Question

* In relation to prescribing, handling of and dealing with biological preparations:

→ You are in an internship in one major Hospital, You were in rotation with a clinical pharmacist in oncology section and you came over a breast cancer patient. The personal doctor was making a quick visit to the patient to make sure the patient is following the therapeutic protocol and the treatment is running smoothly. The doctor wrote in the prescription sheet “Trastuzumab” to be dispensed by the In Patient Pharmacy, when the clinical pharmacist saw this he advised the doctor politely to use the trade name of the medication as this is more appropriate for dispensing such biological preparation. Answer the following:

-What is the type of monocloncal antibody of “Trastuzumab”? and give the mechanism of action of it?

-What is the trade name of “Trastuzumab”?

-Give one example of a biosimilar for “Trastuzumab”.

-Which action is appropriate in prescribing “Trastuzumab”: the doctor or the clinical pharmacist. Explain why?

Answer 1

TRASTUZUMAB

TYPE OF ANTIBODY - It is a monoclonal antibody used to treat breast cancer and stomach. IT ACTS ON HER2 receptor

Mechanism of action - Basixally cells in breast and stomach grows by Her2 receptor and in cancer this receptor are upregulated. Trastuzumab binds with this receptors and down regulates the cell division and thereby helping controlling growth of cancer cells.

one example of a biosimilar for “Trastuzumab” - ABP 980 is a biosimilar for trastuzumab used for breast cancer.

Which action is appropriate in prescribing “Trastuzumab”: the doctor or the clinical pharmacist. Explain why - Doctor is the right person to prescribe trastuzumab as this drug is not for all breast cancer but it is specifically for HER2 receptor positive breast cancer which doctor would know and not the pharmacist.