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25/01/2013CCO Eligibility Form Required ¨ Grey STR
CLINICAL MONITORING:
CISPLATIN-ETOPOSIDE Chemotherapy
- Oral examination upon patient complaint of a sore mouth.
CISPLATIN
1. Asymptomatic; loss of deep tendon reflexes or paresthesia (including tingling) but not interfering with function 2. Sensory alteration or paresthesia (including tingling), interfering with function, but not interfering with ADL 3. - Mix in 500mL bag Normal Saline; Infuse over 60 minutes.
Sensory alteration or paresthesia interfering with ADL 4. Disabling 5. Death ETOPOSIDE
1. Asymptomatic, detected on exam/testing only 2. Symptomatic, not - Dose < or =200mg, mix in 500mL Normal Saline; Infuse over 30-60
minutes.
3. Symptomatic, interfering with ADL 4. Life-threatening; disabling 5. - Dose > 200mg, mix in 1000mL Normal Saline; Infuse over 1 to 2 hours.
- Adjust rate if blood pressure drops.
ANTIEMETIC PRE-CHEMO REGIMEN:
- Give Etoposide BEFORE Cisplatin, to hydrate patient.
REPEAT EVERY 21 DAYS For a Total of 4 Cycles - Ondansetron 8mg PO/IV or Granisetron 1mg PO/IV PATIENT VISITS and APPOINTMENT TYPE:
ANTIEMETIC TAKE-HOME REGIMEN:
Level B/C
HYDRATION:
- Ondansetron 8mg PO BID for 2-3 days, or Granisetron 1mg PO 12 hours post chemotherapy, then 2mg PO OD for 2-3 days - Infuse 1000mL Normal Saline with 20mEq Potassium Chloride IV over 1
hour on Days 1-2.
Concurrent:
TOXICITIES:
- Physician may order 250mL of 20% Mannitol solution (50G Mannitol) IV. Hematologic
Infuse through sidearm concurrent with Cisplatin (may give Furosemide 1. If ANC < 1.5 x 109/L, or if PLT < 75 x 109/L, HOLD dose for 1 week.
Renal Failure
1. If CrCl = 0.5-1.0mL/sec, or SrCr = 136-185umol/L, REDUCE Cisplatin to - Infuse 500mL Normal Saline with 10mEq Potassium Chloride IV (2G
50% dose, and Etoposide to 75% dose.
Magnesium Sulfate may also be ordered) over 1 hour after Cisplatin on Days 2. If CrCl < 0.5mL/sec, or SrCr > 185umol/L, OMIT Cisplatin dose.
3. If CrCl < 0.2mL/sec, REDUCE Etoposide to 50% dose.
Hepatic Dysfunction
Baseline Tests - WBC HB PLT ANC K Na Chloride Mg Glucose
1. If T.Bili = 26-51umol/L, or AST = 60-180 IU/L, REDUCE Etoposide to 25%
- WBC HB PLT ANC Cr Urea
2. If T.Bili = 52-85umol/L, REDUCE Etoposide to 50% dose.
Test Notes:
3. If T.Bili > 85umol/L, or AST > 180 IU/L, OMIT Etoposide dose.
- Baseline & routine renal function tests, especially if there are other FORMULAE:
Male: [140-age(yrs)] x TBW(Kg) / [50 x SCr(umol/L)] Female: [140-age(yrs)] x TBW(Kg) / [50 x SCr(umol/L)] x 0.85 Baseline Tests - WBC HB PLT ANC K Na Chloride Mg Glucose
- WBC HB PLT ANC Cr Urea
Baseline Tests - WBC HB PLT ANC K Na Chloride Mg Glucose
- WBC HB PLT ANC Cr Urea

Source: http://jcc.hhsc.ca/workfiles/PHARMACY/CN-CISP-ETOP.pdf