Research Journal of Pharmacy and Technology

K. Sukanya Mathew ¹, Anjana Thomas ¹, P. R. Roshni ², Akhila Sivadas ³, K. Pavithran ³

Affiliations
1 Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidhyapeetham, Kochi, Kerala, IN
2 Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidhyapeetham University AIMS Health Science Campus, Kochi – 682041, Kerala, IN
3 Department of Medical Oncology and Hematology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidhyapeetham University AIMS Health Science Campus, Kochi – 682041, Kerala, IN

Abstract

Regorafenib{first small-molecule multikinase inhibitor ³}is used for patients who had earlier treatment with multiple regimens for metastatic colorectal cancer. Here we address a female patient who is 45 year old who had stage III disease with carcinoma recto sigmoid and hemicolectomy. From November 2012 to May 2013, patient had 12 cycles of FOLFOX regimen as adjuvant chemotherapy and it got relapsed after 7 months , later on, 6 cycles of Irinotecan ⁶ 5FU/LV/Avastin as a second line agent was administered. From December 2013– May 2014, she had a 6 months of PFS. On her next follow up, she showed relapse of the disease in USG abdomen and PET scan and hence initiated on regorifinib with a dose of 160 mg once daily as the third line therapy. On development of jaundice and hand foot syndrome after 2 weeks of treatment, the dose was reduced to 80mg 2 tablets/day. As she was tolerating well with the decreased dose and showed good clinical response, she was advised for regular follow up. After 22 months of revaluation, it was observed that rising CEA and CT scan showed progressive disease, hence the treatment was changed to capecitabine. Even after 50 months from the diagnosis of disease, she is still continuing in good performance status 5. The patients survival period were less than 6 months only, before the availability of these newer targeted and chemotherapuetic agents. We emphasize the fact that Regorafenib plays an significant role in the treatment of refractory metastatic colorectal cancer patients as a third line agent with meaningful improvement in the survival and minimum side effects.

Keywords

Progression Free Survival (PFS), Regorafenib.

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K. D. Salima ¹, Rajesh Gopalakrishna ², Renjitha Bhaskaran ³, P. R. Roshni ⁴

Affiliations
1 Department of Pharmacy Practice, Amrita School of Pharmacy, Kochi, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Kochi, Kerala, IN
2 Department of Gastroenterology, Amrita Institute of Medical Sciences and Research Centre, Kochi, IN
3 Department of Biostatistics, School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, IN
4 Department of Pharmacy Practice, Amrita School of Pharmacy, Kochi, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Kochi, IN

Abstract

Aim: There are no guidelines for use of diabetic medications in pancreatic diabetes. Hence we attempted to the benefits of antidiabetic agents in pancreatic diabetes. Materials and methods: a total of 670 chronic pancreatitis patients are selected. Out of that about 126 patients with pancreatic diabetic are selected for the study. The data collected from 2010. Results: In this study mean age was found to be 53.86±12.53. The male patients (73.8%) were more predominant in this study than female patients (26.2%). The complications of chronic pancreatitis among 126 patients, 126 (100) patient had diabetes mellitus (DM), 100 (79) patients had pain. Among 126 patients 52 (41.3%) patients had taken insulin only, 21 (16.7%) patients had taken insulin+ oral combination, 16 (12.7%) patients had taken Biguanides, 13 (10.3%) of patients had taken oral combinations, 13 (10.3%) patients had taken alpha glucosidase inhibitors, 11 (8.7%) patients who are taken sulfonyl ureas. Most of the patients took insulin monotherapy. Conclusion: Insulin was most preferred agent. Metformin was the most commonly preferred oral antidiabetic agent.

Keywords

Chronic Pancreatitis, Type3c DM, Pancreatic Enzymes, Pseudocyst, Malabsorption.

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