Lutathera (lutetium Lu 177 dotatate) Cost, Side effects, Dosage, Uses

Lutathera (lutetium Lu 177 dotatate) Cost, Side effects, Dosage, Uses. The FDA granted the approval of Lutathera to Advanced Accelerator Applications.

Lutathera is a drug designed to treat cancer specially gastroenteropancreatic neuroendocrine tumors involving pancreas, stomach, intestines, rectum, colon and any other region in gastrointestinal tract. It also include pancreatic neuroendocrine tumors which have somatostatin receptors. It is a radioactive drug with active ingredient lutetium 177 dotatate. Pancreatic neurocrine tumors are most common tumors above all other pancreatic tumors. Lutathera drug belongs to pharmacological class of somatostatin analogs. Somatostatin is a primary hormone which actively binds to somatostatin receptors and leads to production and release of secondary hormones.

It is the 1st ever radioactive drug introduced and also known as radiopharmaceutical. There are two main reasons behind approval of this drug 1st one is randomized clinical trial which consist of 229 patients treated with Lutathera drug and chemotherapy drug i.e. octreotide. In this case, Lutathera increased progression free survival rate of patients. 2nd reason is clinical trials based on 360 patients and only Lutathera drug is administered. As a result tumor got shrink in about 16 percent of patients.


Lutathera (lutetium Lu 177 dotatate) Cost, Side effects, Dosage, Uses

Lutathera Mechanism of Action

         
Lutathera drug is a radioactive drug which is used to treat cancer of gastroenteropancreatic neuroendocrine.it is a peptide receptor radionuclide therapy. It belongs to pharmacological class of somatostatin analogs. It is a type of hormone which primarily bind to somatostatin receptor and leads to production or release of secondary hormones. Lutathera drug bind to these receptors as a somatostatin analog and change the level of secondary hormones. This change in level of secondary hormone will reduce symptoms of tumor as well as slow down the growth of cancer cells present in certain organs.


Lutathera Dosage

         
Lutathera drug is available in the form of an intravenous dosage form. It is available in two strengths i.e. 370 mBq/ml single dose vial and in each vial solution volume is adjusted from 20.5 to 25 ml in order to provide 7.4 GBq of radioactivity per vial. In case of neuroendocrine tumors, 7.4 GBq IV 4 times a day for about 8 weeks is administered with other medications. Dose adjustment is required in case of renal and hepatic impairment, pregnancy and lactation, thrombocytopenia, anemia and neutropenia, renal toxicity, hepatotoxicity and other non-hematological toxicity.


Lutathera Uses

         
Lutathera drug is a radioactive drug used for treatment of gastroenteropancreatic neuroendocrine tumors. It is administered with pre medications and concomitant medications. Long acting somatostatin analog should discontinue at least 4 weeks before Lutathera drug treatment. Patient can take small acting octreotide if required. During Lutathera treatment, long term Lutathera can be administered. If antiemetic are prescribed, then it should be administer almost 30 min before lutetium treatment. Amino acid solution in intravenous form should be initiated before Lutathera treatment. A 3 way valve is used for this purpose to inject both solutions via same venous access.

Lutathera Side effects


Side effects of Lutathera involves high level of working enzymes in associated organs, level of white blood cells become low, high blood sugar level, vomiting, nausea and last but not least high level of potassium in blood.


Lutathera Cost


Lutathera cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Biktarvy Cost, Side Effects, Dosgae, Uses

Biktarvy Cost, Side Effects, Dosgae, Uses. US FDA granted approval of Biktarvy to Gilead Sciences, Inc.

Biktarvy drug is the combination of three active ingredients i.e. bictegravir, emtricitabine and tenofovir alafenamide. It is recently approved by food and drug administration on February 7, 2018. It is available in the form of tablet. Biktarvy drug is specially designed for the treatment of HIV infection. Many clinical trials are performed globally and then finally biktarvy drug is approved by food and drug administration with its side effects and adverse effects. Where it is active against HIV infection, there are also some side effects associated with it like worsening of hepatitis B virus infection.

It is not used with other drugs of HIV 1 infection in adults. HIV 1 is a virus which causes AIDS. AIDS is abbreviated as Acquired Immune Deficiency Syndrome). It is still unknown that whether this drugs is safe in children or not. Biktarvy drug is contraindicated with dofetilide and rifampin. Lactation or breast feeding is prohibited while taking Biktarvy drug. Adverse effects of biktarvy was observed in only 5 percent of patients involved in clinical trials.


Biktarvy Cost, Side Effects, Dosgae, Uses

Biktarvy Mechanism of Action

       
Biktarvy drug is designed in a fixed dose combination of bictegravir, emtricitabine and tenofovir alafenamide. It is the combination of HIV 1 (human immunodeficiency virus 1) integrase strand transfer inhibitor (INSTI). It also works as two human immunodeficiency virus type 1 nucleoside analog reverse transcriptase inhibitor (NRTI’s). It acts as a nucleoside and inhibit the process of reverse transcription. With the help of these two main functions it actively treat HIV 1 infection especially in adults. Active ingredients used in biktarvy drug work collectively with their specific mechanism of action.

Biktarvy Drug Dose

       
Biktarvy is a fixed dose combination drug of bictegravir 50 mg, emtricitabine 200 mg and tenofovir alafenamide 25 mg. biktarvy drug is recommended to administer 1 tablet per day which can be taken with food or without food. Biktarvy drug is contraindicated with some drugs like anti-retroviral drugs i.e. rifampin, metformin, acyclovir, Val acyclovir, gentamicin and dofetilide. Dose adjustment is required in case of hepatic impairment, renal abnormality, pregnancy and lactation. Physician recommend not to take biktarvy drug in case of pregnancy and lactation because one of its active ingredient can pass placental barrier and transfer to fetus.


Biktarvy Drug Uses

     
It is a specially designed complete regimen for treatment of human immunodeficiency virus type 1 infection. Its active ingredients belongs to pharmacological class of human immunodeficiency virus type 1 integrase strand transfer inhibitor and nucleoside reverse analog reverse transcriptase inhibitors. This drug is used in adults who are not taking other anti-retroviral drugs not even in past. There are some limitations in its use like it is not recommended in patients who are virologically suppressed, in patients who are using substitutes of one of its active ingredients, in patients with no treatment failure history of anti-retroviral therapy.

Biktarvy Side effects

Adverse reactions of this drug are as follows.

Nausea, headache, renal impairment can occur or worsen the pre-existing renal impairment, diarrhea, HBV exacerbation, lactic acidosis, immune reconstitution syndrome and hepatomegaly.

Biktarvy Cost

Biktarvy cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Symdeko (tezacaftor & ivacaftor) Cost, Side Effects, Dosage, Uses

Symdeko (tezacaftor & ivacaftor) Cost, Side Effects, Dosage, Uses. US FDA granted approval of Symdeko to Vertex Pharmaceuticals Inc.

Symdeko drug is vertex’s third drug which is the combination of tezacaftor and ivacaftor. It is approved by Food drug authority for treatment of leading cause of cystic fibrosis. It is effective in patients with 12 years of age and older. It is specifically designed for patients having a pair of copies of F508del mutation in CFTR protein. CFTR is abbreviated as cystic fibrosis conductance regulator (It is a protein which works as a channel in transporting salt and water in and out of cell.) Symdeko is also effective in patients with at least one gene mutation.

It is approved after 3 global clinical trials involving 750 patients. Symdeko is contraindicated with some antibiotics like rifampin, rifabutin, medicines used in seizures i.e. phenobarbital, carbamazepine or phenytoin. Some of its factors are still unknown like if it pass on to infant during pregnancy and lactation. Dose adjustment of Symdeko is also required when other drugs are in prescription. Symdeko also have some side effect i.e. dizziness so patient should avoid activities which require attention like driving or running a machine. Other side effects involve abnormality of eye lens and high level liver enzymes in blood. Grapefruit juice and orange juice is contraindicated with Symdeko.

Symdeko (tezacaftor & ivacaftor) Cost, Side Effects, Dosage, Uses

Symdeko Mechanism of Action

       
 Normally CFTR (cystic fibrosis conductance regulator) is a protein which acts as a channel on the cell surface. It is responsible for transportation of salt and water molecule. But in cystic fibrosis, this specific protein is missing or not in a working position. This improper working leads to formation of a thick, sticky mucus which can effect multiple organs including lungs. Active ingredients of Symdeko works separately i.e. tezacaftor helps CFTR protein to move towards cell surface and ivacaftor help this protein to be open for longer time.

Symdeko Dosage

       
Dose adjustment of Symdeko drug is important to get optimum response. As two drugs are combined in Symdeko, so dosage of each drug is designed to get desired effect. Tezacaftor 100 mg is adjusted with 150 mg of ivacaftor in single tablet of Symdeko. Dose adjustment is required If Symdeko is administered with other drugs like anti-fungal i.e. ketoconazole, itraconazole, posaconazole, voriconazole or fluconazole and some antibiotics like telithromycin, erythromycin or clarithromycin. Dosage adjustment is also required if patient is suffering from a kidney or liver disease. In pregnancy and lactation Symdeko should be avoided.


Symdeko Uses

       
Symdeko drug is specially designed to treat cystic fibrosis in patient with 12 years of age or above. A specific dosage combination is required for treating cystic fibrosis. In this drug, tezacaftor and ivacaftor are working collectively to regulate CFTR protein. But these two active ingredients if with different strength are combined, will be effective against HIV 1 infection. These are used as three months regimen for complete cure. These are the only two main diseases in which tezacaftor and ivacaftor are used in fixed dose combination for treatment. Further uses of tezacaftor and ivacaftor combination are not reported yet.

Symdeko Side effects


According to health authorities following side effects might be associated with use of this drug.

  • Increased Liver Enzymes
  • Nausea
  • Vomiting
  • Headache
  • Sinus Congestion
  • Dizziness
  • Palpitation
  • Rashes

Symdeko Cost

Symdeko cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Segluromet Cost, Side effects, Dosage, Uses

Segluromet is a combination of ertugliflozin and metformin hydrochloride. It is indicated to administer along with diet and exercise in diabetes mellitus 2 to control blood glucose level. Ertugliflozin is a selective competitor of sodium glucose transporter 2 inhibitor and metformin is a biguanide. Segluromet is recommended in patients with type 2 diabetes mellitus. It is not recommended for diabetes mellitus type 1 and diabetic ketoacidosis. Patient with severe renal impairment, dialysis and end stage renal disease cannot take segluromet.

It is also contraindicated in metabolic acidosis i.e. diabetic ketoacidosis and in patients with serious hypersensitivity reaction towards metformin or ertugliflozin. It also shows some drug interactions with carbonic anhydrase inhibitors as it may increase risk of lactic acidosis. Drugs like ranolazine, vandetanib, dolutigravir and cimetidine also show interaction as it can increase accumulation of metformin. Alcohol is reported causing increase in metformin and lactate metabolism. There are some warning and precautions associated with segluromet that it should not be administer during 2nd and 3rd trimester as it can effect fetus. Breastfeeding is not allowed during treatment. Premenopausal females can face potential for an unintended pregnancy.

Segluromet Cost, Side effects, Dosage, Uses

Segluromet Mechanism of Action

       
Segluromet is the combination of two drugs i.e. ertugliflozin and metformin hydrochloride. So mechanism of action of both drugs is different. Ertugliflozin is a selective competitor of sodium glucose transporter 2. It decrease the renal threshold of glucose, which rises when maximum glucose reabsorption capacity of kidney exceeds. The decrease in renal glucose threshold leads to increased urinary excretion of glucose.Metformin works by decreasing glucose production in liver. And also decrease absorption of glucose in intestine. Sideways it increase peripheral uptake of glucose improving insulin sensitivity. It also lowers basal and postprandial plasma glucose.

Segluromet Dosage

       
It is available in the form of tablet concentration available is

  • 2.5 mg/500 mg
  • 2.5 mg/1000 mg
  • 7.5 mg/500 mg
  • 7.5 mg/1000 mg.

It is indicated along with diet and exercise in patients with diabetes mellitus type 2 in order to control blood glucose level. The starting dose of segluromet is totally based on current regimen. Daily dose of ertugliflozin should not increase 15 mg with metformin not increasing 2000 mg. it is prescribed two times a day with meal. Patients already on metformin switch to 2.5 mg ertugliflozin tablets and patients already on ertugliflozin switch to tablets containing same dose with metformin.

Segluromet Side effects

       
Segluromet is the combination of two drugs so wide variety of side effects are reported which involves mycotic infection in female and male genitalia. Volume depletion adverse effects, urinary tract infections, vaginal pruritus, headache, Nasopharyngitis, increased urination flow, pain in back, increased thirst and decrease in body weight. Adverse effects of kidney are also reported. All these above mentioned conditions related to ertugliflozin. Side effects related to metformin are diarrhea, nausea, vomiting, flatulence, abdominal discomfort, asthenia, headache and indigestion. Long term use of segluromet can cause decrease in vitamin B 12 absorption.


Segluromet Cost

Segluromet cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Steglujan Cost, Side effects, Dosage, Uses

Steglujan Cost, Side effects, Dosage, Uses.

When ertugliflozin and sitagliptin are combined in a fixed dose combination it is known as steglujan. Ertugliflozin (brand name steglatro) is a sodium glucose transporter 2 (SGLT2) inhibitor and sitagliptin is a dipeptidyl peptidase 4 (DDP 4) inhibitor. Steglujan is used in diabetes mellitus type 2 to control blood glucose level. It is indicated as adjunct to diet and exercise in patients with diabetes mellitus type 2. Steglujan is only prescribed when ertugliflozin and sitagliptin is appropriate. There are some limitations with the use of steglujan. Like it is not recommended in diabetes mellitus type 1 and diabetic ketoacidosis.

Contraindications of steglujan includes end stage kidney disease, dialysis and renal impairment because of its excretion through kidney. If patient is sensitive to sitagliptin, then steglujan is not recommended. Patient with history of anaphylaxis and angioedema should avoid steglujan. Sitagliptin is reported with acute pancreatitis which involve fatal and non-fatal hemorrhagic or necrotizing pancreatitis. Hypotension is reported with steglujan in patients with renal impairment. With hypotension, there may be associated hypoglycemia due to decreased level of blood glucose. If patient is sensitive to any of the active drug of steglujan then special instructions and precautions should be followed regarding use of steglujan.

Steglujan Cost, Side effects, Dosage, Uses

Steglujan Mechanism of Action

         
As steglujan is a combination of two drugs, so each drug have its own specific mechanism of action. Ertugliflozin is a competitor selective sodium glucose transporter 2 inhibitor. It decrease the renal threshold of glucose, which rises when maximum glucose reabsorption capacity of kidney exceeds. The decrease in renal glucose threshold leads to increased urinary excretion of glucose. Sitagliptin is a dipeptidyl peptidase 4 inhibitor. It increases the incretin hormone activity which get inhibited by dipeptidyl peptidase 4 enzyme. Incretins are responsible for increased production of insulin and also increases its synthesis from pancreatic beta cells.

Steglujan Side effects

       
Steglujan have a wide range of reported side effects. It involves side effects of both active drugs and may involve female and male genital mycotic infections. Adverse effects related to volume depletion, headache and most commonly urinary tract infections. Vaginal pruritus, Nasopharyngitis, increased urine flow, back pain and various renal adverse effects. Patient weight may decrease and feels thirst all the time. All the above mentioned side effects are related to ertugliflozin. Side effects related to sitagliptin involve nausea, diarrhea, peripheral edema and upper respiratory tract infection. Post marketing reports reported acute pancreatitis and hepatic enzyme elevations.

Steglujan Dosage

         
It is available in tablet dosage form with concentration of ertugliflozin/sitagliptin 5mg/15mg and 100mg/100mg respectively. Starting dose of steglujan is 5 mg/100 mg administered per day in morning initially. But if further glycemic control is needed, then dose can be increased up to 15 mg/100 mg. patients who are already on ertugliflozin have to maintain its dose when switched to combination. There are some conditions which need dosage modifications and adjustment. Like if steglujan is administered with insulin and insulin secretagogues can increase the risk of hypoglycemia and dosage adjustment is needed there to minimize chances of hypoglycemia.

Steglujan Cost

Steglujan cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Steglatro/ertugliflozin Cost, Side effects, Dosage, Uses

Steglatro is a drug which is competitor of sodium glucose co transporter 2. It is indicated for diabetes mellitus type 2. Its generic name is ertugliflozin. Steglatro can be administered as a single drug therapy or can be used in combination with DPP 4 inhibitor drug named sitagliptin or with metformin. American diabetes association stated that steglatro can cause significant reduction in glycated hemoglobin. When steglatro and sitagliptin are combined in a fixed dose combination it is known as steglujan.

Steglatro is administered as an adjunct to exercise and diet in patients with diabetes mellitus type 2 in order to control glucose level. If treatment with steglujan is appropriate, then it can be used as an adjunct to diet and exercise. Steglatro and steglujan are contraindicated in patients with diabetes mellitus type 1 and in patients with diabetic ketoacidosis. Fixed dose combination of steglatro i.e. steglujan is not prescribed to patients with pancreatitis history because it can increase chances of pancreatitis in diabetic patients. It is also strictly contraindicated in patients with hypersensitivity reaction history towards sitagliptin. Both steglatro and steglujan are contraindicated in patients with severe renal failure or in patients with end stage renal disease or on dialysis.

Steglatroertugliflozin Cost, Side effects, Dosage, Uses



Steglatro/ertugliflozin Mechanism of Action
            

Steglatro is a selective sodium glucose transporter 2 inhibitor. It is a competitive drug to other inhibitor drugs. When steglatro inhibit sodium glucose transporter 2, it decreases the threshold of renal glucose. I.e. glucose concentration in plasma. Increases the glucose reabsorption capacity of kidney. When there will be decrease in renal glucose threshold, ultimately glucose excretion through urine will increase. Steglatro can show peak level in plasma within one hour of administration in fasting state and 2 hours in fed state. It shows 93.6 % protein binding in plasma during distribution phase. Metabolism is minimum.


Steglatro/ertugliflozin Dosage

         
It is available in the form of tablet (5 mg and 15 mg). as it is indicated as an adjunct to diet and exercise, so its starting dose is 5 mg PO per day in morning. If this dosage concentration is not enough and require further glycemic control then, dosage concentration may increase up to 15 mg per day. There are some precautions which should be followed like, it is prohibited in combination with high dose insulin and insulin secretagogues because it increases chances of hypoglycemia. Lower dose of insulin or insulin secretagogues can be administered to reduce chances of hypoglycemia.

Steglatro/ertugliflozin Side effects

       
Steglatro is a competitive drug and its administration also considers its side effects as compare to other drugs. Some of the main side effects regarding steglatro are mentioned below:

  • There may be volume depletion adverse effects.
  • Patient may feel headache.
  • Urination is increased.
  • Adverse effects related to kidney are also increased.
  • Patient got decrease in weight and feel thirst most of the time.
  • Mycotic infections may occur in male and female genitalia.
  • Urinary tract infections are commonly seen due to its clearance through kidney.
  • Vaginal pruritus, Nasopharyngitis and pain in back side are also reported side effects.

Steglatro/ertugliflozin Cost


Steglatro cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Macrilen/macimorelin Cost, Side effects, Dosage, Uses

Macrilen/macimorelin Cost, Side effects, Dosage, Uses.

Macrilen is the brand name of macimorelin acetate. It is an agonist of ghrelin. It is used in evaluating deficiency of adult growth hormone. This drug was developed by aeterna zentaris. Macrilen binds with receptor named growth hormone secretagogue receptor (GHSR) which is responsible for release of growth hormone from pituitary gland. There are some limitations with use of Macrilen drug i.e. it is not effective in diagnosing adult hormone with BMI >40 kg/m2. With Macrilen, increase in QT interval can be seen. 11 micro sec in corrected QT interval is increased.

So Macrilen is not recommended to use in combination of drugs responsible for prolong QT interval. If it is administered with drugs causing prolong QT interval, it may lead to development of torsade de pointes type ventricular tachycardia. Macrilen is considered a diagnostic test for growth hormone deficiency. There are some drugs which can increase the functioning of Macrilen drug like drugs effecting release of growth hormone from pituitary gland (insulin) and drugs which inhibit cyclooxygenase enzyme (aspirin). Administration of drugs intriguing production of growth hormone should be quit right 1 week before administration of diagnostic test i.e. Macrilen. It is the most effective drug diagnosing growth hormone deficiency.

Macrilenmacimorelin Cost, Side effects, Dosage, Uses

Macrilen/macimorelin Mechanism of Action


Macrilen mimics the effect of ghrelin or known as agonist of ghrelin. Ghrelin is the hormone which releases in response to hunger. It release from cells present in stomach and pancreas. Peptide is released by ghrelin neuropeptide. Ghrelin or Macrilen primarily stimulates release of growth hormone via activating receptor named growth hormone secretagogue receptor. These receptor lies in hypothalamus and pituitary gland. This is the mechanism of action of Macrilen. And it diagnose level of growth hormone because it mimics ghrelin. Its absorption is total dependent on its dosage concentration i.e. o.5 mg/kg/dose.

Macrilen/macimorelin Dosage

       
Macrilen is available in the form of granules containing 60 mg/ packet (0.5 mg/ml) reconstitution.
Macrilen is administered after at least 8 hours of fasting. Dosage recommended is 0.5 mg/ kg PO as a single dose. There are some precautions which should be followed while administering Macrilen.
Drugs responsible for prolong QT interval should be completely washout from body. As Macrilen is contraindicated with these drugs. Macrilen is not recommended with drugs causing prolong QT interval in the form of combination. Administration of Macrilen with drugs effecting secretion of growth hormone in pituitary gland is completely prohibited.

Macrilen/macimorelin Side effects

       
Macrilen is a diagnostic drug. So its administration require great care. A little higher dose concentration may cause serious adverse effects or can make side effects worse.

Some of the common side effects related to administration of Macrilen are as follow:


  • Dysgeusia may occur sometimes.
  • Patient may feel dizziness and headache.
  • Nausea is reported in about 3 percent of cases.
  • Fatigue, diarrhea and increased feeling of hunger are also reported side effects.
  • Rare chances of upper respiratory tract infection UTI
  • Nasopharyngitis, sinus bradycardia and hyperhidrosis may occur.
  • Last but not least, patient may feel hotness in body.

Macrilen/macimorelin Cost

Macrilen cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Gammapod Stereotactic Radiotherapy System For Breast Cancer

Stereotactic radiotherapy is designed for the treatment of cancer in brain and other parts of body like lungs, spine and liver and is known as stereotactic body radiation therapy. Recently it is also designed to treat breast cancer at early stage. Stereotactic body radiotherapy is a device named as Gamma Pod in case of breast cancer. Radiations are used to eliminate breast tumor at early stage of diagnosis. Scientists after small clinical trials of about 17 patients reported that Gamma pod have greater efficacy and deliver boost radiation dose of about 8 gy directly to tumor and cause very less adverse effects.

All adverse effects it causes are 1st grade adverse events. 1st breast is immobilized with the help of a vacuum assisted cup specially designed for this purpose, having 1mm slice thickness, cup have stereotactic frame inside it. Immobilization of breast ensures proper delivery of radiations to breast tumor. Patient is asked to lie down on her stomach which ease the immobilization of breast.With gamma pod breast cancer can be treated by delivering ablative doses with sharp gradients with the help of stereotactic image guidance. This system have highly focused radiation which can be achieved at isocenter, this happens because of cross firing radiations from 36 radiation arcs which can be achieved by rotating by 36 individual beams of cobalt 60.

This system is effective and widely used due to its spot action i.e. radiations only hit the tumor without disturbing healthy cells of breast. This system optimizes an optimal path of the focal spot, it is done by optimization algorithm which is borrowed from computational geometry. Target of radiations can be covered 90 to 95 % with gamma pod single dose prescribed. Doses prescribed for surrounding tissues of breast are reduced. Treatment plan of gamma pod works by continuous motion of the treatment couch.

Gammapod Stereotactic Radiotherapy System For Breast Cancer



Gamma pod stereotactic radiotherapy have greater potential to shorten the timing of radiation treatment and also have the potential to eliminate surgery option. As it ablate the tumor cells completely and also sterilize the tumor bed along with this. There are 5 sessions of gamma pod stereotactic body radiotherapy. This system is most efficient system along with reduced cost. It is also patient friendly. It is mostly preferred as compare to current accelerated, hypo fractionated and conventional treatments.

Gamma pod stereotactic body radiotherapy system have following benefits over other current treatment options:


  • Higher doses can be delivered with high conformity and is completely a non-invasive treatment.
  • This system reduce the duration of treatment i.e. from many weeks to some days. (treatment with gamma pod hardly take 5 min to 40 min in single session depending on therapy plan being used)
  • It improves quality of life of patients (women).
  • It increases patient comfort while treatment continues
  • It also reduce dose of surrounding cells along with heart and lungs.
  • Gamma pod system after invention is under development for almost a decade. The 1st prototype was installed and tested at the university of Maryland medical center.

Giapreza/angiotensin II Cost, Side effects, Dosage, Uses for low blood pressure

Giapreza/angiotensin II Cost, Side effects, Dosage, Uses for low blood pressure. The FDA granted the approval of Giapreza to La Jolla Pharmaceutical Company.

Giapreza is an angiotensin II injection. It is indicated for septic and other distributive shock. Septic shock occurs due to reduction in blood pressure. This intravenous injection is designed to elevate systemic blood pressure especially in adult patients with hypotension. Shock occurs when blood is not properly supplied to vital organs of body and could not function properly. Angiotensin II injection i.e. Giapreza proved beneficial in clinical trials. It can also be used in combination with other conventional treatments and greater number of patients respond to combination therapy as compare to placebo drug.

Angiotensin is a peptide hormone which effectively cause vasoconstriction and ultimately leads to high blood pressure. It is considered main part of renin angiotensin system, angiotensin targets this system and increases level of systemic blood pressure. Angiotensin is a dual stimulator, as it stimulates the release of aldosterone from adrenal cortex along with increased blood pressure. Aldosterone is a hormone which increases sodium retention and ultimately leads to blood pressure. While using giaprezin, patient should take prophylactic treatment of blood clots because Giapreza can cause blood clots in veins and arteries including deep venous thrombosis. Giapreza is a drug used in emergency situation because it has sudden onset.

Giaprezaangiotensin II Cost, Side effects, Dosage, Uses for low blood pressure


Giapreza/angiotensin II Mechanism of Action

     
Giapreza is the brand name of angiotensin II injection. Angiotensin II is the main agent acting on RAAS abbreviated as renin angiotensin-aldosterone system. RAAS is known as the main system responsible for regulation of blood pressure. Giapreza of mechanism in which Angiotensin primarily cause vasoconstriction and also increase aldosterone release. Angiotensin directly act on walls of vessels by binding to G protein coupled angiotensin II type 1 receptor. This receptor is present on vascular smooth muscle cells which are responsible for stimulating Ca2+/ calmodulin dependent phosphorylation of myosin. As a result causes smooth muscle contraction.

Giapreza/angiotensin II Dosage

         
Giapreza is administered in dosage levels. 1st dose is administered of concentration 20 mg/ kg/minute IV with the help of continuous infusion. 2nd dose is administered to titrate with concentration 15 ng/kg/min by keeping in view of blood pressure responding. This dose is titrated every 5 min to achieve desired blood pressure level. Dose should not exceed 80 ng/kg/min during 1st three hours of treatment. Maintenance dose should not increase 40 ng/kg/min and recommended dose is 1.25 ng/kg/min. when desired blood pressure is achieved, dose is titrated downwards every 5 to 15 min. administration is recommended via central venous line.

Giapreza/angiotensin II Side effects

       
Giapreza is used as a primary treatment to hypotension and shock and other distributive shocks. Main side effect associated with Giapreza is formation of clots. So, prophylactic treatment of blood clots is recommended before administration of Giapreza. There are 12.9 % cases reported thromboembolic events. Thrombocytopenia, increased heart rate (tachycardia) due to vasoconstriction, fungal infection, rare chances of acidosis, delirium, deep vein thrombosis, hyperglycemia and peripheral ischemia. Patient may feel hyper active after increase in blood pressure. Giapreza is also administered in combination with other therapies so, side effects may vary according to combination therapy.

Giapreza/angiotensin II Cost

Giapreza cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.

Luxturna/voretigene neparvovec-rzyl Cost, Side effects, Dosage, Uses

Luxturna/voretigene neparvovec-rzyl Cost, Side effects, Dosage, Uses

Luxturna is a novel gene therapy. It is used to treat congenital disease related to vision, or we can say inherited blindness. It is a rare disease. Its active ingredient is voretigene neparvovec. FDA have decently approved luxturna making 2017 a milestone year in medicine field. The active ingredient of luxturna is used to treat vision related disease named retinal dystrophy. In this condition, patient suffer from obscured vision at very young age and it can further lead to complete blindness when patient becomes adult.

Basically this disease occurs due to abnormal gene mutation. A gene is responsible for damaging retinal cells and also for production of proteins which are crucial for eyesight. About 2000 people from all over the world get effected to this disease. With the use of luxturna, genes can be replaced and healthy genes with protein generating capabilities can be restored. The gene is injected just below retina. Delivery of healthy gene creates more healthy enzymes and on the other hand it stops progress of disease. It also improves vision of patient but in rare cases. Food drug authority approved luxturna after third clinical trial stage. It also have some side effects along with beneficial effects.


Luxturnavoretigene neparvovec-rzyl Cost, Side effects, Dosage, Uses

Luxturna/voretigene neparvovec-rzyl Mechanism of Action

       
Retinal pigment epithelial cells produce RPE65 which converts all Trans retinal into 11 cis retinol. This 11 cis retinol forms chromophore i.e. 11 cis retinal which is responsible for vision. Chromophore is formed during retinoid cycle (visual cycle). Gene mutation is responsible for reduced concentration of RPE65 which disturbs visual cycle and effects vision. An adeno virus based on vector gene therapy is injected as a healthy copy of infected gene. Which encodes human retinal pigment epithelial 65 kd protein in cells of retina. And increase production of RPE65 or make it biologically active.


Luxturna/voretigene neparvovec-rzyl Dosage


Luxturna is indicated for congenital blindness disease named confirmed biallelic RPE65 mutation associated retinal dystrophy.

Dosage recommended for this disease is 1.5* 10 ^11 vector genome per eye with the help of sub retinal injection. Sub retinal Injection contains 0.3 ml of total volume. Each eye should be administered with sub retinal injection on separate days with specific interval minimum 6 days apart. It is available in 0.5 ml extractable volume in 2 ml vial. The concentration of RPE65 which is supplied is 5* 10^ 12 vg/ml. it should be diluted before administration. And the dilution required is 1:10.

Luxturna/voretigene neparvovec-rzyl Side effects


There are many side effects as well as adverse effects associated with use of luxturna. Some of them are as follows:

  • There are 19% chances of occurrence of cataract and 11% chances of conjunctival hyperemia. 
  • Intraocular pressure may increase. 
  • Inflammation in eye along with retinal tear. 
  • About 4% of cases have reported thinning of corneal stroma called dellen. 
  • Macular hole and sub retinal deposits are also seen around eye and reported in about 4% cases with sub retinoid dystrophy treatment. 
  • Macular surface may get wrinkles.
  • Pain and itching in eye due to sub retinoid injection administration. 
  • Retinal hemorrhage.

Luxturna/voretigene neparvovec-rzyl Uses


Luxturna is used to treat children and adult patients with an inherited form of vision loss that may result in blindness. Luxturna is the first directly administered gene therapy approved in the U.S. that targets a disease caused by mutations in a specific gene.

Luxturna/voretigene neparvovec-rzyl Cost

Luxturna cost is difficult to evaluate at the moment as according to market survey this drug is currently not available at retail pharmacies because it is recently approved by FDA and is under manufacturing process. Once, it will be available at retail outlets we will let you know about the unit cost of drug and its dosage frequency.