chemotherapy administration have been developed, which state that nurses should conduct and document comprehensive health assessments for patients prior to administration of chemotherapy. METHODS The project was conducted in the Breast Surgery Department of a nearly 3000-bed tertiary hospital in China. Evidence-based audit criteria were developed based on a JBI evidence summary. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit tool were used to promote changes in practice. Sample sizes of 13 clinical nurses and 30 breast cancer patients undergoing chemotherapy were included in baseline and follow-up audits. RESULTS The baseline audit indicated significant deficits in pre-treatment assessment nursing practice in the unit, with eight of the 12 criteria recording 0% compliance and one criterion recording only 3% compliance. Barriers to compliance were identified by the project team, and a series of strategies were adopted to address the barriers. There was improvement in compliance with all the best practice criteria in the follow-up audit compared with the baseline audit, with each one achieving a minimum of 90% compliance. CONCLUSIONS The project showed that regular and focused education and ongoing audits on pre-treatment assessment can help to optimize safe and effective chemotherapy treatment. Further strategies are planned to sustain the implementation of evidence.
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Affiliation(s)
- Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, PR China.,PR China Nanfang Nursing Centre for Evidence-based Practice: a Joanna Briggs Institute Affiliated Group
| | - Wenji Li
- Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Matthew Stephenson
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Weilian Cong
- Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, PR China.,PR China Nanfang Nursing Centre for Evidence-based Practice: a Joanna Briggs Institute Affiliated Group
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Silva C, Correia-Branco A, Andrade N, Ferreira AC, Soares ML, Sonveaux P, Stephenne J, Martel F. Selective pro-apoptotic and antimigratory effects of polyphenol complex catechin:lysine 1:2 in breast, pancreatic and colorectal cancer cell lines. Eur J Pharmacol 2019; 859:172533. [PMID: 31301308 DOI: 10.1016/j.ejphar.2019.172533] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 01/12/2023]
Abstract
Cancer is a major cause of death in both developed and developing countries. Polyphenols, abundantly found in plants, possess many anticarcinogenic properties, including inhibition of cancer cell proliferation, tumor growth, angiogenesis, metastasis and inflammation, as well as pro-apoptotic effects. Our study aimed to investigate the effects of a complex of (+)-catechin with 2 lysines (Cat:Lys) on cancer and non-cancer cells. For this, the in vitro effects of Cat:Lys on the viability, growth, proliferation, apoptosis, nutrient uptake and migration of breast, pancreatic and colorectal cancer and non-cancer cell lines was evaluated. We found that Cat:Lys exerted antiproliferative and cytotoxic effects in all breast, pancreatic and colorectal cell lines tested, but with a much less marked amplitude in non-cancer cell lines. It nevertheless interfered with nutrient (3H-deoxy-D-glucose and 3H-lactate) uptake and with lactate production in both cancer and non-cancer cell lines. Cat:Lys was found to possess selective antimigratory effects in breast, pancreatic and colorectal cancer cell lines compared to non-cancer cell lines. Cat:Lys also exerted pro-apoptotic effects in all the cancer cell lines that we tested, but not in non-cancer breast and pancreatic cell lines. The antimigratory, but not the pro-apoptotic, effects of Cat:Lys were found to be mediated by JAK2/STAT3 and Wnt pathway inhibition. In conclusion, Cat:Lys is a strong candidate for the development of new, effective anticancer agents against cancer.
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Affiliation(s)
- Cláudia Silva
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Ana Correia-Branco
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Nelson Andrade
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - António Carlos Ferreira
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Laboratório de Apoio à Investigação em Medicina Molecular, Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Miguel Luz Soares
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Laboratório de Apoio à Investigação em Medicina Molecular, Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Pierre Sonveaux
- Pole of Pharmacology & Therapeutics, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | | | - Fátima Martel
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
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Oyenihi AB, Smith C. Are polyphenol antioxidants at the root of medicinal plant anti-cancer success? JOURNAL OF ETHNOPHARMACOLOGY 2019; 229:54-72. [PMID: 30287197 DOI: 10.1016/j.jep.2018.09.037] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/31/2018] [Accepted: 09/28/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Given the severe side effects associated with most of the conventional cancer medications, as well as the expanding body of evidence indicating secondary toxicity of these drugs, individuals with cancer are increasingly turning to natural alternatives. Similarly, the pharmaceutical industry is in search of natural products to treat cancer. An understanding of the specific active components in plant products with which anti-cancer efficacy is achieved is required for this research to move forward. AIM OF THE STUDY To integrate data from cancer-relatestudies on plant-derived products or extracts, to elucidate whether these products may have similar active ingredients and/or mechanisms of action, that can explain their efficacy. This review also includes a discussion of the methodological complexities and important considerations involved in accurate isolation and characterisation of active substances from plant material. CONCLUSIONS From the literature reviewed, most plant products with consistently reported anti-cancer efficacy contains high levels of polyphenols or other potent antioxidants and their mechanisms of action correlate to that reported for isolated antioxidants in the context of cancer. This suggests that natural products may indeed become the panacea against this chronic disease - either as therapeutic medicine strategy or to serve as templates for the design of novel synthetic drugs. The recommendation is made that antioxidant activity of plant actives and especially polyphenols, should be the focus of anti-cancer drug discovery initiatives. Lastly, researchers are advised to exploit current techniques of chemical compound characterisation when investigating polyphenol-rich plants to enable the easy consolidation of research findings from different laboratories.
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Affiliation(s)
- A B Oyenihi
- Dept Physiological Sciences, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch 7602, South Africa
| | - C Smith
- Dept Physiological Sciences, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch 7602, South Africa.
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