piperidines and Stevens-Johnson-Syndrome

Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms, interventions, and treatment-related adverse events addressed in this issue are management of Alzheimer's agitation with donepezil; needle-free lidocaine powder for minor painful procedures; psychostimulants in depression; anticoagulation for cancer-related venous thromboembolism; effect of waiting for acute pain treatment on risk of chronic pain; and an update on severe cutaneous reactions associated with medications.

Topics: Alzheimer Disease; Amphetamines; Anesthetics, Local; Anticoagulants; Antidepressive Agents; Depression; Donepezil; Drug Therapy; Drug-Related Side Effects and Adverse Reactions; Humans; Indans; Lidocaine; Nootropic Agents; Pain; Palliative Care; Phlebotomy; Piperidines; Prescription Drugs; Psychomotor Agitation; Randomized Controlled Trials as Topic; Sertraline; Stevens-Johnson Syndrome; Thromboembolism

Topics: Anemia; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Azetidines; Humans; Melanoma; Piperidines; Proto-Oncogene Proteins B-raf; Skin Neoplasms; Stevens-Johnson Syndrome; Vemurafenib

Combination therapy in the treatment of metastatic melanoma has been associated with more durable response rate compared to monotherapy. However, previous studies have shown that combined target therapy commonly causes a wide spectrum of adverse events. These adverse reactions are usually manageable, however, it is always necessary to compare drug efficacy with its potential adverse effects. Toxic epidermal necrolysis represents severe mucocutaneous reaction, usually triggered by medications and characterized by extensive necrosis and detachment of the epidermis. Here we present a first case of toxic epidermal necrolysis induced by combined target therapy (vemurafenib plus cobimetinib). The case was observed in a young patient with BRAF mutant melanoma who was started on first-line metastatic immunotherapy with pembrolisumab.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Azetidines; Humans; Male; Melanoma; Piperidines; Proto-Oncogene Proteins B-raf; Stevens-Johnson Syndrome; Vemurafenib

Topics: Acetaminophen; Analgesics, Opioid; Anti-Inflammatory Agents; Anticonvulsants; Antiemetics; Antineoplastic Agents; Dacarbazine; Dexamethasone; Drug Combinations; Erythema; gamma-Globulins; Glioblastoma; Humans; Immunologic Factors; Levetiracetam; Male; Methylprednisolone; Middle Aged; Omeprazole; Oxycodone; Piperidines; Piracetam; Proton Pump Inhibitors; Quinazolines; Stevens-Johnson Syndrome; Temozolomide; Wound Healing

Topics: Adenocarcinoma; Benzamides; Colonic Neoplasms; Drug Eruptions; Humans; Male; Middle Aged; Piperidines; Protein Kinase Inhibitors; Pyridines; Stevens-Johnson Syndrome; Thiazoles