Assessment of the individual before starting treatment is necessary to identify and prevent treatment effects, provide a baseline measure to compare response, and ensure correct dosage and administration processes.1 Individual assessment involves:16, 25
- relevant diagnosis, medical and medication history
- drug allergies
- body parameters and laboratory values
- questions regarding compliance, treatment tolerance, and adverse events
- risk assessment of anaphylaxis or extravasation
- venous access.
Treatment protocol considerations:
- medication such as antiemetics should be given as per protocol to ensure effective therapeutic levels16
- cytoprotectants are used to prevent or reduce specific system toxicities while safeguarding the antineoplastic effects2
- drug sequencing
- test dosing.
Dose calculation considerations16
- the dose of a drug is generally based on the individual's body surface area (BSA) or weight
- a standardised method of calculation of the BSA26 should be used by all clinicians within a healthcare facility
- the use of printed tables and slide-rules for the calculation of the BSA is not recommended
- dose adjustments may be made in consideration of toxicities and factors affecting drug elimination.
Access the Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy(PDF, 213KB)16 , and summarise an individual's pre-treatment assessment using the framework provided in table 14.
Discuss specific pre-treatment considerations associated with administration of the following agents:
Identify two agents used as cytoprotectants and discuss the indications for their use.
Access the Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy (PDF, 213KB)16 , and:
- Appraise antineoplastic agents protocols in your facility in light of recommendations in the guidelines.
- Conduct an in-service for new nurses on how to utilise an antineoplastic agents protocol.
Access the medical record for a person who has received antineoplastic agents, and:
- Calculate the individual's BSA.
- Calculate dose requirements as per the protocol.