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CSC BMT Carboplatin(D-5,-4,-3)-Etoposide(D-5,-4,-3) VER 7-6-17 (HL 2028)

CSC BMT Carboplatin(D-5,-4,-3)-Etoposide(D-5,-4,-3) VER 7-6-17 (HL 2028) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Beacon Protocols, BMT


CSC BMT CARBOPLATIN(D:-5,-4,-3)/ETOPOSIDE(D:-5,-4,-3) VER: 7-6-17 –  Properties
Cycle 1 –  7/6/2017 through 7/16/2017 (11 days), Planned
Treatment Orders starting Day -5, Conditioning Regimen prior to BMT, Cycle 1 –  Planned for
7/6/2017
Treatment Plan Information
Reference Information (1)
GERM CELL TUMOR: Einhorn LH, et al. N Engl J Med 2007;357(4):340-8.
Treatment Plan Summary
DISEASE: Germ Cell Tumor; THERAPY: etoposide 750 mg/m2 IV Day -5, -4 and -3, carboplatin 700 mg/m2 IV Day -5, -4
and -3; CYCLE LENGTH: 11 days; COURSE: 1 cycle
Dose Calculation Instructions
All chemotherapy for BMT conditioning regimens should be dosed based on the medication-specific weight in
Standard Operating Procedure (SOP) B4.400: Calculation of High Dose Chemotherapy Doses. Document can be
accessed from the Reference Link of the Navigator.
Consent
Verify Consent
Verify informed consent has been obtained.
Nursing Procedure, Assessment and Monitoring
Vital Signs
SEE COMMENTS Starting when released for 3 hours
Day -5, -4, -3: Monitor blood pressure and heart rate every one hour for 3 hours during etoposide infusion. If blood
pressure falls below 100 mm HG systolic or if baseline decreases 10 % stop infusion and call BMT team to evaluate.
Flush Venous Access Device per Guidelines
Order details
sodium chloride flush 0.9% 10 mL injection
Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin lock flush 10 UNIT/ML injection 1-150 units
1-150 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Flush per VAD guidelines.
heparin 100 UNIT/ML lock flush injection 500 units
500 units, Flush, PRN Starting when released Until Discontinued, flush/line care
Implanted port use ONLY to be used when de-accessing port. Flush per VAD guidelines.
Hydration
sodium chloride 0.9% BOLUS
500 mL, Intravenous, 1 X DAILY, 3 doses Starting S As Scheduled, Administer over 4 Hours
Day -5, -4, -3; Start one hour prior to chemotherapy each day
sodium chloride 0.9 % infusion
at 100 mL/hr, Intravenous, CONTINUOUS Starting when released Until Discontinued
Day -5, -4, -3; Hold during prehydration and chemotherapy.
Pre-Medications
fosaprepitant (EMEND) 150 mg in sodium chloride 0.9 % 250 mL bag
150 mg, Intravenous, ONCE, 1 dose Starting when released
Day -5. Do not infuse with CA++, Mg++, Lactated Ringer's solutions
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Zztestonc,Edward E [2435061]
7/6/2017 3:18:54 PM Page 1 of 2
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 07/2017CCKM@uwhealth.org

ondansetron (ZOFRAN) tab 24 mg
24 mg, Oral, 1 X DAILY, 3 doses Starting when released
Day -5, -4, -3: Administer first dose prior to chemotherapy. May give IV if PO not tolerated.
ondansetron (ZOFRAN) 16 mg in sodium chloride 0.9 % 50 mL bag
16 mg, Intravenous, 1 X DAILY PRN, For 3 days Starting when released until S+3, nausea/vomiting
Day -5, -4, -3:  Administer first dose prior to chemotherapy. Give IV if PO not tolerated.
diphenhydramine (BENADRYL) injection 25 mg
25 mg, Intravenous, 1 X DAILY, 3 doses Starting when released, Administer over 1 Minutes
Day -5, -4, -3: Administer 15  Minutes prior to start of etoposide each day.
dexamethasone (DECADRON) tab 8 mg
8 mg, Oral, 1 X DAILY, 5 doses Starting when released
Day -5 through Day -1: May give IV if PO not tolerated.
dexamethasone (DECADRON) 10 MG/ML injection 8 mg
8 mg, Intravenous, 1 X DAILY PRN, 5 doses Starting when released, nausea/vomiting, also to prevent etoposide reaction
Day -5 through Day -1: May give IV if PO not tolerated.
olanzapine (ZYPREXA) tab 10 mg
10 mg, Oral, ONCE, 1 dose Starting when released
Day -5. Administer prior to chemotherapy.
Treatment Medications
etoposide (VEPESID) 1,500 mg in sodium chloride 0.9 % NSS bag
1,500 mg (750 mg/m2 × 2 m2 Treatment plan BSA from recorded weight), Intravenous, 1 X DAILY, 3 doses Starting S
As Scheduled
Day -5, -4, -3: Administer UNDILUTED in non-PVC bag and through non-PVC tubing. Monitor blood pressure and heart
rate every one hour for 3 hours during etoposide infusion. If blood pressure falls below 100 mm HG systolic or if
baseline decreases 10 % stop infusion and call BMT team to evaluate.
diphenhydramine (BENADRYL) injection 25 mg
25 mg, Intravenous, 1 X DAILY, 3 doses Starting when released, Administer over 1 Minutes
Day -5, -4, -3: Administer 2 hours after the start of etoposide.
CARBOplatin (PARAPLATIN) 1,400 mg in dextrose 5 % 500 mL bag
1,400 mg (700 mg/m2 × 2 m2 Treatment plan BSA from recorded weight), Intravenous, 1 X DAILY, 3 doses Starting S
As Scheduled
Day -5, -4, -3.
Supportive Care Medications
olanzapine (ZYPREXA) tab 10 mg
10 mg, Oral, 1 X DAILY (HS), 4 doses Starting S+1 As Scheduled
Days -4, -3, -2, and -1.
TBO-filgrastim (GRANIX) 300 MCG/0.5ML soln prefilled syringe
Subcutaneous, 1 X DAILY (PM) Starting S+10 As Scheduled
Start on Day +5. Discontinue when ANC is greater than 500/µL for 2 consecutive days.
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Zztestonc,Edward E [2435061]
7/6/2017 3:18:54 PM Page 2 of 2
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
07/2017CCKM@uwhealth.org