Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
GENERIC NAME: granisetron transdermal system (patch)
BRAND NAME: Sancuso
DRUG CLASS AND MECHANISM: Sancuso is granisetron delivered via a
transdermal patch system for the prevention of
nausea and
vomiting resulting
from chemotherapy for cancer. Other formulations of granisetron (for
example, Kytril)
are administered by mouth or injection. Certain chemotherapeutic agents used for
treating cancer stimulate the release of a neurotransmitter called serotonin
from nerves in the brain. Neurotransmitters are chemicals that nerves use to
communicate with one another. Released serotonin binds to other nerves in an
area of the brain called the chemoreceptor trigger zone, causing nausea and
vomiting. Granisetron, the active ingredient in Sancuso, prevents serotonin from
binding to nerves in the chemoreceptor trigger zone thereby preventing nausea
and vomiting. The FDA approved Sancuso in September 2008.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: Transdermal patch delivering 3.1 mg/24 h
STORAGE: Sancuso should be store in the original package at 15-30 C
(59-86 F).
PRESCRIBED FOR: Granisetron patches are used for prevention of nausea
and vomiting in patients receiving five consecutive days of chemotherapy that is
associated with nausea and vomiting.
DOSING: A single patch is applied to clean, dry, intact healthy skin
on the upper outer arm 24-48 hours before chemotherapy is begun and not removed
until at least 24 hours after completion of chemotherapy. The patch may be worn
for up to seven days. It should not be applied on skin that is red, irritated,
or damaged because of concerns about increasing inflammation and increased
absorption of drug. Each patch is packed in a pouch and should be applied
immediately after the pouch has been opened. The patch should not be cut into
pieces.
DRUG INTERACTIONS: Drug interaction studies have not been conducted
with granisetron. Granisetron is broken down in the body by cytochrome P-450
liver enzymes. Drugs that increase or decrease the activity of cytochrome P-450
liver enzymes may affect the levels of granisetron in the body.
PREGNANCY: There are no adequate studies of granisetron use in
pregnant women. It should only be used during
pregnancy if its need outweighs
the unknown risks.
NURSING MOTHERS: It is not know whether granisetron is excreted in
breast milk. Nursing mothers should consider not
breastfeeding.
SIDE EFFECTS: The most common adverse effects of granisetron are
constipation and headache. Other adverse effects include anxiety, dizziness,
diarrhea, abdominal pain, and chest pain. Allergic reactions may occur rarely.
Application site reactions (redness, bumps, rashes, blisters) may occur. The
patch must be removed if serious skin reactions or generalized skin reactions
occur. Light exposure (sunlight, sun lamps, tanning beds) may reduce the effect
of granisetron, and granisetron may cause light sensitivity. To avoid light
exposure, the application site should be covered with clothing during therapy
and for 10 days after the patch is removed. Granisetron may mask the symptoms of
certain gastrointestinal conditions, for example, gastroparesis or ileus
(paralysis of the muscles of the stomach and small intestine, respectively) by
reducing the nausea and vomiting that are their primary symptoms.
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due
to tobacco smoke. Lung cancers are classified as either small cell or non-small
cell cancers.
Liver cancer is the fifth most common cancer in the world and the majority of patients with liver cancer will die within one year as a result. Patients with associated cirrhosis caused by chronic hepatitis B or C infections, alcohol, and hemochromatosis are at the greatest risk of developing liver cancer. Many patients with liver cancer do not develop symptoms until the advanced stages of the tumor which usually makes prognosis poor. The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein will most effectively diagnose liver cancer, while a liver biopsy can make a definitive diagnosis. Medical treatments, including chemotherapy, chemoembolization, ablation, and proton beam therapy, are not very effective. Surgical removal of the tumor or a liver transplant may be most effective in certain cases.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
There are many types of ovarian cancer, epithelial carcinoma is the most common. Women with a family history of ovarian cancer have an increased risk of developing the disease. Some ovarian cancer symptoms include abdominal pain, nausea, diarrhea, constipation, and abnormal vaginal bleeding, however, they usually do not present until the disease has progressed. Early diagnosis is important for successful treatment.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
In the U.S., more than 2,000 people are diagnosed with bone cancer every year. There are many types of bone cancer. The most common forms of bone cancer are osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma. Pain is the most common symptom. Treatment usually involves surgery, chemotherapy, and radiation therapy.
Colon cancer is a malignancy that arises from the inner lining of the colon. Most, if not all, of these cancers develop from colonic polyps. Removal of these precancerous polyps can prevent colon cancer.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Though the cause of stomach cancer is unknown, risk factors for stomach cancer include diet, H. pylori infection, smoking age, gastritis, stomach surgery, family history, and pernicious anemia. Symptoms include stomach discomfort, feeling full after a small meal, nausea and vomiting, and weight loss. Treatment depends upon staging and may involve surgery, radiation therapy, or chemotherapy.
There are several types of kidney cancer, including renal cell cancer (renal adenocarcinoma or hypernephroma), transitional cell carcinoma, and Wilms tumor. Symptoms of kidney cancer include blood in the urine, an abdominal lump or mass, chronic pain in the side, and tiredness. Treatment of kidney cancer--which may include surgery, arterial embolization, radiation therapy, biological therapy or chemotherapy--depends upon the stage of the disease and the patient's overall health.
Treatment for bladder cancer depends on the stage of the disease, the grade of the tumor, and the type of bladder cancer. Options for treatment include surgery, radiation therapy, chemotherapy, and biological therapy.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Esophageal cancer is a disease in which malignant cells form in the esophagus. Risk factors of cancer of the esophagus include smoking, heavy alcohol use, Barrett's esophagus, being male and being over age 60. Severe weight loss, vomiting, hoarseness, coughing up blood, painful swallowing, and pain in the throat or back are symptoms. Treatment depends upon the size, location and staging of the cancer and the health of the patient.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Signs and symptoms of penile cancer include a lump on the penis and redness, irritation, or a sore on the penis. Risk of penis cancer is higher in uncircumcised men, due to a higher risk of HPV infection. Other risk factors include being over 60, having phimosis, having poor hygiene, using tobacco products, and having many sex partners. Prognosis and treatment depend upon the tumor's location and size, the stage of the cancer, and whether the cancer was recently diagnosed or if it recurred.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Testicular cancer symptoms include a painless lump or swelling in a testicle, testicle or scrotum pain, a dull ache in the abdomen, back, or groin, and a feeling of heaviness in the scrotum. Treatment for cancer of the testicles depends on the type of cancer (seminoma or nonseminoma), the stage of the cancer, and the patient's age and health.
Cancers that form from brain tissue are called primary brain tumors. Brain tumors may be malignant (brain cancer) or benign. Certain risk factors, such as working in an oil refinery, as a chemist, or embalmer, increase the likelihood of developing brain cancer. Symptoms include headaches, weakness, seizures, difficulty walking, blurry vision, nausea and vomiting, and changes in speech, memory, or personality. Treatment may involve surgery, radiation therapy, or chemotherapy.
Vaginal cancer is fairly uncommon. There are two types of vaginal cancer: squamous cell carcinoma and adenocarcinoma. Risk factors include being 60 or older, exposure to DES while in the womb, HPV infection, and having a history of abnormal cervical cells. Painful intercourse, pelvic pain, vaginal lumps, and abnormal vaginal bleeding or discharge are all symptoms of vaginal cancer. Treatment depends upon the stage of the vaginal cancer and may involve surgery, radiation therapy, chemotherapy, and the use of radiosensitizers.
Head and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
Gallbladder cancer is a rare form of cancer with symptoms that include jaundice, abdominal pain, fever, nausea and vomiting, abdominal lumps, and bloating. Risk factors include being female and Native American. Treatment of gallbladder cancer depends upon the stage of the cancer, the type of gallbladder cancer, and whether the cancer can be removed by surgery.
Nasopharyngeal cancer is a form of cancer in which malignant cells form in the nasopharynx tissues. Risk factors include being of Chinese or Asian ancestry and exposure to the Epstein-Barr virus. Symptoms and signs of nasopharyngeal cancer include a sore throat, a lump in the neck or nose, trouble hearing, nosebleeds, headaches, and trouble hearing, breathing, or speaking. Treatment depends upon the stage of the cancer, the tumor size, the type of cancer, and the patient's health and age.
Salivary gland cancer is cancer that affects the parotid glands, sublingual glands, or the submandibular glands. Risk factors include older age, radiation therapy treatment to head or neck, and being exposed to certain substances at work. Signs include fluid draining from the ear, pain, numbness, weakness, trouble swallowing, and a lump. Treatment depends upon the stage of the cancer and usually involves surgery, radiation therapy, chemotherapy, or radiosensitizers.
Nausea and vomiting are symptoms that may be caused by many conditions. Antiemetics are drugs that treat nausea and vomiting. Though some antiemetics for motion sickness and mild nausea are available over the counter (OTC), most require a medical evaluation and prescription.
The urinary bladder, or the bladder, is a hollow organ present in the pelvis.
Most of it lies behind the pubic bone of the pelvis but when full it can extend
up into the lower part of the abdomen. Its primary function is to store urine
that drains into it from the kidney through tube-like structures called the
ureters. The ureters from both the kidneys open into the urinary bladder. The
bladder forms a low-pressure reservoir which gradually stretches out as urine
fills into it. In males, the prostate gland is located adjacent to the base of
the bladder where urethra joins the bladder. From time to time, the muscular
wall of the bladder contracts to expel urine through the urinary passage
(urethra) into the outside world.
What are the layers of the bladder?
The bladder consists of three layers of tissue. The innermost layer of the
bladder which comes into contact with the urine stored inside the bl...