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(1146)

Podcast # 501: Take Down Potions

Podcast # 501: Take Down Potions

Author: Jared Scott, MD Educational Pearls: Study from Hennepin County EM studied the efficacy of different drugs for agitation, which included 737 patients Most patients in this study were male and ...

16 Sep 20193min

Colorado MAT Part 4: Buprenorphine in the Emergency Department

Colorado MAT Part 4: Buprenorphine in the Emergency Department

Treatment with buprenorphine is easier, less time consuming and far more effective for management of opioid withdrawal and OUD than standard care with clonidine, IVF, haldol and other symptomatic ther...

26 Aug 20191h 5min

Colorado MAT Part 3: Medications for MAT in the ED

Colorado MAT Part 3: Medications for MAT in the ED

There are three MAT drugs available to treat addiction: naltrexone (brand name Vivitrol), methadone (brand names Dolophine or Methadose) & buprenorphine (brand name Suboxone, Subutex, and Sublicade). ...

26 Aug 201927min

Colorado MAT Part 2: Medication Assisted Treatment

Colorado MAT Part 2: Medication Assisted Treatment

Medication Assisted Treatment or (Medication for Addiction Treatment) is an important frontier in ED care of patients with Opioid Use Disorder. Naltrexone, methadone and buprenorphine are the medicati...

26 Aug 201928min

Colorado MAT Part 1: Understanding Addiction & Opioid Use Disorder

Colorado MAT Part 1: Understanding Addiction & Opioid Use Disorder

Addiction is widely misunderstood by the public and by many healthcare providers. It is not taught in most medical schools. Combating the opioid epidemic will require providers to understand Opioid U...

26 Aug 201939min

Podcast #500: 2018-19 Rapid Fire EM Literature Review

Podcast #500: 2018-19 Rapid Fire EM Literature Review

Author: Dave Saintsing Educational Pearls: Poor sleep is an independent risk factor for development of health problems such as type 2 diabetes. A 2019 study, randomized participants to 3 groups: 9 h...

24 Aug 201914min

Podcast #499: Posterior Circulation Ischemia

Podcast #499: Posterior Circulation Ischemia

Podcast # 499: Posterior Circulation Strokes Contributor: Neal O'Connor, MD Educational Pearls: Dizziness is a very common complaint in the emergency department, but how can we find patients with a d...

22 Aug 201912min

Podcast # 498: Ortho Tips

Podcast # 498: Ortho Tips

Author: Susan Ryan, DO Educational Pearls: General orthopedic principles: Examine above and below the injury Document neurovascular status X-ray imaging typically requires three different views F...

19 Aug 201912min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
sinnsyn
rss-paradigmepodden
forskningno
fjellsportpodden
nevropodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
diagnose
dekodet-2
smart-forklart
abid-nadia-skyld-og-skam
rss-lundqvist-podden
hva-er-greia-med