This article will explain the diagnosis of most of these problems, the differential diagnosis that needs to be paid attention to (that is, don’t mistake it for other diseases), the principles of diet or symptomatic drugs, the departments that need to be seen, etc. If there are any questions not mentioned, please leave a message and we will help you answer them! The side effects of crizotinib, ceratinib, Aletinib, bugatinib (AP26113) and Loratinib (3922), targeted drugs for lung cancer, were classified as follows:
Eye problems: conjunctiva redness, floaters, vision loss, tearing
It contains several kinds of symptoms and root causes, among them, the conjunctival redness, or eyelid inside, of course, more red, and tears, and the mucosal damage caused by stems mainly from targeted drugs, and targeted medicine the cause of common oral ulcers, skin rashes, but because of the eyes is very sensitive, intuitive feeling to the person also has a great influence on easily, therefore, Conjunctival redness, eyelid inflammation, no reason of tears, should as soon as possible to the ophthalmic, corresponding drugs are likely to be the mucosal damage of bacterial or viral infection, such cases it is almost impossible to judge for themselves, although the effect of levofloxacin eye drops for the majority of bacterial infection, corresponding drugs is not the same but different pathogens, Do not be afraid of trouble so and self-medicated, still had better see ophthalmology. And appear vision loss, floaters, etc, is more of a fundus optic nerve, the muscle of the lens to adjust or nerve affected by drugs, can also be said in front of the indirect effects of infection type, and also the vision itself with age growth, tumor complications of brain metastasis may cause together, difficult to identify, therefore, It is relatively necessary to see an ophthalmologist for related problems, and treat the window of your soul kindly.
Need to remind you note a myth, all kinds of advertising some material can fill “eyes” are serious misleading, such as carotene, anthocyanins, a variety of vitamins, etc., when the eyes caused by a lack of a substance related disease, the lack of substance is drug treatment, or treatment, one of when is not caused by a lack of eye disease, Filling can only be icing on the cake or gild the lily, finding out the cause is the prerequisite for effective treatment.
Oral problems: bitter mouth, abnormal taste/failure
Mouth bitter, taste this kind of situation is caused directly targeted drug in nerve cell damage and damaged mucosa (near the tongue taste buds) the result of joint action, belongs to a but can small side effects, some people care less to eat and drink at ordinary times, I feel nothing, but people life more delicate for suddenly unable to enjoy the food still can’t endure. What I want to tell you here is that every person’s targeted drugs cause taste abnormalities differently. In addition to appropriate supplementation of vitamin B2, vitamin C, and methylcobalamin, dietary attempts can only be made. For example, if you don’t have high blood pressure or kidney problems, you can be a little salty, if you don’t have diabetes or obesity, you can be a little sweet, if you don’t have gastrointestinal problems and you like spicy food, you can be a little spicy. Anyhow to regulate in various ways and food (of MSG is monosodium glutamate, glutamic acid is human body protein and a variety of plant and animal protein will produce amino acids after digestion, as long as don’t cause too much food more horrible put casually), also note that since feel to eat up not as before, just a little more easy absorption and digestion of the food, Eat fried meat, stewed meat are not fragrant can be made into a trap, do not love to eat vegetables and fruits can be made into mud (I do not cook, also can only say these, welcome to add the kitchen talent)… Not have to look for nutrient solution or to the pharmacy to buy, and the doctor has prescribed a cliche topic, don’t fill eating less than total protein powder, but complement nutrition agent, lest protein as energy consume, both waste and increase the burden of kidney, and especially the starchy diet total energy sufficient material and does not love to eat meat protein don’t complement nutrition agent, Just add protein powder, unless you want to put on weight.
Stomach problems: hunger, decreased appetite, nausea, acid reflux, nausea, vomiting
Targeted drugs cause heartburn and reflux, vomiting and nausea, vomiting, stomach power down completely on the contrary, the disposal methods two cases of gastric acidity conditions needed acid suppression and anti-nausea drugs, gastro upset, try to avoid anti-nausea drugs, said before the problem, many anti-nausea drug side effects are gastrointestinal peristalsis function, In this case, the wrong drug will completely enter a vicious circle, especially in the usual gastric disease patients, should have been regularly see the department of gastroenterology, do not judge the drug or see others medication, especially the hormone drugs to increase appetite, stomach problems are not fixed, forced to eat more can only make the stomach more uncomfortable.
In terms of diet, the diet of patients with acid reflux and vomiting should not be too much liquid food or semi-liquid food. It can be considered to change the type and collocation of normal meals to small meals. When the stomach is in a physical state and not full, acid reflux will be reduced. Gastro upset conditions, should be more appropriate fluids, half liquid diets, at the same time pay attention to maintain a “weird” habit, even the porridge, noodles, such as food, still want to eat slowly, let more saliva amylase hybrid in the food, avoid slower starch digestion in the stomach, which cause stomach bilge gas, nausea, loss of appetite.
In addition, as a reminder similar to the previous abnormal taste condition, do not care about the so-called dietary taboos, the taste can make yourself happy, the food variety is rich and reasonable nutrition is the most important.
Intestinal problems: constipation, diarrhea
Decreased intestinal function (abnormal peristalsis or water absorption), mucosal damage (this side effect of targeted drugs has been mentioned repeatedly) resulting in deterioration of intestinal flora (similar to the scene of police strike), combined with abnormal eating due to the failure to properly address oral and stomach problems mentioned earlier, Can lead to constipation or diarrhea persistent, repeated, or even frequent overcorrection of both and alternate. Here, to do a few routine, in addition to effectively solve oral problems, stomach problems, is the digestive tract mucosal protection agent and intestinal flora regulator to often eat, and must be opened in the hospital or to the pharmacy to buy medicinal, do not take expensive and inefficient health care products.
Constipation notes: to increase the intestinal mosha bili this kind of drugs, occasionally with a few days, good stop, continuous use of most people will fail; Many acid suppressants and bismuth used to treat chronic gastritis have the side effect of causing constipation. Write more long fiber food in the diet, pay attention to long fiber food does not have to leek whole root to eat is long, the mud is also long fiber is more conducive to reach the intestinal tract, want to save trouble can also directly buy nutrients, dietary fiber is known as the “seventh nutrient”; Pay attention to the blood test for low potassium, low potassium can also cause intestinal functional constipation, but potassium supplementation needs a doctor’s guidance; Many fruits, such as bananas, oranges and dragon fruit, can help relieve constipation. A small spoon of sesame oil before meals is also helpful for relieving constipation; Tea, especially strong tea, can aggravate constipation.
Notes for diarrhea: reduce long fiber food; Fruit can be a small amount of juice, drink warm do not drink cold; Pay attention to electrolyte, diarrhea is heavy when you can drink light salt water; As for antidiarrheal drugs, it is also a cliche that montmorillonite can be used routinely, but loperamide can be used only when intestinal infection is excluded, or after exclusion, it can also be used with berberine.
Limb problems: leg swelling, leg numbness, leg fatigue, finger end swelling, hand numbness
These symptoms mainly focus on one problem, peripheral neuritis and neuroedema caused by ALK/ROS1 targeted drugs, which can be relatively simple to deal with. At ordinary times, vitamin B1 and mecobalamin can be used, moderate exercise but not long or intense exercise, to avoid overheating and skin irritation.
It is important to say here that leg swelling is not necessarily a side effect of drugs, especially unilateral swelling. Thrombi should be prioritized for screening, and bilateral persistent swelling should pay attention to renal function and electrolytes. Leg numbness is not necessarily a problem of the nerves in the legs, but also pay attention to some problems of the lumbar spine that may compress the nerves, including bone metastasis and disc herniation. When the symptoms are serious, we must go to the orthopedics department as soon as possible. Finger numb also do not only consider peripheral neuritis, but also may be caused by cervical spondylosis, brain nerve or vascular problems, which need to be paid attention to. No routine examination or too long time without mri itself is a high risk factor for tumor patients.
Liver function, lipid problems: elevated transaminase, elevated cholesterol
Here to share a few drug use experience: prophylactics to protect liver choose bicyclic alcohol or easy to cure; Transaminase to more than 100 priority ammonium glycyrrhizate liver protection drugs; The cause of cholesterol elevation caused by targeted drugs should not be ignored because of drug side effects. Long-term hypercholesterolemia can cause or aggravate arteriosclerosis related cardiovascular diseases, but most cholesterol-lowering drugs also have side effects of liver function damage, so preventive liver protection is often needed.
Heart problems: Heart rate drops and cardiac enzymes rise
Heart rate drop is the most typical side effect of ALK/ROS1 targeted drugs, and the treatment principles are mainly divided into three categories: dosage reduction, heart rate increase and drug change. In the case of crizotinib, 250mg twice daily is the recommended dose. If it causes an intolerable heart rate drop, 200mg twice daily or 250mg once daily is generally chosen, and the effectiveness of the reduced dose should be reviewed at the time of dose change and one month after dose change. There are almost no mature long-term drugs to increase heart rate at present. Some drugs, such as atropine, are only used in emergency treatment. Therefore, when the heart rate drops, we can complete the examination in the department of cardiology to see if there are other problems of the heart. If it has been confirmed that the current drug is effective, the principle of changing the treatment drug is actually mainly focused on the same generation or generation, and the specific drugs are detailed in the previous two stages of pulmonary teng lecture.
Myocardial enzymes increased, this should also pay attention to the index, lactate dehydrogenase (LD or LDH) in abnormal synchronization with liver function and only slightly increased when the general not to consider the urgent problem, but the continuous increase alone to consider whether there is a heart problem; Amino-terminal brain naturetic peptide precursor (NT-probNP) is a monitoring index of heart failure, and it is best to check regularly.