Bioavailability of Tyrosine Kinase Inhibitors
The growing prominence of tyrosine kinase inhibitors (TKIs) as treatment for malignancies prompts oncology nurses to expand the scope of their patient assessment. Because TKIs as oral agents have a different bioavailability than parenteral agents, factors that alter drug absorption and metabolism can have a measurable effect on the amount of active, available drug when TKIs are prescribed. In relation to TKIs as cancer therapies and intended dosing, this article reviews three drug absorption and metabolism factors: changes in stomach pH, as well as P-glycoprotein and cytochrome P450 interactions.
Patient assessment in oncology nursing has focused on side effects associated with traditional cytotoxic chemotherapeutic agents, including myelosuppression (e.g., neutropenia, thrombocytopenia, anemia), gastrointestinal toxicity (e.g., nausea, vomiting, diarrhea, gastritis), cutaneous toxicity, and constitutional symptoms (e.g., fatigue, pain, malaise). In addition, the assessment for a few drug-specific toxicities has included taxane-induced neuropathy or cisplatin-associated hearing loss.
The growing prominence of tyrosine kinase inhibitors (TKIs) in the oncology pharmaceutical arsenal has triggered a shift in what is considered to be a standard assessment. Targeted therapies have expanded the spectrum of side effects in scope and diversity. Therefore, with targeted therapies, the assessment template includes a wider range of considerations when monitoring and educating patients.
Abstract and Introduction
Abstract
The growing prominence of tyrosine kinase inhibitors (TKIs) as treatment for malignancies prompts oncology nurses to expand the scope of their patient assessment. Because TKIs as oral agents have a different bioavailability than parenteral agents, factors that alter drug absorption and metabolism can have a measurable effect on the amount of active, available drug when TKIs are prescribed. In relation to TKIs as cancer therapies and intended dosing, this article reviews three drug absorption and metabolism factors: changes in stomach pH, as well as P-glycoprotein and cytochrome P450 interactions.
Introduction
Patient assessment in oncology nursing has focused on side effects associated with traditional cytotoxic chemotherapeutic agents, including myelosuppression (e.g., neutropenia, thrombocytopenia, anemia), gastrointestinal toxicity (e.g., nausea, vomiting, diarrhea, gastritis), cutaneous toxicity, and constitutional symptoms (e.g., fatigue, pain, malaise). In addition, the assessment for a few drug-specific toxicities has included taxane-induced neuropathy or cisplatin-associated hearing loss.
The growing prominence of tyrosine kinase inhibitors (TKIs) in the oncology pharmaceutical arsenal has triggered a shift in what is considered to be a standard assessment. Targeted therapies have expanded the spectrum of side effects in scope and diversity. Therefore, with targeted therapies, the assessment template includes a wider range of considerations when monitoring and educating patients.
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