Skin Cancer Pill
The choice of treatment for basal cell carcinoma includes surgical removal of the affected area by excision, cryosurgery or radiation therapy. The contemporary method of treatment introduced is through the administration of skin cancer pills called as Erivedge approved by United States food and drug administration society. Erivedge pills are designed to treat advanced levels of basal cell carcinoma. This drug was designed to prevent surgical or radiation associated intervention in sensitive areas such as the nose regions of the face where the carcinoma predominantly occurs.
Erivedge
Erivedge the revolutionary pill for the treatment of advanced basal carcinoma is chemically known as vismodegib. This oral medicine is associated with the prevention of overactive signaling of the Hedgehog pathway by binding to a trans membrane protein occurring in basal cell carcinoma. The continuum of the Hedgehog pathway may result in the metastases of the carcinoma.
Vismodegib (erivedge) is highly permeable and has low aqueous solubility. The plasma protein binding in patients is very high. It binds to albumin and alpha- 1acid glycoprotein. The metabolic pathways associated are oxidation, glucouronidation and also pyridine ring cleavage. The excretion of the drug predominantly happens through the hepatic route. The absorption and retention of the drug occurs in feces and urine.
Dosage and administration
The recommended dosage of erivedge is 150mg taken orally once a day. The duration of medication has to continue until the complete prophylaxis of the disease. Discontinuation of erivedge is only advisable under the incidence of drug toxicity. Additional doses of erivedge are not recommended in case of missing a dose; the next dose has to be resumed. Erivedge intake does not depend upon food intake.
Contraindications and adverse effects
Erivedge is considered as teratogenic, embryo toxic and fetotoxic drug and hence it is not recommended for pregnant women. If administered, the effects include severe birth defects such as craniofacial anomalies, absent or fused digits and also open perineum. Erivedge is also not advisable for nursing mothers as it may be excreted in the milk.
Erivedge consuming patients are advised not to donate blood for a period of seven months. Many adverse effects were reported in the clinical trials conducted on erivedge some of which are muscle spasms, arthralgia, fatigue, diarrhea, weight loss, alopecia, constipation and also decreased appetite. Erivedge intervenes with other drugs such as clarithromycin etc. in leading to adverse reactions.
Erivedge usage is not recommended in children as it intervenes in the epiphyseal growth plate affecting the bones; causing damage to the teeth by necrosis, cysts in the dental pulp and also ossification of the root canal.
Geriatric use of erivedge is also not recommended. The other conditions under which the use of erivedge is not recommended is in patients having hepatic and renal impairments.
Immunochemistry
The process of localizing proteins in cells of a tissue section using the principle of antigens in tissue binding to their respective antibodies is known as Immunohistochemistry (IHC). This technique is widely used for the diagnosis of cancer. The antibodies are tagged with color-producing dyes to make them easily visible. Horseradish peroxidase and phosphatase are the two commonly used color-producing tags. Different fluorophores like FITC are also used to tag the antibodies as an alternate method. This method is widely used in confocal laser scanning microscopy to visualize two interacting protein molecules. Adinocarcinomas, Hodgkin's disease, yolk sac tumors and hepatocellular carcinoma,, Gastrointestinal Stromal Tumors (GIST) and prostrate cancer are diagnosed by conducting immunohistochemistry using various antigens like Carcinoembryonic antigen, CD 15 & CD30 or Alpha fetoprotein or CD117 or prostrate specific antigen accordingly. Direct and indirect methods are the two methods used for the immunohistochemical staining of antigens.
In the direct method, one labelled antibody is used for staining. The antibody directly binds to the antigen which is being stained. Involving only one labeled antibody ( FITC conjugated antiserum), this direct method is also known as one-step staining method. Though this method is quick since it uses only one antibody, it is rarely used after the indirect method was introduced.
In the indirect method of immuno-histochemical staining, one antibody is used against the antigen which is being examined and a second labelled antibody is used against the first. The unlabelled primary antibody or the first layer reacts with tissue antigen and the second layer or the labelled secondary antibody reacts with the primary antibody. This indirect method is considered more sensitive, since there is good signal amplification noticed through many secondary antibody reactions with various antigenic sites on the primary antibody.
Ulcerative Colitis
Ulcerative colitis is an condition of inflammation or ulcers in the lining of the large intestine, rectum and colon. Rarely is the small intestine affected by ulcerative colitis. Ulcerative colitis is also referred to as proctitis. While this condition can affect anyone, it is noticed more often in the US, England, Eastern Europe and persons of Jewish ancestry. Ulcerative colitis is a chronic condition that is often noticed to run in families. The symptoms of Ulcerative colitis are similar to Crohn's disease. But this disease tends to affect the small intestine or the mouth, esophagus, appendix or duodenum. Ulcerative colitis and Crohn's disease are both inflammatory bowel diseases. Typical symptoms of Ulcerative colitis include fatigue, nausea and severe abdominal cramps. Rectal bleeding and diarrhea are noticed with persons suffering from Ulcerative colitis, though the intensity depends on the inflammation. There is loss of appetite and weight loss. The symptoms may tend to recur at regular intervals or when eating highly seasoned food or raw fruits and vegetables. Other conditions such as hepatitis, osteoporosis, anemia and arthritis are sometimes triggered by Ulcerative colitis.
Ulcerative colitis has been traced to abnormal disorder of the immune system of the intestine. Consequently the immune system triggers off an inflammation of the intestinal tissues. Often a diet high in fat and refined foods may be responsible for ulcerative colitis. Symptoms of ulcerative colitis tend to come in spurts, with periods of acute illness followed by periods of remission. If left untreated, persons suffering from ulcerative colitis carry significant risk of carcinoma. Treatment for ulcerative colitis is based on the seriousness of the condition. While medication can help in most cases, surgery is resorted to for severe inflamation and life-threatening condition. Medications cannot cure ulcerative colitis but they can help in maintaining periods of remission. The patient can enjoy a better quality of life. Anti-inflammatory and immunomodulators are prescribed for patients of ulcerative colitis to reduce inflammation.
Bibliography / Reference
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