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These drugs are intended to be used in particular types of leukaemia when other forms of treatment have failed to produce a long-lasting remission. The most serious adverse reaction with these drugs is the so-called cytokine release syndrome. This includes fever and chills, nausea and vomiting and allergic reactions such as rashes, itching, angioedema, bronchospasm and difficulty breathing. Fatalities have occurred and these drugs are still being monitored by the Medicines and Healthcare Products Regulatory Agency. ( A monoclonal antibody against human epidermal growth factor receptors has been developed for use in metastatic breast cancer. This drug is trastuzumab and is also being monitored by the MHRA.
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The disease is characterized by fluctuating weakness and easy fatigability of certain skeletal muscles. Patients may present with double vision or a drooping eyelid at the end of the day. Other facial muscles may be affected, resulting in difficulty in chewing, an abnormal smile, or nasal speech. In severe cases there may be difficulty in swallowing with the risk of aspirating food into the lungs and difficulty in breathing, due to weakness of the respiratory muscles, which can be life threatening if untreated.
An outline of normal physiology of the systems is included where appropriate and relevant diseases described briefly. This is not intended to be a physiology book or a pathophysiology book. Should the reader need to consult such books, suggestions are given in the bibliography.
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Side effects of thioxanthines are as expected, being antiemetic, Parkinsonism, tardive dyskinesia and raised prolactin levels. This group of anti-psychotic drugs has a similar mode of action and side effects to the phenothiazines.
There are two general types of metabolic reactions, which are known as Phase Phase on its chemical nature, it is possible for a drug to be metabolized by either type of reaction only. See Figure Phase reactions to a more water-soluble metabolite, which is more likely to be excreted by the kidney or go on to Phase reaction, which involves the addition of oxygen to the drug molecule.