This is the first and largest genetic map the DPYD variants associated with adverse drug reaction to 5-FU in south Asian population. Our study highlights ethnic differences in allelic frequencies.

Background: Abiraterone acetate was approved by FDA and EMA in April and September 2011, respectively for treatment of patients with casteration resistant prostate cancer and those previously treated with docetaxel. It is a selective inhibitor of androgen biosynthesis which potentially and irreversibly blocks CYP17, a crucial enzyme in oestrogen and testosterone synthesis. Materials and Methods: This retrospective study was conducted to evaluate the safety and efficacy of abiraterone acetate in the treatment of castration resistant prostate cancer patients. Twenty-two male patients diagnosed with CRPC and experienced treatment failure with one or more lines of treatment (hormonal manipulation or chemotherapy) were selected and administered abiraterone acetate (1,000 mg daily) along with prednisone (5 mg twice daily). Results: Out of 22 patients, 32% had a good response in reduction of PSA values, while 22% had progression in disease and 45% had a stable disease. Potassium, Haemoglobin, and serum sreatinine levels were not affected by the drug. Due to severe GI intolerance, the drug had to be stopped for one patient. The results of this study showed that abiraterone acetate significantly lowered the PSA values and prolonged progression- free survival in metastatic castration resistant prostate cancer patients who had progressed after first-line or second-line treatment. The overall average median survival and the median duration of drug exposure for CRPC who received AA was found to be 11.1 months [range 3−18]. Since AA plus prednisolone are available as oral dosage forms, they can be given in outpatient setting. Conclusion: Abiraterone acetate is a drug of choice for CRPC and also for those who had previously received one or two chemotherapy regimens. Since it is a new therapeutic regimen, this study included small sample size, but there are a few studies indicating the therapeutic efficacy of AA among patients with castration-resistant prostate cancer.

Tumour Lysis Syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Hyperuricaemia is one of the prominent features of TLS which if not adequately prevented or treated can lead to renal failure requiring dialysis.Rasburicase is the most recent agent indicated for treating TLS which is a recombinant urate oxidase enzyme that will oxidize uric acid to allantoin, a metabolite with 5-10 fold greater solubility than uric acid and reduces serum uric acid (SUA) levels within four hours of administration.The recommended dose according to US Food and Drug Administration is 0.15 to 0.2 mg/kg/d for 5 days. This retrospective study was aimed to evaluate the clinical efficacy of fixed low dose Rasburicase (1.5mg) in hyperuricemic patients who was admitted

Trastuzumab is a monoclonal antibody effective in treating metastatic breast carcinomas. Cardiotoxicity is the most commonly reported adverse event occurring when used in combination with anthracycline derivatives. Even though pulmonary toxicities are uncommon, immediate withdrawal of the drug is recommended and only reinitiates after the vitals of the patient have become normal. Here, we discuss the case of an 81-year-old female patient who was treated with Injection Trastuzumab for the treatment of breast cancer with metastasis to lungs and received 6 cycles without any major complications. However, 24 h post the last dose; the patient developed a sudden onset of breathlessness and desaturation and was intubated in view of severe metabolic and respiratory acidosis. Blood investigations revealed elevated brain natriuretic peptide, aspartate transaminase, and alkaline phosphatase. Her blood and urine cultures were found to be sterile. She was managed with IV antibiotics, nebulizations, IV fluids, and other supportive medications and had improved considerably. However, on the 11th day, her condition had deteriorated and developed bradycardia. The patient could not be revived and died. Review of the patient’s medication did not reveal the presence of any other possible drugs capable of producing pulmonary toxicity. Trastuzumab should be avoided in patients with underlying respiratory or cardiac issues.

Context:Citicoline (CN) and piracetam (PM) combination in tablet formulation is newly introduced in market. It is necessary to develop suitable quality control methods for rapid and accurate determination of these drugs. Aim: The study aimed to develop the methods for simultaneous determination of CN and PM in combined dosage form.Materials and Methods:The first method was developed by formation and solving simultaneous equations using 280.3 and 264.1 nm as two analytical wavelengths. Second method was absorbance ratio in which wavelengths selected were 256.6 nm as its absorptive point and 280.3 nm as λmax of CN. According to International Conference on Harmonization (ICH) norm, the parameters – linearity, precision, and accuracy were studied. The methods were validated statistically and by recovery studies.Results:Both the drugs obeyed Beer-Lambert's law at the selected wavelengths in concentration range of 5-13 μg/ml for CN and 10-22 μg/ml for PM. The percentage of CN and PM in marketed tablet formulation was found to be 99.006 ± 0.173 and 99.257 ± 0.613, respectively; by simultaneous equation method. For Q-Absorption ratio method the percentage of CN and PM was found to be 99.078 ± 0.158 and 99.708 ± 0.838, respectively.Conclusions:The proposed methods were simple, reproducible, precise and robust. The methods can be successfully applied for routine analysis of tablets.

Cardiotoxicity associated with 5-fluorouracil (FU) is an uncommon, but potentially lethal, complication. Cardiac toxicity of 5FU include acute coronary syndrome (ACS), cardiomyopathy, vasospastic angina, coronary thrombosis and dissection, malignant arrhythmias, and sudden cardiac death.With shorter bolus regimens, the incidence of cardiotoxicity typically lies between 1.6% to 3% of cases and with more prolonged regimens, these percentages increase to 7.6% to 18%. We intend to share four cases which showed cardiac toxicity on chemotherapy with 5FU. All our patients were getting continuous infusion regimens. 2 patients had arrhythmias one SVT and one bradycardia), one had reversible cardiomyopathy and one had acute coronary vasospam. 2 patients were suffering from carcinoma esophagus and one from carcinoma nasopharynx and another from cholangiocarcinoma. All were not having any cardiac risk factors. In all our cases the event was completely reversible. Except in the patient who had cardiomyopathy, chemotherapy was continued without any further issues.Here we Concluded With increased usage of 5-FU for the treatment of gastrointestinal malignancies, cardiotoxicities may be expected to be encountered more frequently in the future. A pre-chemotherapy history, physical examination and a basic cardiac evaluation and monitoring in high risk cases might be able to prevent such events ABS056

No abstract

No abstract