Zzbeacon,Zayna [MR ]

Transcription

1 AALL1131-DS INDUCTION HR-ALL, DAYS 1-14 Properties Cycle 1 9/27/2012 through 10/10/2012 (14 days), Planned Day 1, Cycle 1 Planned for 9/27/2012 Release Labs CBC and differential Release Release Comprehensive metabolic panel Release Bilirubin, direct (GH L Q YH) Release CSF cell count with differential (L YH) Release Immunoglobulin G Release Varicella-zoster virus by PCR (BH GH YH) Release Release Release Release 25 ml/hr, Intravenous, CONTINUOUS PRN, Other, as needed to keep vein open., Starting Release Release Release 0.15 mg/kg 35.8 kg (Treatment plan actual weight) = 5.38 mg, IV Push, EVERY 4 HOURS PRN, Nausea or vomiting, Starting midazolam (VERSED) injection 1.79 mg Release 0.05 mg/kg 35.8 kg (Treatment plan actual weight) = 1.79 mg, Intravenous, PRN, for sedation for procedure., Starting, For 3 doses fentanyl PF (SUBLIMAZE) injection 36 mcg 1 mcg/kg 35.8 kg (Treatment plan actual weight) = 36 mcg, IV Push, PRN, for sedation for procedure., Starting, For 3 doses Release naloxone (NARCAN) injection 0.36 mg 10 mcg/kg 35.8 kg (Treatment plan actual weight) = 0.36 mg, IV Push, PRN, Opioid Reversal, Starting, For 10 doses May repeat every 2-3 minutes. Release flumazenil (ROMAZICON) injection mg Release 0.01 mg/kg 35.8 kg (Treatment plan actual weight) = mg, Intravenous, PRN, for benzodiazepine reversal., Starting, For 5 doses Ordered dose of 0.01 mg/kg PRN exceeds the recommended single dose limit of 0.2 mg. 9/27/2012 3:37:24 PM Page 1 of 5

2 lidocaine (LMX) 4 % cream Topical, PRN, for procedure sites., Starting Release Release cytarabine (CYTOSAR) in sodium chloride 0.9 % 5 ml PF INTRATHECAL chemo injection Intrathecal, ONCE, Starting, For 1 dose Release Prepared in preservative-free 0.9% sodium chloride. Administration is by MD or other licensed oncology provider. leucovorin (WELLCOVORIN) tablet 5 mg 5 mg/m m2 (Treatment plan actual BSA) = 5 mg, Oral, EVERY 12 HOURS, Starting 48 hours after treatment start time Release 5 mg/m2 (5.8 mg = 1.16 tablet) cannot be administered using available products. The nearest available dose is 5 mg (4.31 mg/m2). vincristine (ONCOVIN) 1.7 mg in sodium chloride 0.9 % 25 ml chemo Release infusion 1.5 mg/m m2 (Treatment plan actual BSA) = 1.7 mg, Intravenous, for 5 Minutes, ONCE, Starting, For 1 dose Vesicant-monitor infusion site frequently. Fatal if given intrathecally. 2.5 ml = 250 Units, Intra-Catheter, PRN, Catheter Care, for Portacath., Starting 2.5 ml = 25 Units, Intra-Catheter, PRN, for broviac/picc catheter use., Starting Release Release Release draw/administration., Starting Release Day 4, Cycle 1 Planned for 9/30/2012 Drug Reaction Instructions Monitor for drug related reactions: if reaction occurs stop infusion, notify oncology provider, assess vitals, administer emergency meds as ordered. 25 ml/hr, Intravenous, CONTINUOUS PRN, Other, as needed to keep vein open., Starting 9/27/2012 3:37:24 PM Page 2 of 5

3 0.15 mg/kg 35.8 kg (Treatment plan actual weight) = 5.38 mg, IV Push, EVERY 4 HOURS PRN, Nausea or vomiting, Starting PEGaspargase (ONCASPAR) 2,903 Int'l Units in sodium chloride 0.9 % 100 ml chemo infusion 2,500 Int'l Units/m m2 (Treatment plan actual BSA) = 2,903 Int'l Units, Intravenous, for 1 Hours, ONCE, Starting, For 1 dose 2.5 ml = 250 Units, Intra-Catheter, PRN, Catheter Care, for Portacath., Starting 2.5 ml = 25 Units, Intra-Catheter, PRN, for broviac/picc catheter use., Starting draw/administration., Starting Emergency Medications hydrocortisone sodium succinate (Solu-CORTEF) injection 71.5 mg 2 mg/kg 35.8 kg (Treatment plan actual weight) = 71.5 mg, IV Push, ONCE PRN, for hypersensitivity reaction, Starting, For 1 dose diphenhydramine (BENADRYL) injection 36 mg 1 mg/kg 35.8 kg (Treatment plan actual weight) = 36 mg, IV Push, ONCE PRN, Other, for hypersensitivity reactions, Starting, For 1 dose Give by IV Push no faster than 25 mg/min EPINEPHrine (PF) (ADRENALIN) injection 0.36 mg 0.01 mg/kg 35.8 kg (Treatment plan actual weight) = 0.36 mg, Intramuscular, EVERY 15 MIN PRN, for anaphylaxis leading to hypotension or breathing difficulty., Starting Ordered dose of 0.01 mg/kg EVERY 15 MIN PRN exceeds the recommended single dose limit of 0.3 mg. Labs Day 8, Cycle 1 Planned for 10/4/2012 CBC and differential CSF cell count with differential (L YH) 9/27/2012 3:37:24 PM Page 3 of 5

4 25 ml/hr, Intravenous, CONTINUOUS PRN, Other, as needed to keep vein open., Starting midazolam (VERSED) injection 1.79 mg 0.05 mg/kg 35.8 kg (Treatment plan actual weight) = 1.79 mg, Intravenous, PRN, for sedation for procedure., Starting, For 3 doses fentanyl PF (SUBLIMAZE) injection 36 mcg 1 mcg/kg 35.8 kg (Treatment plan actual weight) = 36 mcg, IV Push, PRN, for sedation for procedure., Starting, For 3 doses naloxone (NARCAN) injection 0.36 mg 10 mcg/kg 35.8 kg (Treatment plan actual weight) = 0.36 mg, IV Push, PRN, Opioid Reversal, Starting, For 10 doses May repeat every 2-3 minutes. flumazenil (ROMAZICON) injection mg 0.01 mg/kg 35.8 kg (Treatment plan actual weight) = mg, Intravenous, PRN, for benzodiazepine reversal., Starting, For 5 doses Ordered dose of 0.01 mg/kg PRN exceeds the recommended single dose limit of 0.2 mg. lidocaine (LMX) 4 % cream Topical, PRN, for procedure sites., Starting 0.15 mg/kg 35.8 kg (Treatment plan actual weight) = 5.38 mg, IV Push, EVERY 4 HOURS PRN, Nausea or vomiting, Starting methotrexate in sodium chloride 0.9 % 5 ml PF INTRATHECAL chemo injection Intrathecal ONCE, Starting, For 1 dose Prepared in preservative-free 0.9% sodium chloride. Administration is by MD or other licensed oncology provider. vincristine (ONCOVIN) 1.7 mg in sodium chloride 0.9 % 25 ml chemo infusion 1.5 mg/m m2 (Treatment plan actual BSA) = 1.7 mg, Intravenous, for 5 Minutes, ONCE, Starting, For 1 dose Vesicant-monitor infusion site frequently. Fatal if given intrathecally. 2.5 ml = 250 Units, Intra-Catheter, PRN, Catheter Care, for Portacath., Starting 2.5 ml = 25 Units, Intra-Catheter, PRN, for broviac/picc catheter use., Starting draw/administration., Starting 9/27/2012 3:37:24 PM Page 4 of 5

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