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Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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Medication (Generic & Brand Names) Class (Therapeutic & Pharmacologi c) Indications (Why is pt. taking this drug?) Dose Route Frequency Contraindications Nursing Considerations Side Effects Pt. Teaching methotrexate T:antineoplastics P: antimetabolites ● Acute lymphoblas tic leukemia (in combinatio n with other chemothera py drugs). ● Treatment and prophylaxis of meningeal leukemia. Acute Lymphoblastic Leukemia IV (Adults and Children): 10–5, mg/m^2 followed by leucovorin rescue (for doses >500 mg/m^2 ). Lower doses (20– mg/m^2 /wk may be used IM. PO (Adults): 20 mg/m^2 once weekly Meningeal Leukemia IT (Adults and Children ≥9 yr): 12–15 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis). IT (Children 3–<9 yr): 12 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis). IT (Children 2–<3 yr): 10 mg given at intervals of 2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis). IT (Children 1–<2 yr): 8 mg given at intervals of ● Hypersens itivity; ● Alcoholis m or hepatic impairme nt; ● Immunosu ppression; ● ↓ bone marrow reserve; ● OB: Pregnancy ; ● Lactation: Lactation; ● Pedi: Products containing benzyl alcohol should not be used in neonates. ● Monitor vital signs periodically during administration. Report significant changes. ● Monitor for abdominal pain, diarrhea, or stomatitis; therapy may need to be discontinued. ● Monitor for bone marrow depression. Derm: alopecia, ERYTHEMA MULTIFORME, painful plaque erosions (during psoriasis treatment), photosensitivity, pruritus, rash, skin ulceration, soft tissue necrosis, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, urticaria EENT: blurred vision, transient blindness GI: anorexia, diarrhea, nausea, stomatitis, vomiting, GI PERFORATION, HEPATOTOXICITY GU: nephropathy, ↓ fertility, acute renal failure, menstrual abnormalities, oligospermia Instruct patient to take medication as directed. If a dose is missed, it should be omitted. Consult health care professional if vomiting occurs shortly after a dose is taken. Advise patients taking PO or SUBQ therapy to read Patient Information before starting therapy and with each Rx refill in case of changes.
Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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2 or more days up to twice weekly (for treatment) and no more than once weekly (for prophylaxis). cytarabine (^) T: antineoplastics P: antimetabolites IV Treatment of leukemias and non-Hodgkin's lymphomas (in combination with other agents). IT Prophylaxis and treatment of meningeal leukemia. IV (Adults): Induction dose: 200 mg/m^2 /day for 5 days every 2 wk as a single agent or 2– mg/kg/day (100– mg/m^2 /day) as a single daily dose or in 2– divided doses for 5– days or until remission occurs as part of combination chemotherapy. Maintenance: 70– mg/m^2 /day for 2– days monthly. Refractory leukemias/lymphomas: 3 g/m^2 every 12 hr for up to 12 doses. SUBQ (Adults): Maintenance: 1–1. mg/kg every 1–4 wk. IT (Adults): Usual dose = 30 mg/m^2 every 4 days; range = 5– mg/m^2 once daily for 4 days or every 4 days until CNS findings normalize, followed by one additional treatment. ● Hypersens itivity; ● Active meningeal infection (IT only); OB: Pregnancy ● Lactation: Lactation. ● Assess patient for respiratory distress and pulmonary edema. Occurs with high doses rarely; may be fatal. ● Monitor patient for signs of anaphylaxis (rash, dyspnea, swelling). Epinephrine, corticosteroids, and resuscitation equipment should be readily available. CV: edema Derm: alopecia, rash EENT: corneal toxicity (high dose), hemorrhagic conjunctivitis (high dose), visual disturbances (including blindness) GI: GI ulceration (high dose), HEPATOTOXICITY, nausea, vomiting, stomatitis GU: sterility, urinary incontinence Hemat: (less with IT use): anemia, leukopenia, thrombocytopenia Metabolic: hyperuricemia Neuro: IT: abnormal gait, CHEMICAL ARACHNOIDITIS, CNS dysfunction (high dose), confusion, drowsiness, headache Resp: PULMONARY EDEMA (high dose) Misc: cytarabine syndrome, fever Caution patient to avoid crowds and persons with known infections. Report symptoms of infection (fever, chills, cough, hoarseness, sore throat, lower back or side pain, painful or difficult urination) immediately. Instruct patient to report unusual bleeding. Advise patient of thrombocytopenia precautions (use soft toothbrush and electric razor, avoid falls, do not drink alcoholic beverages or take medication containing aspirin or NSAIDs; may precipitate gastric bleeding). Instruct patient to inspect oral mucosa for redness and ulceration. If mouth sores occur, advise patient to use sponge brush and rinse mouth with water after eating and drinking. Stomatitis may require treatment with opioid analgesics.
Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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Breast carcinoma, and a variety of other tumors. ● Minimal change nephrotic syndrome in children. IV (Adults): 40– mg/kg in divided doses over 2–5 days or 10–15 mg/kg every 7–10 days or 3– mg/kg twice weekly or 1.5–3 mg/kg/day. Other regimens may use larger doses. IV (Children): Induction: 2–8 mg/kg/day (60– mg/m^2 /day) in divided doses for 6 days or longer. Total dose for 7 days may be given as a single weekly dose. Maintenance: 10– mg/kg every 7–10 days or 30 mg/kg every 3– wk. cystitis and to promote excretion of uric acid, fluid intake should be at least 3000 mL/day for adults and 1000–2000 mL/day for children. May be administered with mesna. Alkalinization of the urine may be used to help prevent uric acid nephropathy. GU: hematuria, ↓ fertility, HEMORRHAGIC CYSTITIS Hemat: thrombocytopenia, anemia, LEUKOPENIA Metabolic: hyperuricemia Resp: PULMONARY FIBROSIS Misc: SECONDARY MALIGNANCY contact health care professional. Advise caregivers to use gloves when handling capsules. If capsule opens, wash hands thoroughly. carmustine T:antineoplastics P:alkylating agents Alone or with other treatments (surgery, radiation) in the management of: Brain tumors, Multiple myeloma, Hodgkin's disease, Other lymphomas. IV (Adults and Children): 150– mg/m^2 every 6–8 wk or 75–100 mg/m^2 /day for 2 days every 6 wk or 40 mg/m^2 /day for 5 days every 6 wk. Intracavitary: (Adults): 61.6 mg (8 wafers) placed in cavity created during surgical resection of brain tumor. ● Hypersensitivit y; ● OB: Pregnancy (may cause fetal harm); ● Lactation: Lactation. ● Monitor vital signs before and frequently during therapy. ● Monitor for bone marrow depression. Assess for bleeding (bleeding gums, bruising, petechiae, guaiac stools, urine, and emesis) and avoid IM injections and taking rectal temperatures if platelet count is low. Apply pressure to venipuncture sites for 10 min. Assess for signs of infection during neutropenia. Anemia may occur; monitor for increased fatigue, dyspnea, and orthostatic Derm: alopecia GI: hepatotoxicity, nausea, vomiting, anorexia, diarrhea, esophagitis GU: ↓ fertility (males), renal failure Hemat: anemia, LEUKOPENIA, THROMBOCYTOPENIA Local: pain at IV site Resp: PULMONARY FIBROSIS, pulmonary infiltrates ● Instruct patient to notify health care professio nal if fever; chills; sore throat; signs of infection; lower back or side pain; difficult or painful urination ; bleeding gums; bruising; petechia e; or blood in urine,
Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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hypotension. stool, or emesis occurs. Caution patient to avoid crowds and persons with known infection s. Instruct patient to use soft toothbru sh and electric razor. Patients should be cautione d not to drink alcoholic beverage s or to take products containin g aspirin or NSAIDs. ● Instruct patient to notify health care professio nal if shortness of breath or increased cough occurs. Encourag
Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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Medication (Generic & Brand Names) Class (Therapeutic & Pharmacologic ) Indications (Why is pt. taking this drug?) Dose Route Frequency Contraindications Nursing Considerations Side Effects Pt. Teaching cisplatin T: P: doxorubicin T: P: vincristine P: T: paclitaxel
T:
P:
topotecan
T:
P:
Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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Medication (Generic & Brand Names) Class (Therapeutic & Pharmacologic ) Indications (Why is pt. taking this drug?) Dose Route Frequency Contraindications Nursing Considerations Side Effects Pt. Teaching leuprolide
T:
P:
flutamide T: P: tamoxifen T: P: raloxifene T: P: anastrozole T: P:
Student Name: Luz Angel Week: 1 Date: 04/08/24 Pt. Initials: Page:
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