Medical Information

Although terbotinib is a targeted drug, it is still necessary to be vigilant about the specific toxic reactions of the four major organ systems. Early identification and proactive reporting are the core of safe medication, and immediate contact with the attending team is required when the following signs appear.

1. Peripheral edema (the most common physical response)

1.1 Daily self inspection: Press the back of the foot, ankle, and front of the calf every morning. If the finger pressure depression lasts for a few seconds or one side of the limb suddenly swells, record the time of occurrence.

1.2 Basic intervention: Raise the lower limbs (above heart level), limit sodium intake (<5g per day), and avoid standing for long periods of time.

1.3 Medical threshold: When the weight increases by ≥ 2kg within 3 days, or when swelling spreads to the thighs, perineum, or back of the hand, the doctor needs to evaluate whether to add diuretics or suspend medication.

2. Interstitial lung disease (ILD, non infectious lung injury requiring urgent identification)

2.1 Symptom sentinel: newly developed dry cough, shortness of breath after activity, difficulty breathing at rest, or low-grade fever (without thick phlegm) - even mild, should be reported on the same day.

2.2 Action instructions: Suspend medication before imaging confirmation; If diagnosed with ILD, tepotinib should be permanently discontinued and glucocorticoid therapy should be initiated.

2.3 Identification reminder: Do not mistake the above symptoms for "cold" or "bronchitis", and do not take cough suppressants to cover up the condition.

3. Hepatotoxicity (elevated enzymes and jaundice)

3.1 Monitoring cycle: ALT, AST, and total bilirubin are checked every 2 weeks before treatment, every 2 weeks in the first month, and every month thereafter.

3.2 Home Warning: When white eyes or yellow skin, strong tea colored urine, dull pain in the upper right abdomen, or abnormal skin itching occur, it is considered an emergency signal.

3.3 Grading treatment: ALT>5 times the upper limit or bilirubin>2 times the upper limit - stop medication immediately; ALT3-5 times and asymptomatic - follow the doctor's advice to reduce dosage (refer to previous dose adjustment plan).

4. Pancreatic toxicity (risk of acute pancreatitis)

4.1 Key Symptoms: Sudden severe pain in the upper abdomen, radiating to the back, accompanied by nausea, vomiting, or worsening when lying flat.

4.2 Immediate examination: Emergency blood sampling for amylase and lipase testing; Strictly fast and avoid water intake before diagnosis to avoid stimulating pancreatic secretion.

4.3 Discontinuation principle: Once pancreatitis is confirmed by imaging or enzymology, the medication must be permanently discontinued and cannot be challenged for further use.