/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/beacon-protocols/,/clinical/cckm-tools/content/beacon-protocols/hem---leukemia/,

/clinical/cckm-tools/content/beacon-protocols/hem---leukemia/name-96813-en.cckm

201612340

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Beacon Protocols,Hem - Leukemia

CSC HEM INPT Cladribine (7D 1-7)VER 11-28-16 (HL 4362)

CSC HEM INPT Cladribine (7D 1-7)VER 11-28-16 (HL 4362) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Beacon Protocols, Hem - Leukemia


CSC HEM INPT CLADRIBINE (7D:1-7) VER: 11-28-16 – Properties
Cycle 1 – 12/2/2016 through 12/8/2016 (7 days), Planned
Day 1 through 7 (Inpatient), Cycle 1 – Planned for 12/2/2016
Treatment Plan Information
Reference Information (1)
HAIRY CELL LEUKEMIA: Piro LD, et al. N Engl J Med 1990;322(16):1117-21
Treatment Plan Summary
DISEASE: Hairy Cell Leukemia; THERAPY: cladribine 0.1 mg/kg/day IV as a continuous infusion over 24 hours (Total dose = 0.7
mg/kg over 168 hours); CYCLE LENGTH: 7 days; COURSE: 1 cycle
Consent
Verify Consent
Verify informed consent has been obtained.
Pre-Labs
CBC WITH DIFFERENTIAL
ONCE Starting when released, Routine
BUN
ONCE Starting when released
CREATININE
ONCE Starting when released, Routine
BILIRUBIN, TOTAL
ONCE Starting when released
AST/SGOT
ONCE Starting when released
ALT/SGPT
ONCE Starting when released
LD, TOTAL
ONCE Starting when released
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC with DIFF, BUN, Creatinine, Total Bilirubin, AST, ALT, LDH.
Treatment Parameters
Hold and notify authorizing prescriber for Creatinine greater than ULN.
Nursing Procedure, Assessment and Monitoring
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 % infusion
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Zztestonc,Fiona F [2462287]
12/2/2016 3:21:40 PM Page 1 of 2
Copyright © 2016 University of Wisconsin Hospitals and Clinics Authority

at 20 mL/hr, Intravenous, ONCE, 1 dose Starting when released
To establish line and for flushing.
Treatment Medications
cladribine (LEUSTATIN) 14 mg in sodium chloride 0.9 % 500 mL bag
14 mg (rounded from 13.8 mg = 0.1 mg/kg × 138 kg Treatment plan recorded weight), Intravenous, EVERY 24 HOURS, 7 doses
Starting when released
Days 1 through 7: Each bag to run as a continuous infusion over 24 hours. Dose = 0.1 mg/kg/day: Total dose= 0.7 mg/kg over 168
hours.
Take Home Medications
ondansetron (ZOFRAN) 8 MG tab
Take 1 tab by mouth every 8 hours as needed for nausea/vomiting., 8 mg, Disp-30 tab, R-5, EVERY 8 HOURS PRN starting S,
Local Printer
Actions
Actions
Actions
Actions
Zztestonc,Fiona F [2462287]
12/2/2016 3:21:40 PM Page 2 of 2
Copyright © 2016 University of Wisconsin Hospitals and Clinics Authority