Module 4 - Case Study Flashcards Preview

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Flashcards in Module 4 - Case Study Deck (5)
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1
Q

Stan was experiencing anemia (reduced RBC count), easy bruising/bleeding, loss of appetite, fever and signs of infection. Which drug, methotrexate or mercaptopurine caused these?

A

Both, the side effects overlap

2
Q

Which drug(s) are accounting for Stan’s worsening condition?

A

Side effects overlap between both drugs - we need to look into pharmacokinetics to uncover more

3
Q

What pharmacokinetic parameter indicates which drug is the culprit for Stan’s worsening condition?

A

Mercaptopurine (pro-drug) –> activated to become TGN
TGN is metabolized by TPMT
TPMT deficiency can lead to TGN accumulation, and life-threatening bone-marrow suppression

4
Q

What lab tests could be done to help the doctor?

A

Genetic tests to look for TPMT deficiency

5
Q

What would you suggest should be done to optimize drug therapy for Stan?

A

Reduce the dose, or stop giving mercaptopurine