SMILE Chemotherapy Treatment

What a ridiculous name! I have made several requests that the name of the protocol is changed, but it was created in Japan, so I have little influence. There are 5 drugs that make up the protocol which give the acronym SMILE.

The drugs that Ryan is subjected to are as follows:

Steroid Dexamethasone, days 2-4: A steroid used as an anti-inflammatory, increase appetite, prevents reactions.

Side effects: Muscle weakness, mood swings, insomnia.

Methotrexate, day 1: A cytotoxic - Anti Cancer Antimetobolite drug that prevents cell division.

Side effects: Neutropenia, Alopecia, Fertility.

Ifosfamide, days 2-4: A cytotoxic - Anti Cancer Alkylating Agent that changes cell DNA.

Side effects: Neutropenia, Alopecia, Fertility.

L-asparaginase, day 8: A cytotoxic - Anti Cancer Pancreatitis Enzyme that breaks down asparagine in the body. Since the cancer cells cannot make more asparagine, they die.

Side effects: Anaphylaxis, Neurotoxicity, Liver function.

Etoposide, days 2-4: A cytotoxic - Anti Cancer Plant alkaloid that halts cell division.

Side effects: Neutropenia, Alopecia, Fertility.

Ry also has to take all of these in addition to counteract some of the effects on the body.

Sodium Lactate 500ml on day 1 for Electrolytes balance
Phenytoin 300mg days 1-6. Anti-neurotoxicity. Can cause muscle & bone pain.
Folinic Acid days 2-5. Assists in Methotrexate breakdown
Mesna days 2-4. Bladder protection
Filgrastim (GCSF) 300mg day 6-15. Assists bone marrow to make stem cells for neutrophils.
Cyclizine days 1-10. Anti sickness.
Ondansetron days 1-10. Anti sickness
Methylene blue prophylaxis for ifosfamide reaction. Ryan unfortunately had a grade 1 neurotoxic reaction to Ifosfamide in cycle 2.

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