Introduction Ambulatory chemotherapy is an important and major advance in clinical oncology practice since it allows the administration of chemotherapy in the comfort of the patient's home without the assistance of a health professional by means of an elastomeric pump. However, these pumps are not without risks and can be the cause of incidents due to technical failures. Our objective is to study the technical failures of elastomeric pumps in the Cytotoxic Preparation Unit and in the patient's home, to evaluate the possible impact of these failures on the patient and on the staff and to propose measures to reduce them. Materials and methods This is a retrospective study conducted at the pharmacy of the National Institute of Oncology in Rabat. It gathered all the specific reports on elastomeric pumps issued during the period (January 2017–May 2021) by the cytotoxic preparation unit to the materiovigilance cell via a notification form. Results 205 cases of elastomeric pump materialovigilance were identified during the study period. The main technical failures were: chemotherapy product leakage (44%), flow rate anomalies (30%) and injection difficulties (20%). Following these incidents, certain actions were undertaken such as alerts sent to the supplier and letters sent to the competent health authorities. Conclusion Despite the failures that may have occurred, elastomeric pumps have revolutionized home chemotherapy delivery. They are considered reliable, consistent, easy to use and handle, and are well accepted in the population.
During Ifosfamide treatment, encephalopathy may occur in about 3% of cases. Additional investigations, such as biology or imaging, are usually normal. Encephalopathy is generally reversible without medium-or long-term sequelae but rare cases of death are described. It is recommended, as soon as Ifosfamide encephalopathy is suspected, to suspend its administration, to correct any hydroelectrolytic disorder, and to inject methylene blue at a dose of 50 mg every 4 hours until the symptoms regress. Reintroduction of Ifosfamide in subsequent courses of treatment should be discussed on a case-by-case basis, under prophylactic treatment with methylene blue at a dose of 50 mg every 6 hours. The mechanism of this complication is not fully elucidated. It is important to continue pharmacological studies in order to determine precisely the toxic metabolite(s) responsible and thus to look for an effective protector.
Introduction Capecitabine is a molecule of choice in the therapeutic arsenal of anticancer drugs used in Morocco for the treatment of breast cancer and colorectal cancer. Its frequent use imposes a follow-up and a post-prescription monitoring of the treatment modalities as well as the adverse events that may occur following its administration. Objective The objective of this study is to evaluate the level of knowledge of patients in the day hospital of an oncology facility about their treatment with capecitabine. Materials and methods This is a prospective study conducted over a period of 2 months (January–February 2022) at the day hospital in the National Institute of Oncology in Rabat, and it was conducted using a questionnaire in order to evaluate patients’ knowledge about their treatment with capecitabine. Results This study involved 95 patients, 76% claimed to have ever received pharmaceutical advice on capecitabine treatment. The main indications were colorectal and breast cancer. Ninety seven percent knew the indication for capecitabine and the action of the molecule on the relevant tumor. Eighty three percent receiving capecitabine therapy reported the occurrence of side effects and hand-foot syndrome was the most reported in 31.2% of the total listed side effects. Discussion Capecitabine is an oral treatment of choice for colorectal and breast cancer in Morocco. Therapeutic education happens to be an effective tool in order to guarantee the best effectiveness and manage the possible side effects that can occur during the treatment.
Introduction Tamoxifen is widely used for the treatment of hormone-responsive breast cancer. In this article, we report a case of a patient who developed hand deformities following long-term administration of tamoxifen. Case report A 57-year-old woman, followed for invasive ductal carcinoma of the left breast under tamoxifen for 7 years, presenting joint pain with deformities in her fingers. Management & outcome Following the appearance of the adverse effect, tamoxifen was stopped. A series of biologic and radiologic analysis were performed in order to explain the appearance of this event. A substitution treatment was discussed and a rheumatologist's opinion was requested. Discussion Tamoxifen appears to be associated with the development of inflammatory osteoarthritis resembling rheumatoid arthritis. Possible mechanisms of such an effect are discussed.
parallel testing was performed using Chemfort VA from which the filter system had been removed. Results No drug was found in any of the test samples with the intact air filter system in Chemfort VAs, either fresh, following aging for 3 years or after 7 days of exposure to drug vapours. Recovered vapour was consistently found in the positive control samples which had Chemfor VAs without a filter system. Mean±SD (n=5) levels were 69±34 and 35±20 ng for cyclophosphamide and 5-FU, respectively. Conclusion and relevance The results confirm the efficacy of the Chemfort air filtration system, even after 7 days of exposure to drug vapour or a shelf life of 3 years.
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