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Principles of pharmacotherapy.

Tracy Batchelor1, Jordi Rodon2, Manmeet Ahluwalia3

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Handbook of Clinical Neurology
|March 8, 2016
PubMed
Summary

Overcoming drug delivery challenges in primary brain tumors requires addressing the blood-brain barrier and drug efflux. Strategies to improve brain drug penetration and manage drug interactions are crucial for effective patient treatment.

Keywords:
blood–brain barrierchemotherapyconvection-enhanced deliverydrug deliveryintrathecalpharmacotherapy

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Area of Science:

  • Neuro-oncology
  • Pharmacology
  • Drug Delivery

Background:

  • Primary brain tumors present unique pharmacotherapy challenges, including the blood-brain barrier (BBB) and blood-tumor barrier (BTB).
  • Active drug efflux pumps and high plasma protein binding further limit therapeutic agent efficacy.
  • Corticosteroids and antiseizure drugs used in brain tumor management can cause significant drug interactions.

Purpose of the Study:

  • To review the challenges associated with pharmacotherapy for primary brain tumors.
  • To discuss approaches for enhancing drug delivery across the blood-brain barrier.
  • To examine drug interactions relevant to brain tumor treatment and methods for assessing drug distribution.

Main Methods:

  • Literature review of challenges in brain tumor pharmacotherapy.
  • Discussion of drug delivery enhancement strategies.
  • Review of techniques for assessing drug distribution in the brain.

Main Results:

  • Key challenges include the BBB, BTB, efflux pumps, and protein binding.
  • Various methods exist to improve drug delivery to the brain.
  • Drug interactions with common medications can affect treatment outcomes.
  • Techniques for assessing brain drug distribution are available.

Conclusions:

  • Effective pharmacotherapy for primary brain tumors necessitates overcoming significant delivery barriers.
  • Careful management of drug interactions is essential for optimizing treatment efficacy and safety.
  • Further research into drug delivery and interaction management is warranted.