Orders & Policies?
Adult dosing for each drug will be calculated using this except Carboplatin
BSA
This antimetabolite requires Q4 hour urine pH's along with IV Sodium Bicarbonate to alkalize the urine and prevent crystal formation in the tubules.
Methotrexate
This drug is administered with Ifosfamide & Cyclophosphamide to prevent hemorrhagic cystitis.
Mesna
Chemotherapies, Radiation, prophylactic anti-bacterial agents, and even graft-versus host disease (GVHD) after transplant can cause this symptom characterized by increase of frequent, loose or watery bowel movements in our oncology population.
Diarrhea
The point in treatment when blood counts are at their lowest.
Nadir
Dose variance of less than or equal to 10% of this dose is safe for chemotherapy/biotherapy administration
The Ordered Dose
This assessment is required prior to Ifos and high-dose Cytarabine administration.
Signature Log & Neuro Assessments
This antineoplastic is administered when patients are in leukocytosis and is sometimes given as induction therapy.
Hydrea (hydroxyurea)
This is a typical finding approximately 2-10 weeks following chemotherapy when a patient's hair falls out. Some specific chemos known for causing this are 5-FU, Cyclophosphamide, Platins, Rubicins, Ifosfamide, Vincristine, and Paclitaxel. Hair typically begins to regrow about 1-3 months following treatment.
Alopecia
The largest blood cell that has a life expectancy of a few hours to a few days.
WBC
Vesicants should be administered at this rate via IV push
1-2 mL/minute
Acetaminophen / Tylenol must be held for patients receiving this chemotherapy.
Busulfan
This drug is indicated to diminish the toxicity and counteract the effects of impaired methotrexate elimination.
Leucovorin
Various chemotherapies that affect the function of the heart, lungs, & kidneys in addition to maintenance IV fluids, poor nutrition (low protein), and steroids can contribute to a patient's development of this abnormal fluid buildup and swelling in the body.
This symptom is most often seen in the extremities & abdomen, but can be problematic if the fluid begins to encroach upon heart & lungs.
Edema
These small red spots may be visible on a patient's skin due to low platelets.
Petechiae
For vesicants infusing through a peripheral line, the vascular access should not be older than this time frame.
24 hours
This biotherapy binds to the antigen CD20 on B-cells.
Rituximab (Rituxan)
This colony stimulating factor can be administered 24 hours after chemotherapy to "wake up" the bone marrow.
Neupogen
Chemotherapy and Radiation place our patients at risk for this finding when the treatment affects the lining of the patient's GI tract. This finding is displayed as painful sores and ulcerations of the mucosal lining of the GI tract.
Mucositis
Despite a low hemoglobin, a blood transfusion may be held if this blood count is significantly high.
WBC
This type of chemotherapy is not appropriate for a midline catheter and requires a central venous access.
Continuous Chemotherapy (24-hour infusions)
Dexamethasone eye drops are required to be given 4 times a day in order to prevent conjunctivitis and frequent neurological checks are imperative when a patient is receiving this chemotherapy.
High-Dose Cytarabine
This Neurokinin-1 antagonist is indicated for prevention of acute and delayed N/V and patient's may complain of a headache after administration.
Ondansetron (Zofran)
This side effect is seen after certain chemotherapies and is characterized by numbness, pain, and/or tingling of the extremities (typically the hands & feet).
Common symptomatic relief medications include gabapentin/Neurontin, pregabalin/Lyrica, etc.
Peripheral Neuropathy
This lab level may rise with rapid cell death and if not treated can result in an oncologic emergency.
Uric Acid