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 818: Local Anesthetics and LAST

Podcast 818: Local Anesthetics and LAST

Contributor: Don Stader, MD Educational Pearls: There are two major groups of local anesthetics: Amide and Esther To recall what group an anesthetic belongs to, use this memory trick: Amide has...

4 Okt 20226min

Podcast 817: MI Risk during Elections

Podcast 817: MI Risk during Elections

Contributor: Aaron Lessen, MD Educational Pearls: 2020 retrospective study with dat from two California hospitals compared rates of cardiovascular admissions in a five day period two weeks before and...

3 Okt 20222min

Podcast 816: Ventilator Management in Asthmatics

Podcast 816: Ventilator Management in Asthmatics

Contributor: Aaron Lessen, MD Educational Pearls: The management of severe asthma or COPD exacerbation is complex, especially when the patient requires intubation/ventilation Asthma is an obstructive...

27 Sep 20224min

Podcast 815: Fluid Resuscitation in Pancreatitis

Podcast 815: Fluid Resuscitation in Pancreatitis

Contributor: Aaron Lessen, MD Educational Pearls: Historically, pancreatitis has been treated with aggressive IV fluid rehydration. Recently published data shows this may not be appropriate. A random...

26 Sep 20223min

Podcast 814: Post-concussion Treatment

Podcast 814: Post-concussion Treatment

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looked at the impact of screen time on duration of post-concussive symptoms 125 patients aged 12-25 diagnosed with a concussion were ran...

19 Sep 20222min

Podcast 813: Pulse Oximetry

Podcast 813: Pulse Oximetry

Contributor: Travis Barlock, MD Educational Pearls: Most oxygen in the body is bound to hemoglobin, forming oxyhemoglobin. Less than 1% of the oxygen in the body is dissolved in plasma.  Pulse Oximet...

13 Sep 20224min

Podcast 812: PO Medications

Podcast 812: PO Medications

Contributor: Nick Tsipis, MD Educational Pearls: PO medications are less frequently used in the ED due to their longer onset of action The position the patient is in when given PO medications ...

12 Sep 20223min

Podcast 811: Ketamine for Pain

Podcast 811: Ketamine for Pain

Contributor: Lessen, Aaron MD Educational Pearls: Ketamine can be given at 0.2-0.3 mg/kg as subdissociative doses for pain control in the ED Ketamine coadministered with Haldol may reduce agitation...

7 Sep 20223min

Populært innen Vitenskap

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