Chapter 96. Chronic Leukemias and Multiple Myeloma
A first-line treatment for a newly diagnosed Ph positive chronic phase CML includes which of the following?
Option A: Correct. Nilotinib, dasatinib, and imatinib are BCR-ABL tyrosine kinase inhibitors used in the first-line treatment for chronic phase CML.
Option B: Incorrect. Ibrutinib is used in the treatment of chronic lymphocytic leukemia.
Option C: Incorrect. Omacetaxine is used after failure of a tyrosine kinase inhibitor. It is not used as a first-line agent.
Option D: Incorrect. Ponatinib is used after failing two or more tyrosine kinase inhibitors and in those patients with the T315I mutation.
Patient counseling points for dasatinib include:
A. Avoiding iron preparations
B. Avoiding proton pump inhibitors
C. Discussing hand-foot syndrome
D. Discussing peripheral neuropathy
Option A: Incorrect. There is not a drug interaction with iron preparations.
Option B: Correct. Coadministration with a proton pump inhibitor can result in decrease absorption of dasatinib.
Option C: Incorrect. Hand-foot syndrome is not a commonly reported adverse effect.
Option D: Incorrect. Peripheral neuropathy is not a commonly reported adverse effect.
MP is a 54-year-old female with newly diagnosed chronic phase CML. Current medications include ferrous sulfate for anemia, naproxen for arthritis, esomeprazole for peptic ulcer disease, hyoscyamine for irritable bowel and levofloxacin for a urinary tract infection. Which drug–drug interaction may warrant concern?
A. Ferrous sulfate and dasatinib
B. Levofloxacin and nilotinib
C. Esomeprazole and imatinib
D. Hyoscyamine and ponatinib
Option A: Incorrect. There is not a drug–drug interaction with ferrous sulfate and dasatinib.
Option B: Correct. The combination of levofloxacin and nilotinib may prolong the QT interval. Clinician should determine length and frequency of levofloxacin use for urinary tract infections.
Option C: Incorrect. There is not a drug–drug interaction with esomeprazole and imatinib.
Option D: Incorrect. There is not a drug–drug interaction with hyoscyamine and ponatinib.
SC is a 32-year-old male ...