Difference between revisions of "Example orders for Cabazitaxel (Jevtana) in prostate cancer"
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Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 12 mg PO once 30 minutes prior to | + | *[[Dexamethasone (Decadron)]] 12 mg PO once 30 minutes prior to chemotherapy |
| − | *Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to | + | *Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy |
| − | *Ondansetron (Zofran) 8 mg PO once 30 minutes prior to | + | *Ondansetron (Zofran) 8 mg PO once 30 minutes prior to chemotherapy |
| − | *If ondansetron not used: Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to | + | *If ondansetron not used: Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy |
| − | *Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to | + | *Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy |
| − | *[[Pegfilgrastim (Neulasta)]] 6 mg SC once on day 2, 24 hours after completion of | + | *[[Pegfilgrastim (Neulasta)]] 6 mg SC once on day 2, 24 hours after completion of chemotherapy |
Hydration: | Hydration: | ||
| Line 28: | Line 28: | ||
Monitoring/precautions: | Monitoring/precautions: | ||
*Notify physician if ANC <1500, AST/ALT ≥1.5 times upper limit of normal | *Notify physician if ANC <1500, AST/ALT ≥1.5 times upper limit of normal | ||
| − | *Exercise caution with/avoid use of Cyp3A inducers such as | + | *Exercise caution with/avoid use of Cyp3A inducers such as phenytoin and rifampin |
*Exercise caution with/avoid use for patients with hepatic insufficiency | *Exercise caution with/avoid use for patients with hepatic insufficiency | ||
| + | |||
| + | Nursing: | ||
| + | *Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete. | ||
| + | *Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete. | ||
| + | |||
| + | ===Example order set #2=== | ||
| + | *[[Cabazitaxel (Jevtana)]] 25 mg/m2 IV over 1 hour once on day 1; use non-DEHP (paclitaxel) tubing | ||
| + | |||
| + | '''21-day cycles''' | ||
| + | |||
| + | Supportive medications: | ||
| + | *[[Dexamethasone (Decadron)]] 12 mg IV once 30 minutes prior to chemotherapy | ||
| + | *Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy | ||
| + | *Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy | ||
| + | *Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy | ||
| + | *Due to refractory nausea/vomiting, the following were also used: | ||
| + | **Ondansetron (Zofran) 8 mg IV once 30 minutes prior to chemotherapy | ||
| + | **Fosaprepitant (Emend) 150 mg IV once 30 minutes prior to chemotherapy, admix with dexamethasone and ondansetron | ||
Nursing: | Nursing: | ||
Revision as of 00:11, 17 June 2013
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.
Published regimen and references can be found on the prostate cancer page.
Cabazitaxel (Jevtana)
Example order set #1
- Cabazitaxel (Jevtana) 25 mg/m2 IV over 1 hour once on day 1; use non-DEHP (paclitaxel) tubing
- Optional: Prednisone (Sterapred) 10 mg PO once per day on days 1 to 21
21-day cycles
Supportive medications:
- Dexamethasone (Decadron) 12 mg PO once 30 minutes prior to chemotherapy
- Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy
- Ondansetron (Zofran) 8 mg PO once 30 minutes prior to chemotherapy
- If ondansetron not used: Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy
- Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy
- Pegfilgrastim (Neulasta) 6 mg SC once on day 2, 24 hours after completion of chemotherapy
Hydration:
- Normal saline IV continuous infusion at 5 mL/H
- Normal saline 25 to 50 mL IV prn flush before and after chemotherapy
Monitoring/precautions:
- Notify physician if ANC <1500, AST/ALT ≥1.5 times upper limit of normal
- Exercise caution with/avoid use of Cyp3A inducers such as phenytoin and rifampin
- Exercise caution with/avoid use for patients with hepatic insufficiency
Nursing:
- Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
- Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.
Example order set #2
- Cabazitaxel (Jevtana) 25 mg/m2 IV over 1 hour once on day 1; use non-DEHP (paclitaxel) tubing
21-day cycles
Supportive medications:
- Dexamethasone (Decadron) 12 mg IV once 30 minutes prior to chemotherapy
- Prochlorperazine (Compazine) 10 mg PO/IV once 30 to 60 minutes prior to chemotherapy
- Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 minutes prior to chemotherapy
- Famotidine (Pepcid) 20 mg IV over 15 minutes once 30 minutes prior to chemotherapy
- Due to refractory nausea/vomiting, the following were also used:
- Ondansetron (Zofran) 8 mg IV once 30 minutes prior to chemotherapy
- Fosaprepitant (Emend) 150 mg IV once 30 minutes prior to chemotherapy, admix with dexamethasone and ondansetron
Nursing:
- Patients without central lines: insert peripheral IV before therapy. Flush peripheral IV with 10 mL 0.9% normal saline after each day's dose of chemotherapy. Remove peripheral IV when therapy is complete.
- Patients with central lines: access the central venous access device before therapy. Flush central line according to institutional guidelines after each day's dose of chemotherapy. Deaccess device when therapy is complete.