Select a medication and discuss the ethnic, cultural, or genetic differences in the use and consideration for cancer treatment. Share the mechanism of action of this medication and hints for monitoring side effects and drug interactions, including interactions with CAM. Elaborate on one drug-drug interaction and devise a plan to clinically manage the interaction. Include the drug name in your topic line and choose a different drug from your peers.
Fluorouracil
The selected medication commonly used in cancer treatment is Fluorouracil. Fluorouracil is a pyrimidine analog that works by interfering with the synthesis of DNA by inhibiting the conversion of deoxyuridylic acid into thymidylic acid by thymidylate synthetase. The inhibition causes cell death due to a lack of RNA and DNA synthesis (Casale & Patel, 2022). Significant cultural differences are evident in the use of Fluorouracil in cancer treatment. For example, the risk of hematologic toxicities is high in individuals of African American and Caucasian ethnicities. The difference is largely attributed to the reduced responsiveness of Fluorouracil tumors and tolerance to therapy among individuals from these ethnicities. The implicated genes that contribute to the differences include TYMS and DPYD while the variants are DPYD2A and TSER2,3 (Iwuji et al., 2021).
Fluorouracil is associated with several side effects. They include immune suppression, infection, easy bruising and bleeding, anemia, diarrhea, sore throat and mouth, loss of appetite, hair loss, and tiredness. Patients should be educated about the side effects and the need to report them should they worsen. Laboratory investigations such as complete blood count can also be performed to identify risks such as anemia and infection (Casale & Patel, 2022). Fluorouracil has extensive drug interactions. For instance, Abametapir increases its serum concentration. Abatacept increases the metabolism of Fluorouracil while Abciximab increases the risk of bleeding when used together with Fluorouracil. Other drugs such as Abemaciclib lower the excretion rate while Acetaminophen or Tylenol decreases the metabolism of Fluorouracil. Fluorouracil also interacts with complementary and alternative medicines. For example, Xian-Sha-Liu-Jun-Zi-Tang (XSL)ZT), a Chinese traditional herb used in breast and colorectal cancer extends the distribution volume and residence time of Fluorouracil (Liu et al., 2017). Therefore, an effective approach to critically managing drug interactions with Fluorouracil would be minimizing the prescription of drugs that can affect the effectiveness of Fluorouracil in cancer treatment.
References
Casale, J., & Patel, P. (2022). Fluorouracil. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK549808/
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Select a medication and discuss the ethnic, cultural, or genetic differences in the use and consideration for cancer treatment. Share the mechanism of action of this medication and hints for monitoring side effects and drug interactions, including interactions with CAM. Elaborate on one drug-drug interaction and devise a plan to clinically manage the interaction. Include the drug name in your topic line and choose a different drug from your peers.
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Iwuji, K., Hyde, B., & Uke, N. (2021). Colorectal cancer disparities and African Americans: Is it time to narrow the gap? The Southwest Respiratory and Critical Care Chronicles, 9(40), 27–30. https://doi.org/10.12746/swrccc.v9i40.887
Liu, J.-H., Cheng, Y.-Y., Hsieh, C.-H., & Tsai, T.-H. (2017). The Herb–Drug Pharmacokinetic Interaction of 5-Fluorouracil and Its Metabolite 5-Fluoro-5,6-Dihydrouracil with a Traditional Chinese Medicine in Rats. International Journal of Molecular Sciences, 19(1), 25. https://doi.org/10.3390/ijms19010025
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Select a medication and discuss the ethnic, cultural, or genetic differences in the use and consideration for cancer treatment. Share the mechanism of action of this medication and hints for monitoring side effects and drug interactions, including interactions with CAM. Elaborate on one drug-drug interaction and devise a plan to clinically manage the interaction. Include the drug name in your topic line and choose a different drug from your peers.