Chemotherapy Patient Monitor,Vomiting,Chemotherapeutic Agents Mangement

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Chemotherapy- General Guidelines

Pediatrics Oncology in Children

Chronic Leukemias

Thyroid Malignancies in Children

Retinoblastoma

Hodgkin's Lymphoma

Non-Hodgkin's Lymphoma

Cancer Patients In Remission Follow up

Solid Tumors

Childhood Leukemia

Congenital Leukemia and Hypoplastic Preleukemia

Infection Control in Cancer Patients

How to Diagnose Pediatric Cancer

Wilm's Tumor

Acute Lymphoblastic Leukemia (ALL)

Chemotherapy- General Guidelines

Acute Myeloid Leukemia (AML)

Oncologic Emergencies

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

CHEMOTHERAPY- GENERAL GUIDELINES

Related topics

Chemotherapeutic Drugs Types and Agents

Chemotherapeutic Agents in Cell Cycles and Its Side Effects

Dr Ira Shah
M.D, DCH(Gold Medalist), FCPS, DNB
Edited by Dr. Bharat R Agarwal
Consultant Pediatric Hematologist and Oncologist.

Q. How do you monitor a patient on chemotherapy?

A. Most of the drugs depress the bone marrow. The bone marrow function can be assessed by doing the blood cell counts (RBC counts, Hemoglobin, Platelet count, white cell count etc). The blood counts may fall at any time during the treatment or soon after that (usually about a week following intensive regimes). Blood counts should be checked ideally every day during intensive treatments and once in a week during maintenance treatments. Usually, the drugs are given only if the absolute neutrophil count is above 1000/cumm (some centers take 1500/cumm as the lower limit) and platelet count above 100,000/cumm. However, during induction phase in Acute leukemia, treatment should continue as far as possible to prevent the inhibitory effect of the blast cell on the normal cell population in the bone marrow.

Q. How do you deal with a patient with excessive vomiting due to chemotherapy?

A. Most chemotherapeutic agents produce vomiting for about 24 hours or a little longer. The various anti-emetics used are :

Metaclopramide
Dexamethasone
Ondansteron

Antiemetic therapy should begin before the chemotherapy starts and not after the patient has started vomiting.

Q. How do you manage extravasation while giving these agents intravenously?

A. Ideally for intravenous injection, a veinflon or a butterfly needle should be used. Metacarpal veins on the dorsum of the hand are usually preferred. Bruised and inflamed areas should be avoided. Each vein should be tested with normal saline before injecting chemotherapy and should be well flushed after administration.

If there is any leakage of vesicant drugs into the tissue, these will be severe necrosis and ulceration. Extravasation should be suspected if :

Swelling arises at the site of the needle.
The patient complains of a sharp stinging or burning sensation around the needle or cannula site.
No blood is obtained with pull on the syringe.
Resistance is felt on the plunger of syringe during bolus administration.
Free flow of fluid is absent if an infusion is in progress.

If these signs are present, then stop administration immediately. Withdraw any solution by pulling back on syringe. Remove the needle. Cover site with icepack. Inject hydrocortisone or dexamethasone around the entire area twice daily until all redness disappears. If very severe, then fasciotomy may be required.

Q. Who should give these chemotherapeutic agents?

A. Cytotoxic agents should not be prescribed by physicians inexperienced in their use. It should be given by specialized pediatric oncologists at pediatric oncology centres.

Last created on 13-07-2001
Last updated on 01-07-2006

Mail To Your Friend

Print This Article

TOP SEARCH TERMS

Chronic Myelogenous Leukemia

Thyroid Malignancies

Retinoblastoma

Hodgkin's Lymphoma

Non Hodgkin's Lymphoma (NHL)

Post Cancer Patient Follow Up

Solid Tumors and its Types

Childhood Leukemia

Congenital Leukemia & Hypoplastic Preleukemia

Infection Control in Cancer Patient

Pediatric Cancer Diagnosis

Wilms Tumor (Nephroblastoma)

Acute Lymphoblastic Leukemia

Chemotherapy General Guidelines

Acute Myeloid Leukemia

Oncologic Emergencies and its Types

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Head circuferences Calculator

Mid parental height Calculator

Body surface area Calculator

BMR Calculator

Temperature Calculator

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids