 SIDE EFFECTS

**Frequent (49%–41%):** Dry mouth, drowsiness, asthenia. **Occasional (16%–4%):** Dizziness, UTI, constipation. **Rare (3%):** Nervousness, amblyopia, pharyngitis, rhinitis, vomiting, urinary frequency.

#####  ADVERSE EFFECTS/TOXIC REACTIONS

Hypotension may be associated with bradycardia, orthostatic hypotension, and, rarely, syncope. Risk of hypotension increases as dosage increases; hypotension is noted within 1 hr after administration.

#####  NURSING CONSIDERATIONS

BASELINE ASSESSMENT

Record onset, type, location, duration of muscular spasm. Check for immobility, stiffness, swelling. Obtain baseline serum hepatic function tests, alkaline phosphatase, total bilirubin.

INTERVENTION/EVALUATION

Assist with ambulation at all times. For those on long-term therapy, serum hepatic/renal function tests should be performed periodically. Evaluate for therapeutic response (decreased intensity of skeletal muscle pain/tenderness, improved mobility, decrease in spasticity). Go from lying to standing slowly.

PATIENT/FAMILY TEACHING

• Avoid tasks that require alertness, motor skills until response to drugOTC medications (analgesics, sedatives). • May cause drowsiness, dizziness, blurred vision. • Avoid tasks requiring alertness, motor skills until response to drug is established. • Report severe constipation, difficulty breathing, excessive sedation, seizures, muscle weakness, tremors, chest pain, palpitations.

####  trametinib

tra- **me** -ti-nib

(Mekinist)

**Do not confuse trametinib with imatinib or tipifarnib.**

#####  ♦ CLASSIFICATION

**PHARMACOTHERAPEUTIC:** Kinase inhibitor. **CLINICAL:** Antineoplastic.

#####  USES

Used as a single agent or in combination with dabrafenib for treatment of unresectable or metastatic melanoma with BRAF V600E or V600L mutations, as detected by FDA-approved test. Single-agent regimen is not indicated in pts who have received prior BRAF-inhibitor therapy.

#####  PRECAUTIONS

**Contraindications:** Hypersensitivity to trametinib. **Cautions:** Cardiac/pulmonary impairment, preexisting diabetes or diabetes.

#####  ACTION

Inhibits mitogen-activated extracellular kinase (MEK), **Therapeutic Effect:** Inhibits tumor cell growth, causing apoptosis.

#####  PHARMACOKINETICS

Rapidly absorbed