peripheral nerve motor or sensory loss, Guillaine Barre type syndrome, multiple cranial nerve palsies Immune related adverse events (IrAE) occur in up to 90% patients administered ipilimumab up to 70% patients administered PD1/PDL1 inhibitors (pembrolizumab, nivolumab, atezolizumab) First line pembrolizumab (PD1) in lung cancer 1 in 10 had a G3 or G4 toxicity (better than chemotherapy) 1 in 20 stopped treatment due to toxicity These are very rarely immunosuppressive drugs sick patients are unlikely to have neutropenic sepsis mainstay of treatment of immune related adverse events - STEROIDS Immune Related Adverse Events: Primary care need to be aware that side effects may not be immediate: onset of these toxicities varies but usually starts within the first 8 to 12 weeks of initiation of treatment Reference: Brooks M, Olsson-Brown A
Vitamin C (as ascorbic acid), Setria L-Glutathione (reduced), L-Cysteine Hydrochloride
Dark Spots & Marks Sun exposure, pimples, and scars create dark patches what dermatologists call hyperpigmentation
Sinopoli A, Magr A, Milardi D, Pappalardo M, Pucci P, Flagiello A, Titman JJ, Nicoletti VG, Caruso G, Pappalardo G, Grasso G
Nasal Sprays for Daily Wellness Bring the Hydration Room experience home with nasal sprays designed to support comfort and overall wellness