Chemotherapy

Question 1

What can chemotherapy errors result in?

Answer 1

• Increased toxicity
• Reduced efficacy
• Increased cost of care

Question 2

What are chemotherapy dosing errors most commonly reported with?

Answer 2

• Ordering (36%)
• Administration (56%)

Question 3

How do chemotherapy dosing errors happen?

Answer 3

• Calculation mistakes
• Typos and/or illegible handwriting
• Look-alike/sound-alike (LASA) drugs
• Inappropriate route of administration
• Omission of supportive care medications
• Poor patient understanding/communication

Question 4

What are some oncology references/resource?

Answer 4

• Databases (Micromedex, Clinical pharmacology)
• Treatment guidelines (NCCN)
• References (hemonc.org)
• Product labeling
• Clinical Trial Protocol

Question 5

What is Micromedex used for?

Answer 5

• Dosing for off-label indications
• Does adjustments
• Drug interactions
• ADME

Question 6

What is the NCCN used for?

Answer 6

Chemotherapy regimen recommendations:
* Diagnosis- and stage-specific
* Tumor marker-directed
* Evidence-based
* Frequent updates

Question 7

What is the hemonc.org used for?

Answer 7

Chemotherapy regimen compendium:
* Diagnosis- and stage-specific
* Tumor marker directed
* Evidence-based
* Frequently updated

Question 8

What is the NIH Daily Med used for?

Answer 8

Package insert PDFs-generic & tradename
* Boxed warnings
* Inactive ingredients (excipients/preservatives)

Question 9

What is considered significant change in weight?

Answer 9

> 10% weight loss or gain

Question 10

What is Calvert Formula?

Answer 10

Target AUC x (GFR + 25)

Question 11

What are some treatment parameters?

Answer 11

• Labs and/or physical exam
• ANC > 1500 or 1,5
• Plts > 100 K
• ClCr
• LFTs, Bilirubin
• Blood pressure
• QTc
• Dose adjustments are often needed when: CrCl < 60 mL/min or AST/ALT > 75 (~2xULN)