Podcast 577:  Immunotherapies

Podcast 577: Immunotherapies

Contributor: Don Stader, MD

Educational Pearls:

  • Checkpoint inhibition normally helps our body detect abnormal cells and terminate it but cancerous cells often are able to avoid this countermeasure
  • Monoclonal antibodies that bind to checkpoint inhibitors can stop cancerous cells from turning off immunologic T cells and allows the immune system to continue to attack cancers.
  • These therapies carry risks of exacerbating autoimmune problems due to the ramped up immune response
  • Most often this autoimmune attack leads to skin and GI symptoms but can affect many other organ systems. In the emergency room this can present many different ways, but the mainstay of treatment is steroids to stop these exacerbations.
  • Chimeric Antigen Receptor (CAR) T-cell Therapy is another immunotherapy where antigens to a cancerous cell are re-introduced to spur a directed immune response
  • Cytokine release syndrome can occur in these patients and mimic other presentations such as septic shock, a result of tumor break down
  • This is treated with steroids and monoclonal antibodies that help thwart the cytokine release

References

Hay, KA. Cytokine release syndrome and neurotoxicity after CD19 chimeric antigen receptor-modified (CAR-) T cell therapy. Br J Haematol. 2018 Nov;183(3):364-374. doi: 10.1111/bjh.15644. Epub 2018 Nov 8.

Hryniewicki AT, Wang C, Shatsky RA, Coyne CJ. Management of Immune Checkpoint Inhibitor Toxicities: A Review and Clinical Guideline for Emergency Physicians. J Emerg Med. 2018;55(4):489-502. doi:10.1016/j.jemermed.2018.07.005

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Episoder(1145)

Podcast #220: A-Fib Cardioversion

Podcast #220: A-Fib Cardioversion

Author: Aaron Lessen, M.D. Educational Pearls Atrial fibrillation is common. One of the best treatments for a fib is cardioversion back into sinus rhythm. Cardioversion may increase stroke risk if A-...

23 Jun 20172min

Podcast #219: History of Sepsis

Podcast #219: History of Sepsis

Author: Chris Holmes, M.D. Educational Pearls "Sepo' is a term from Homer (author of The Iliad and The Odyssey), and means "I rot". Hippocrates in 400 BC identified sepsis as a "dangerous decay withi...

21 Jun 20176min

Podcast #218: Estimating Pediatric Weight

Podcast #218: Estimating Pediatric Weight

Author: Aaron Lessen, M.D. Educational Pearls Asking parents and Broselow Tape are common options for estimating pediatric weight. Equipment sizes should not be adjusted for under/overweight kids bas...

19 Jun 20172min

Podcast #217: Designer Drugs

Podcast #217: Designer Drugs

Author: John Winkler, M.D. Educational Pearls: Designer, or "synthetic" drugs include bath salts, synthetic THC, and many others. Many of these drugs are originally manufactured in China and are ship...

17 Jun 20173min

Podcast #216: Roller Coasters and Kidney Stones

Podcast #216: Roller Coasters and Kidney Stones

Author: Aaron Lessen, M.D. Educational Pearls: Anecdotal evidence suggests that roller coasters may help with kidney stones. A recent study used a model of a kidney and ureter with different sized s...

13 Jun 20171min

Opioid MIniseries Part IV: Harm Reduction

Opioid MIniseries Part IV: Harm Reduction

PRACTICE RECOMMENDATIONS 1. Patients who abuse opioids should be managed without judgement; addiction is a medical condition and not a moral failing. Caregivers should endeavor to meet patients "where...

8 Jun 201748min

Opioid Miniseries Part III: Alternative to Opioids

Opioid Miniseries Part III: Alternative to Opioids

PRACTICE RECOMMENDATIONS 1. All emergency departments should implement ALTO programs and provide opioid-free pain treatment pathways for the following conditions: a. Acute on chronic opioid-tolerant r...

8 Jun 201749min

Opioid Miniseries Part II: Limiting Opioids in the Emergency Department

Opioid Miniseries Part II: Limiting Opioids in the Emergency Department

RACTICE RECOMMENDATIONS 1. Opioids are inherently dangerous, highly addictive drugs with significant abuse potential, numerous side effects, lethality in overdose, rapid development of tolerance, and ...

8 Jun 20171h 8min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-nysgjerrige-norge
rss-rekommandert
sinnsyn
forskningno
rss-paradigmepodden
villmarksliv
vett-og-vitenskap-med-gaute-einevoll
fjellsportpodden
nordnorsk-historie
smart-forklart
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
aldring-og-helse-podden
pod-britannia
tidlose-historier