Chemo Drugs that Require Pre-medications / rescue agents

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Irinotecan

premedicate with atropine for diarrhea
treat with loperamide for diarrhea

5-FU

treat diarrhea with loperamide
treat myelosupression with G-CSF (filgrastin, pegfilgrastim)
treat thrombocytopenia with platelet transfusion, RBC transfusion, Epo stimulating agents (Darbepoetin, epoetin)
Hold ice chips in mouth and admin palifermin for stomatitis

Docletaxel

use prophylactic dexamethasone (steroids) for edema

Vincristine

use heat packs for extravasation reaction

Vinblastine

use heat packs for extravasation reaction

Vinerelbine

use heat packs for extravasation reaction

Doxorubicin

use cold compress for extravasation reaction
use dexrazoxane to prevent cardiotoxicity

Daunorubicin

use cold compress for extravasation reaction
use dexrazoxane to prevent cardiotoxicity

Epirubicin

use cold compress for extravasation reaction

Idararubacin

use cold compress for extravasation reaction

Mitomycin

use cold compress for extravasation reaction
premedicate with dexamethasone, phenothiazine (compazine), 5HT3 Rc antagonist, neurokinine 1 antagonist, for delayed acute CINV nausea and vomiting.
treat with corticosteroids for pulmonary toxicity

Paclitaxel

use cold compress for extravasation reaction

premedicate with ranitidine, diphenhydramine, dexamethasone for hypersensitivity reaction

Mechlormethamine

use cold compress for extravasation reaction
premedicate with dexamethasone, phenothiazine (compazine), 5HT3 Rc antagonist, neurokinine 1 antagonist, for delayed acute CINV nausea and vomiting.

Cyclophosphamide

premedicate with hydration and Mesna for hemorrhagic cystits
treat myelosupression with G-CSF (filgrastin, pegfilgrastim)
treat thrombocytopenia with platelet transfusion, RBC transfusion, Epo stimulating agents (Darbepoetin, epoetin)
premedicate with dexamethasone, phenothiazine (compazine), 5HT3 Rc antagonist, neurokinine 1 antagonist, for delayed acute CINV nausea and vomiting.

Ifosfamide

premedicate with hydration and Mesna for hemorrhagic cystits
premedicate with dexamethasone, phenothiazine (compazine), 5HT3 Rc antagonist, neurokinine 1 antagonist, for delayed acute CINV nausea and vomiting.

Asparaginase

premedicate with ranitidine, diphenhydramine, dexamethasone for hypersensitivity reaction

Cisplatin

premedicate with ranitidine, diphenhydramine, dexamethasone for hypersensitivity reaction
premedicate with dexamethasone, phenothiazine (compazine), 5HT3 Rc antagonist, neurokinine 1 antagonist, for delayed acute CINV nausea and vomiting.
premedicate with hydration therapy for renal toxicity

Carboplatin

premedicate with ranitidine, diphenhydramine, dexamethasone for hypersensitivity reaction

Etoposide

premedicate with ranitidine, diphenhydramine, dexamethasone for hypersensitivity reaction

Tenoposide

premedicate with ranitidine, diphenhydramine, dexamethasone for hypersensitivity reaction

Alkylating Agents

treat myelosupression with G-CSF (filgrastin, pegfilgrastim)
treat thrombocytopenia with platelet transfusion, RBC transfusion, Epo stimulating agents (Darbepoetin, epoetin)

Methotrexate

treat myelosupression with G-CSF (filgrastin, pegfilgrastim)
treat thrombocytopenia with platelet transfusion, RBC transfusion, Epo stimulating agents (Darbepoetin, epoetin)
Leucovorin rescue agent for too much of this drug which can cause megaloblastic anemia
premedicate with hydration therapy for renal toxicity
Hold ice chips in mouth and admin palifermin for stomatitis

Cytarabine

premedicate with dexamethasone, phenothiazine (compazine), 5HT3 Rc antagonist, neurokinine 1 antagonist, for delayed acute CINV nausea and vomiting.

Bleomycin

treat with corticosteroids for pulmonary toxicity

Busulfan

treat with corticosteroids for pulmonary toxicity

Traztuzumab

treat with corticosteroids for pulmonary toxicity

Streptozocin

premedicate with hydration therapy for renal toxicity

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