Comparative study of dexamethasone premedication regimens with docetaxel chemotherapy in early HER-2 positive breast cancer: A safety net hospital experience.

INTRODUCTION: Docetaxel can cause fluid retention reactions (FRRs) and hypersensitivity reactions (HSRs). The manufacturer recommends a multi-day oral dexamethasone premedication to prevent these toxicities, but steroid related side effects and regimen compliance remain a concern. This study aimed to determine if modified dexamethasone premedication regimens resulted in differences in HSRs or FRRs to docetaxel. We also examined side effects of dexamethasone and delays in chemotherapy. METHODS: A retrospective chart review was conducted on 82 early breast cancer patients treated with docetaxel. Three steroid regimens were examined: IV 20 mg single-dose dexamethasone, or IV 12 mg dexamethasone with either dexamethasone 8 mg BID for three days starting the day before chemotherapy or dexamethasone 4 mg BID for three days following chemotherapy. Adverse effects, delays in chemotherapy, and reasons for delays in chemotherapy were recorded. RESULTS: The incidence and severity of FRRs and HSRs was low, with less than 10% incidence of HSRs or FRRs in any group. Delays were most common in the group receiving dexamethasone 8 mg BID for 3 days starting the day before chemotherapy (63.3%) (p < 0.05) and were most commonly due to patient noncompliance (26%). CONCLUSION: A single dose of intravenous dexamethasone alone or followed by lower doses of oral dexamethasone may improve patient compliance and avoid delays in chemotherapy, without an increase in docetaxel toxicity.

A Brief Review of Three Common Supplements Used in Alzheimer's Disease.

Individuals with Alzheimer's disease (AD) and their caregivers are using supplements in an effort to halt the progression of the disease. Individuals at risk for or fearing Alzheimer's may use these supplements to try to prevent the disease. Senior care pharmacists are accessible and uniquely qualified to answer questions, make recommendations, and attempt to make drug therapy safe and effective for these individuals. With this in mind, it is important to know the data supporting (or not supporting) common supplements marketed toward those with AD. A review of efficacy and safety data, drug interactions, as well as the mechanism of action believed to benefit those with AD of three common supplements (Prevagen, Cerefolin NAC, and the omega-3 polyunsaturated fatty acid DHA), are highlighted.

A Brief Review of Caprylidene (Axona) and Coconut Oil as Alternative Fuels in the Fight Against Alzheimer's Disease.

Type 3 diabetes mellitus has been coined to describe an alternative pathologic pathway of Alzheimer's disease (AD). The insulin resistance and impaired insulin signaling seen on positron-emission tomography scans in the brain of those affected by AD support this disease hypothesis. Two products-the medical food caprylidene (Axona) and coconut oil-seek to target the underlying pathology of type 3 diabetes mellitus by providing an alternative fuel source in the brain. Rather than improving glucose utilization, these two products seek to supply ketone bodies in sufficient quantities to pass through the blood-brain barrier and provide an alternative energy source to glucose. This review will provide an overview of the research behind these two modalities, as well as information necessary to ensure the safe use of these supplements.