Oncology drug information

Solimondo D, Bressler L, Kintzel P and Geraci M (2007) Drug Information Handbook for Oncology. Hudson, OH Lexi-Comp Inc. 

When new agents become available for use within a healthcare system, the oncology pharmacy specialist is usually the individual responsible for providing drug information to the general pharmacy staff, nursing staff, house staff, and prescribers. The provision of this information can be disseminated through memorandums. 

At the National Institutes of Health Clinical Center, oncology clinical pharmacists participate as members on the NCI Physician s Data Query online cancer information service supportive care and drug information panels and serve on the Board of Pharmaceutical Specialties Council on Oncology Pharmacy Practice. - These pharmacists, in conjunction with the NIH Division of Safety, developed the first recommendations for safe handling and disposal of antineoplastic drug products and waste. 

As previously noted, it is essential that the oncology pharmacist be well versed in the pharmacotherapy-based management of severe pain, infection, and the nausea, vomiting, and fatigue associated with chemotherapy. The provision of contemporary and valid drug information to patients and families is essential, as is assistance in helping with the interpretation of information that patients and loved ones secure either through their health care providers or independently (e.g., from the Internet). 

Table 10.1 provides some examples of cardiotoxicity information listed in drug labels of oncologic drugs and biologies. These examples include QT prolongation/tor flrfe, hypertension, and cardiomyopathy, each of which is then discussed in more detail. 

Information on approved oncology drugs may be obtained from http //www.fda.gov/cder/regulatorv/applications/ind page l.htm. 

US Food and Drug Administration (FDA). Online. Available HTTP cancer/index.htm> (accessed 5 April 2003). Oncology Tools contains a variety of information related to cancer and approved cancer drug therapies. 

The calcium channel blocker mibefradil (Posicor ) was removed from the market in 1998. The headline for the Pink Sheets article describing this action was "Posicor Withdrawal Reflects Complexity of Interaction Profile" (59). Products identified as potentially dangerous in combination with mibefradil included cardiac drugs, such as amiodarone, flecainide, and propafenone oncologic products, such as tamoxifen, cyclophosphamide, etoposide, ifosfamide, and vinblastine and the immunosuppressant medications cyclosporine and tacrolimus. The sponsor s decision to withdraw mibefradil was based on the complexity of the drug interaction information that would have to be communicated to ensure safe usage. 

Situations may arise when a patient is in need of a drug that is not available commercially or in an ongoing clinical trial at the institution. The oncology pharmacy specialist may arrange to obtain the drug which may only be available from the pharmaceutical company or the National Cancer Institute for nonresearch (compassionate) use. The NCI Cancer Therapy Evaluation Program (CTEP) Treatment Referral Center provides guidelines and contact information for this process. 

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