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Drug Interactions in Palliative Cancer Care and Oncology

  • Chapter
Palliative Care in Oncology

Abstract

As palliative care expands into the outpatient clinic, the potential for drug interactions increases as patients that are on active treatment for their cancer are also receiving coordinated management for symptoms such as pain, depression, and nausea and vomiting. The drugs used in inpatient palliative care for patients with advanced illness but not on active management of their malignancy must now be reviewed for potential interactions with both older and newer oncology drugs. Reported frequencies of drug interactions in oncology range from 12 to 63 %; and in palliative care they range from 31 to 43 %. Among the drugs which are most likely to cause interactions, nonsteroidal anti-inflammatories, warfarin, antiemetics, and antipsychotics still account for the largest proportion of reports in survey literature. Many of these interactions are pharmacodynamic. Recently, prolongation of the QT interval has become a pharmacodynamic effect of increasing concern with antidepressants, methadone, and many of the newer oral oncology agents.

Newer classes of drugs such as tyrosine kinase inhibitors are often orally administered and increasingly are being utilized in outpatient oncology practices. The ease of administration and the perceived paucity of serious side effects mean that these oncology drugs will be administered for longer periods of time before the patient stops active treatment. For palliative care practitioners seeing oncology patients earlier in their illness course, encounters with these drugs will become more frequent.

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Authors and Affiliations

  1. Department of Pharmacy, Duke University Hospital, Durham, NC, 27710, USA

    Theresa Stehmer PharmD

  2. University of North Carolina, Chapel Hill, NC, 27514, USA

    Stephen A. Bernard MD

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Editors and Affiliations

  1. Department of Palliative Medicine, University Medical Center, Göttingen, Germany

    Bernd Alt-Epping

  2. Department of Palliative Medicine, University Medical Center, Göttingen, Germany

    Friedemann Nauck

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Stehmer, T., Bernard, S.A. (2015). Drug Interactions in Palliative Cancer Care and Oncology. In: Alt-Epping, B., Nauck, F. (eds) Palliative Care in Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46202-7_11

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