Guidance on the management of adverse reactions induced by poly(ADP-ribose) polymerase inhibitors

by Selleckchem | Sep 20 2023

The common adverse reactions caused by poly (ADP-ribose) polymerase (PARP) inhibitors include hematological toxicity, gastrointestinal toxicity and fatigue. The main prevention and treatment of hematological toxicity include: regular blood tests, referral to hematology department when routine treatment is ineffective, and being alert of myelodysplastic syndrome/acute myeloid leukemia. The key points to deal with gastrointestinal toxicity include: taking medicine at the right time, light diet, appropriate amount of drinking water, timely symptomatic treatment, prevention of expected nausea and vomiting, and so on. For fatigue, full assessment should be completed before treatment because the causes of fatigue are various; the management includes massage therapy, psychosocial interventions and drugs such as methylphenidate and Panax quinquefolius according to the severity. In addition, niraparib and fluzoparib can cause hypertension, hypertensive crisis and palpitation. Blood pressure and heart rate monitoring, timely symptomatic treatment, and multidisciplinary consultation should be taken if necessary. When cough and dyspnea occur, high resolution CT and bronchoscopy should be performed to exclude pneumonia. If necessary, PARP inhibitors should be stopped, and glucocorticoid and antimicrobial therapy should be given. Finally, more attention should be paid to drug interaction management, patient self-management and regular monitoring to minimize the risk and harm of adverse reactions of PARP inhibitors.

Comments:

Your statement provides a comprehensive overview of the common adverse reactions caused by poly (ADP-ribose) polymerase (PARP) inhibitors and their prevention and treatment strategies. Here's a summary of the key points you mentioned:

1. Hematological toxicity prevention and treatment:
   - Regular blood tests to monitor blood cell counts.
   - Referral to a hematology department if routine treatments are ineffective.
   - Being alert to the development of myelodysplastic syndrome/acute myeloid leukemia.

2. Gastrointestinal toxicity management:
   - Taking medication at the prescribed time.
   - Following a light diet.
   - Drinking an appropriate amount of water.
   - Timely symptomatic treatment.
   - Prevention of expected nausea and vomiting.

3. Fatigue management:
   - Conducting a thorough assessment before treatment to identify the causes of fatigue.
   - Implementing interventions such as massage therapy and psychosocial support.
   - Considering medications like methylphenidate and Panax quinquefolius based on the severity of fatigue.

4. Adverse cardiovascular effects of niraparib and fluzoparib:
   - Monitoring blood pressure and heart rate regularly.
   - Timely symptomatic treatment for hypertension, hypertensive crisis, and palpitations.
   - Seeking multidisciplinary consultation when necessary.

5. Cough and dyspnea management:
   - Performing high-resolution CT and bronchoscopy to rule out pneumonia.
   - Temporary discontinuation of PARP inhibitors if needed.
   - Administering glucocorticoids and antimicrobial therapy.

6. Drug interaction management, patient self-management, and monitoring:
   - Paying attention to potential drug interactions.
   - Educating patients on self-management techniques.
   - Regular monitoring to minimize the risk and harm of adverse reactions.

It's important to note that medical advice should always be sought from a healthcare professional for personalized recommendations regarding the prevention and management of adverse reactions to PARP inhibitors.