Drugs

Here's a list of drugs I get regularly (and my two cents on each of them). I've tried to make these informal descriptions interesting enough for the scientifically-disadvantaged while still including a little bit of medical information for those of you who thrive on detail. After all I am, by nature, a scientist (but you would never know it from these descriptions).

If you want real information on these drugs then stop reading already! You should go somewhere else, like MEDLINEplus Drug Information. (This is the first decent online drug guide I found so I didn't bother to look further, but it's likely that there are better ones out there.)



Chemotherapy - CHOP + Rituxan

Cytoxan - If there were any drug I should be mad at, this would be the one. Why? Cytoxan has harmful and annoying side effects. It is a significant contributor to that terrible nausea I get the night after chemo. Furthermore, if it drips into me too fast (by IV obviously; I will refrain from including any Stanford-Band-like comments here because that would be disgusting) I get sinus pain. Just thinking about Cytoxan is making me feel funny. As punishment, I will write no more about it. Bad drug!

Adriamycin - This drug is red like cranberry juice and it comes out red in urine. That's about the only interesting thing about it. Like Cytoxan, it causes nausea. I get it through IV push (IVP) which means instead of dripping it from a bag, a nurse sits there and uses a syringe to inject it slowly into my IV line while saline (salt water) is dripping.

Vincristine - What a boring drug. (If you disagree, please let me know why and I might change my mind.) I don't get much of it and it doesn't add much to the list of chemo side effects--except jaw pain. It is administered IV push, just like Adriamycin.

Prednisone - During my first chemo our pharmacist only had 20mg tablets of Deltasone (a version of Prednisone) so I ended up having to take five large sour-tasting tablets per day. Just great for someone who was already feeling nauseous. Luckily after that I was able to get smaller 50mg tablets. Why were the 50mg tablets smaller than the 20mg tablets? The same reason one was white and the other pink--go figure or better yet, ask the drug companies. Prednisone is a steroid which is sometimes used to treat asthma (I take much more than any asthma patient). It is the only chemo drug which I take orally. I take it for five days starting with the day I get Cytoxan, Adriamycin, and Vincristine. Supposedly its side effects include increased appetite and insomnia, but I haven't really noticed either.

Rituxan - This is a monoclonal anti-body and if you don't know what that is, don't worry about it. All you need to know is that it targets only the "bad" cells by marking them so my immune system will destroy them. Since it leaves the rest of my cells alone it doesn't seem to have many side effects. However, Benadryl and acetaminophen (Tylenol) must be given along with Rituxan so I do get some brief side effects (like drowsiness) from those drugs. I get Rituxan a few days before getting all the other chemo drugs. Oh yeah, it's REALLY expensive too. We're talking thousands of dollars per treatment. Now I really know that life isn't cheap.


Chemotherapy - ICE

Ifosfamide, Carboplatin, and Etopicide (VP-16)


Chemotherapy - HyperC-VAD

I am only getting part of the HyperC-VAD regimen: Cytoxan, Adriamycin, Vincristine, and Dexamethasone.


Anti-Nausea

Anzemet, Kytril, and Zofran - These are the best anti-nausea drugs available. I've had Anzemet and Kytril (Zolfran is supposed to be about the same because they're all from the same drug family) both through IV and pills. They supposedly work for 24 hours, but right after chemo it doesn't seem that way so I take them every 8 hours. They are also quite expensive with Anzemet priced as high as $80 PER PILL! That's no typo, it really was eighty dollars for each pill at one of the pharmacies we went to, but I guess it's usually supposed to be about $60. Kytril is much cheaper--a little over seventeen dollars per pill. But it's worth the cost. The only downside so far is I've had a few light headaches and, ahem, constipation from taking so much of these drugs.

Torecan and Compazine - These anti-nausea drugs work differently than the ones above, but don't ask me how they work--I'll figure it out later. They are not as strong either. I take them every 4-6 hours for several days after chemo. If you watch "ER" (you know, the TV show) you will hear them mention Compazine once in a while.

Inapsine - Actually, I don't get this drug regularly--thank goodness I've only had it once. It was awful, not to mention I got twice the dose any anesthesiologist would have ever given to a person my size. And that's according to two different anesthesiologists that I've talked to. It made me feel all jittery which I hear is a relatively common side effect in young people. Don't ever let someone give you this drug--it's not worth that side effect. Hospitals like it because it's "dirt cheap" according to one anesthesiologist. I recommend you insist on something better. That's what health insurance is for, right?


Hematopoietic Drugs

Neupogen - Shots! Yikes! I have to get subcutaneous (under the skin) injections of Neupogen daily for several days after chemo. Neupogen tells my body to produce more white blood cells (most importantly phagocytic cells like neutrophils) which fight infection. It is also called GCSF (granulocyte colony stimulating factor), but the only reason I remember that acronym is because it sounds like UCSF--University of California San Francisco, haha.

Procrit - Interesting fact: this drug was developed in outer space. Think: "floating mice!" It's another subcutaneous shot. But only once a week. Procrit is like Neupogen except it causes me to make red blood cells instead of white blood cells. In the long run, more red blood cells will mean less fatigue. Procrit even has another name that sounds like Neupogen--"Epogen" from erythropoiesis, the process of red blood cell production. Bet you didn't know that (unless you're a doctor). I always thought -poiesis was the weirdest sounding suffix in medical terminology.

Note: If you're paying attention, you might notice that this leaves one type of blood cell that I am not getting shots for--the platelets. Okay, technically it leaves the agranulocytes too, but if you knew that much then you should be able to tell me why I'm not getting any shots for platelets. My best guess is first that there is no such drug and second that such a drug is not nearly as important as Neupogen and Procrit. But I could be wrong.

Note about this note: Whatever the case, my platelet counts seem unaffected by chemo.


Other Drugs

Ativan (Lorazepam) - Here's another drug you'll hear often on the show "ER". Ativan is sedative which I take either to help sleep while I'm on Prednisone or to settle my stomach just a ~little~ bit before taking any other anti-nausea pills. I take it orally or sublingually (under the tongue) but I've also had it by IV.

Coumadin - A blood thinner, the same one prescribed for a lot of heart conditions. I take one very small (1mg), very pink pill daily to discourage blood from clotting in my port. I guess I have to explain what a port is now, huh.

Lupron - I'm tired of writing about drugs now. Are you really still reading this? Lupron blocks FSH. FSH is follicle stimulating hormone--see, I told you it wouldn't make a difference if you knew what it was. Basically, Lupron is an experiment to protect my ovaries from the damaging effects of chemo. There haven't been many studies on this usage of Lupron, but none of my doctors could think of any harm in my getting it. I get a shot (intramuscular like a tetanus booster, youch!) once a month. As a result, my brain stops sending the signal (per FSH) to my ovaries to produce estrogen. And, hopefully, my ovaries will be in excellent working order when I'm done with chemo.

vitamins, minerals, and other supplements - I take several vitamins (usually a multi-vitamin and some calcium) and occaisionally an herbal supplement (echinacea or mushroom). Who doesn't these days?


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