{"id":7590,"date":"2023-08-17T19:26:21","date_gmt":"2023-08-17T19:26:21","guid":{"rendered":"http:\/\/d1s07skqdwll4z.cloudfront.net\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-2-managing-hypertension\/"},"modified":"2024-03-28T17:57:21","modified_gmt":"2024-03-28T17:57:21","slug":"5-2-2-managing-hypertension","status":"publish","type":"page","link":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-2-managing-hypertension\/","title":{"rendered":"5.2.2 Managing hypertension"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:-60px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-search-element fusion-search-element-1 fusion-search-form-clean\" style=\"--awb-border-radius:7px;--awb-text-color:var(--awb-color8);--awb-border-color:var(--awb-color8);--awb-bg-color:var(--awb-color3);\">\t\t<form role=\"search\" class=\"searchform fusion-search-form  fusion-live-search fusion-search-form-clean\" method=\"get\" action=\"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/\">\n\t\t\t<div class=\"fusion-search-form-content\">\n\n\t\t\t\t\n\t\t\t\t<div class=\"fusion-search-field search-field\">\n\t\t\t\t\t<label><span class=\"screen-reader-text\">Search for:<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input type=\"search\" class=\"s fusion-live-search-input\" name=\"s\" id=\"fusion-live-search-input-0\" autocomplete=\"off\" placeholder=\"Search...\" required aria-required=\"true\" aria-label=\"Search...\"\/>\n\t\t\t\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"fusion-search-button search-button\">\n\t\t\t\t\t<input type=\"submit\" class=\"fusion-search-submit searchsubmit\" aria-label=\"Search\" value=\"&#xf002;\" \/>\n\t\t\t\t\t\t\t\t\t\t<div class=\"fusion-slider-loading\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t<input type=\"hidden\" name=\"post_type[]\" value=\"any\" \/><input type=\"hidden\" name=\"search_limit_to_post_titles\" value=\"0\" \/><input type=\"hidden\" name=\"live_min_character\" value=\"4\" \/><input type=\"hidden\" name=\"live_posts_per_page\" value=\"100\" \/><input type=\"hidden\" name=\"live_search_display_featured_image\" value=\"1\" \/><input type=\"hidden\" name=\"live_search_display_post_type\" value=\"1\" \/><input type=\"hidden\" name=\"fs\" value=\"1\" \/>\n\t\t\t<\/div>\n\n\n\t\t\t\t\t\t\t<div class=\"fusion-search-results-wrapper\"><div class=\"fusion-search-results\"><\/div><\/div>\n\t\t\t\n\t\t<\/form>\n\t\t<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-title-center fusion-title-text fusion-title-size-five\" style=\"--awb-text-color:#c1c1c1;--awb-sep-color:#e2e2e2;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">5.2.2 Hantera hypertoni<sup>1,2<\/sup><\/h5><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><section class=\"av_textblock_section \">\n<div class=\"avia_textblock \">\n<p>Mer \u00e4n 80 % av patienterna som behandlas med TKI utvecklar hypertoni \u2013 antingen nydebuterad eller f\u00f6rs\u00e4mring av tidigare kontrollerat h\u00f6gt blodtryck. Patienter som utvecklar hypertoni tenderar att svara b\u00e4ttre och l\u00e4ngre p\u00e5 TKI. Riskfaktorer f\u00f6r utveckling av hypertoni under behandling med TKI:<\/p>\n<\/div>\n<\/section>\n<section class=\"av_textblock_section \">\n<div class=\"avia_textblock \">\n<ol>\n<li>\u00c5lder &gt; 65 \u00e5r<\/li>\n<li>Hypertoni i anamnesen<\/li>\n<li>Anamnes p\u00e5 k\u00e4rlsjukdom (AMI, cerebral stroke, perifer k\u00e4rlsjukdom)<\/li>\n<li>Diabetes mellitus<\/li>\n<\/ol>\n<p>Snabb utveckling av hypertoni under behandling med TKI hos patienter utan tidigare k\u00e4nd hypertoni, kan orsaka akut organskada, inklusive traumatisk cerebral stroke\/cerebral stroke, hj\u00e4rtinfarkt, hj\u00e4rtsvikt och akut njurfunktionsneds\u00e4ttning. Det \u00e4r d\u00e4rf\u00f6r viktigt att blodtrycket \u00e4r v\u00e4lkontrollerat i b\u00f6rjan av TKI-behandlingen och att patienten instrueras att:<\/p>\n<ul>\n<li>M\u00e4ta blodtrycket ofta \u2013 s\u00e4rskilt i b\u00f6rjan av behandlingen<\/li>\n<li>Kontakta sin egen l\u00e4kare eller avdelningen om blodtrycket stiger och blodtrycket \u00e4r &gt; 150\/90.<\/li>\n<\/ul>\n<\/div>\n<\/section>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">CTCAE-grad<\/h4><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Hantering<\/h4><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Follow-up<\/h4><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#faf2f7;--awb-bg-color-hover:#faf2f7;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 1:<\/strong><br \/>\nSystoliskt blodtryck 120\u2013139 mmHg eller diastoliskt blodtryck 80\u201389 mmHg.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#faf2f7;--awb-bg-color-hover:#faf2f7;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-3 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 1:<\/strong><br \/>\nForts\u00e4tt med samma TKI-dos. Intervention ej indikerad.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#faf2f7;--awb-bg-color-hover:#faf2f7;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-4 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 1:<\/strong><br \/>\nInstruera patienten att m\u00e4ta blodtrycket hemma varje vecka (dagbok med veckovisa blodtrycksv\u00e4rden ska tas med till varje bes\u00f6k).<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#efe1ea;--awb-bg-color-hover:#efe1ea;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-5 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 2:<\/strong><br \/>\nSystoliskt blodtryck 140\u2013159 mmHg eller diastoliskt blodtryck 90\u201399 mmHg om tidigare inom normalomr\u00e5det<br \/>\n\u00c5terkommande eller ih\u00e5llande (&gt;24 timmar) eller symtomatisk \u00f6kning med &gt; 20 mmHg (diastoliskt)<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#efe1ea;--awb-bg-color-hover:#efe1ea;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-6 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 2:<\/strong><br \/>\nForts\u00e4tt med samma TKI-dos. Monoterapi indicerad (se nedan)<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#efe1ea;--awb-bg-color-hover:#efe1ea;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-7 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 2:<\/strong><br \/>\nDagbok f\u00f6r daglig blodtrycksm\u00e4tning ska fyllas i. Ge patienten r\u00e5d om:<br \/>\n1) motion 2) viktminskning 3) r\u00f6kstopp 4) saltrestriktion<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#e1bdd3;--awb-bg-color-hover:#e1bdd3;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-8 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 3:<\/strong><br \/>\nSystoliskt blodtryck \u2265160 mmHg eller diastoliskt blodtryck \u2265100 mmHg. Kr\u00e4ver mer \u00e4n ett l\u00e4kemedel eller intensivare behandling \u00e4n tidigare.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#e1bdd3;--awb-bg-color-hover:#e1bdd3;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-9 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 3:<\/strong><br \/>\n1) Forts\u00e4tt med samma TKI-dos om patienten \u00e4r asymtomatisk. Intensifiera blodtryckss\u00e4nkande behandling (se nedan),<br \/>\n2) Om patienten har symtom ska TKI pausas.<br \/>\n3) TKI kan \u00e5terupptas med reducerad dos vid grad \u2264 2.<br \/>\n4) Om hypertoni av grad 3 \u00e5terkommer efter \u00e5terins\u00e4ttning ska TKI pausas och patienten remitteras till kardiologavdelningen f\u00f6r ytterligare blodtrycksreglering. TKI kan \u00e5terupptas med ytterligare reducerad dos efter samtal med specialist.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#e1bdd3;--awb-bg-color-hover:#e1bdd3;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-10 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><b>&#8211;<\/b><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#d4a4c2;--awb-bg-color-hover:#d4a4c2;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-11 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 4:<\/strong><br \/>\nLivshotande konsekvenser (t.ex. hypertensiv kris).<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-16 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#d4a4c2;--awb-bg-color-hover:#d4a4c2;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-12 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\"><strong>Grad 4:<\/strong><br \/>\n1) Pausa TKI. 2) \u00d6verv\u00e4g sjukhusinl\u00e4ggning om patienten har symtom eller om blodtrycket \u00e4r ih\u00e5llande &gt;220\/120. 3) TKI kan \u00e5terupptas med reducerad dos vid grad \u22642.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-17 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-stretch\" style=\"--awb-bg-color:#d4a4c2;--awb-bg-color-hover:#d4a4c2;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:5px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-13 fusion-text-no-margin\" style=\"--awb-margin-top:20px;--awb-margin-right:20px;--awb-margin-bottom:20px;--awb-margin-left:20px;\"><p style=\"text-align: center;\">&#8211;<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-18 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-top:30px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Farmakologisk behandling av hypertoni (enligt rekommendationer fr\u00e5n Danish Society of Cardiology):<\/h4><\/div><div class=\"fusion-text fusion-text-14\"><p>Okomplicerad hypertoni (hypertoni utan f\u00f6ljdtillst\u00e5nd). Fritt val mellan 4 l\u00e4kemedelsgrupper.<\/p>\n<ul>\n<li>Tiazider och tiazidliknande \u00e4mnen (andra \u00e4n hydroklortiazid ska anv\u00e4ndas i f\u00f6rsta hand)<\/li>\n<li>Kalciumantagonister av dihydropyridintyp (amlodipin). Kalciumantagonister av icke-dihydropyridintyp \u00e4r kontraindicerade tillsammans med TKI p\u00e5 grund av interaktion<\/li>\n<li>ACE-h\u00e4mmare (Inte f\u00f6rstahandsval vid eGFR &lt;30 ml\/min)<\/li>\n<li>Angiotensin II-antagonister (Inte f\u00f6rstahandsval vid eGFR &lt;30 mL\/min och ska normalt inte kombineras med ACE-h\u00e4mmare)<\/li>\n<\/ul>\n<p>Betablockerare, s\u00e4rskilt atenolol, betraktas inte l\u00e4ngre som rutinm\u00e4ssiga f\u00f6rsta linjens l\u00e4kemedel. F\u00f6r n\u00e4rvarande rekommenderas att betablockerare reserveras f\u00f6r patienter som ut\u00f6ver hypertoni har en kompletterande indikation f\u00f6r betablockad, t.ex. ischemisk hj\u00e4rtsjukdom, snabbt f\u00f6rmaksflimmer eller hj\u00e4rtsvikt. Detsamma g\u00e4ller om en symtomatisk f\u00f6rdel kan uppn\u00e5s genom betablockad (tremor, extrasystoli eller migr\u00e4n).<\/p>\n<p>Kombinationsbehandling: F\u00f6r att n\u00e5 de rekommenderade m\u00e5len kr\u00e4vs ofta kombinationsbehandling med 2\u20133 l\u00e4kemedel i gruppen som ska v\u00e4ljas i f\u00f6rsta hand. Betablockerare, alfablockerare och centralt verkande l\u00e4kemedel kan l\u00e4ggas till om blodtrycket inte kontrolleras v\u00e4l med en kombination av ovanst\u00e5ende l\u00e4kemedel.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-top:30px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Hypertoni med f\u00f6ljdtillst\u00e5nd (specialgrupper)<\/h4><\/div>\n<div class=\"table-1\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\">S\u00c4RSKILDA GRUPPER<\/th>\n<th align=\"left\">VAL AV L\u00c4KEMEDEL<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">\u00c4ldre patienter<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Varsam upptitrering rekommenderas. Sittande och st\u00e5ende blodtryck m\u00e4ts f\u00f6re upptitrering f\u00f6r att uppt\u00e4cka ortostatiskt blodtrycksfall. Du kan fritt v\u00e4lja mellan de 4 rekommenderade l\u00e4kemedelsgrupperna och konkurrerande sjukdomar avg\u00f6r oftast valet av l\u00e4kemedel.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Diabetes mellitus <\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">ACE-h\u00e4mmare eller en angiotensin II-antagonist ska ing\u00e5 i behandlingen. Oftast beh\u00f6vs behandling med minst tv\u00e5 l\u00e4kemedel.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ischemisk hj\u00e4rtsjukdom<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Betablockerare, kalciumkanalblockerare och ACE-h\u00e4mmare \u00e4r att f\u00f6redra, eventuellt i kombination.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Hj\u00e4rtsvikt utan symtom<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">ACE-h\u00e4mmare, men en angiotensin II-antagonist rekommenderas vid intolerans mot ACE-h\u00e4mmare.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Hj\u00e4rtsvikt med symtom<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">ACE-h\u00e4mmare. Vid intolerans mot ACE-h\u00e4mmare rekommenderas dock \u00e4ven en angiotensin II-antagonist med till\u00e4gg av alfa-\/betablockerare (karvedilol) eller betablockerare (metoprolol, nebivolol eller bisoprolol) vid normalt eller l\u00e5gt blodtryck. I den m\u00e5n de tolereras kan dessutom aldosteronantagonister och loopdiuretika anv\u00e4ndas som symtomatisk behandling.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Efter stroke<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Behandlingen \u00e4r densamma som f\u00f6r okomplicerad hypertoni (hypertoni utan f\u00f6ljdtillst\u00e5nd), d\u00e4r du kan v\u00e4lja fritt fr\u00e5n de fyra rekommenderade l\u00e4kemedelsgrupperna. De mest positiva resultaten n\u00e4r det g\u00e4ller minskning av risken f\u00f6r \u00e5terfall har uppn\u00e5tts med en kombination av ACE-h\u00e4mmare och tiazid.<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Kronisk njursjukdom<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">ACE-h\u00e4mmare eller en angiotensin II-antagonist, eventuellt i kombination med diuretika, \u00e4r den initiala behandlingen. Vid eGFR <\/span><\/span> &lt; 30 ml\/min <span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">ska behandlingen diskuteras med en nefrolog.<\/span><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><\/div><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-top:30px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">F\u00f6reslagen behandlingsalgoritm<\/h4><\/div><div class=\"fusion-text fusion-text-15\"><p>Om fler \u00e4n 3 blodtryckss\u00e4nkande l\u00e4kemedel beh\u00f6vs \u00e4r detta en specialistuppgift.<\/p>\n<\/div><div class=\"fusion-image-element \" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"1233\" height=\"527\" title=\"5.2.2_1\" src=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1.jpg\" alt class=\"img-responsive wp-image-10116\" srcset=\"https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1-200x85.jpg 200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1-400x171.jpg 400w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1-600x256.jpg 600w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1-800x342.jpg 800w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1-1200x513.jpg 1200w, https:\/\/wave-eu-west-1.s3.eu-west-1.amazonaws.com\/websites\/oncologynow_eu\/wp-content\/uploads\/2023\/12\/16120121\/5.2.2_1.jpg 1233w\" sizes=\"(max-width: 640px) 100vw, 1200px\" \/><\/span><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><\/div><div class=\"fusion-title title fusion-title-8 fusion-sep-none fusion-title-text fusion-title-size-four\" style=\"--awb-margin-top:30px;\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Referenser<\/h4><\/div><div class=\"fusion-text fusion-text-16\"><ol>\n<li><em>Dobbin et al, Heart 2018<\/em><\/li>\n<li><em>Cardiology company\u2019s website<\/em><\/li>\n<\/ol>\n<\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-default-span fusion-button-default-type\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-3-fatigue-management\/\"><span class=\"fusion-button-text\">Forts\u00e4tt till n\u00e4sta avsnitt: 5.2.3 Hantering av tr\u00f6tthet<\/span><i class=\"fa-arrow-alt-circle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-6 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:7px;--awb-border-radius-top-right:7px;--awb-border-radius-bottom-right:7px;--awb-border-radius-bottom-left:7px;--awb-overflow:hidden;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-19 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-9 fusion-title-center fusion-title-text fusion-title-size-five\" style=\"--awb-text-color:#c1c1c1;--awb-sep-color:#e2e2e2;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Utforska den h\u00e4r kapitelmenyn<\/h5><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-20 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-21 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-2 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_bevel_color:rgba(89,96,104,0.7);--button_bevel_color_hover:rgba(89,96,104,0.9);--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:15px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-1-diarrhoea-management\/\"><span class=\"fusion-button-text\">5.2.1 Diarrhoea<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-3 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-2-managing-hypertension\/\"><span class=\"fusion-button-text\">5.2.2 Hypertension<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-4 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-3-fatigue-management\/\"><span class=\"fusion-button-text\">5.2.3 Fatigue<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-5 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-4-management-of-hand-and-or-foot-symptoms-palmar-plantar-erythrodyesthesia-syndrome-ppe\/\"><span class=\"fusion-button-text\">5.2.4 Palmar-Plantar Erythrodyesthesia syndrome (PPE)<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-6 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-5-managing-nausea-loss-of-appetite\/\"><span class=\"fusion-button-text\">5.2.5 Nausea\/Loss of appetite<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-7 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-6-management-of-stomatitis\/\"><span class=\"fusion-button-text\">5.2.6 Oral stomatitis<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-8 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-7-hypothyroidism\/\"><span class=\"fusion-button-text\">5.2.7 Hypothyroidism<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-9 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-8-management-of-haematological-toxicity\/\"><span class=\"fusion-button-text\">5.2.8 Haematological tox<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-10 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-9-managing-liver-toxicity\/\"><span class=\"fusion-button-text\">5.2.9 Liver tox<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-11 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/mrcc-tool\/5-toxicity-management\/5-2-management-of-tki-side-effects\/5-2-10-managing-proteinuria\/\"><span class=\"fusion-button-text\">5.2.10 Proteinuria<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-22 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7578,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7590","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7590","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/comments?post=7590"}],"version-history":[{"count":21,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7590\/revisions"}],"predecessor-version":[{"id":11189,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7590\/revisions\/11189"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/pages\/7578"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/sv\/wp-json\/wp\/v2\/media?parent=7590"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}