chemotherapy order:

weight: ______Kg.  Height : _______cm.  m²:_______. Treatment courses: the ____courses.

l        Start C/T protocol if data (BUN Cr, GOT, Na, K, Cl, CBC, DC, Platelet, EKG) O.K.

l        On diet as tolerable.

l        Record vital signs q4h, record I/O q8h, body weight QD.

l        Set heparin lock with IV line

#1 D5S 500 c.c.    

#2 L-R 500 c.c.

#3 D5S 500 c.c.    

#4 L-R 500 c.c.

#5 N/S 500 c.c.                

alternatively run 125 c.c./hr.

Course 1

Day 1

l        Actinomycin D 0.5 mg IV bolus.

l        Etoposide 100 mg/m², total _____ mg in 250 cc N/S (#5 2nd half bottle) IV infusion 1 hr

l        MTX 100 mg/m², total _____mg IV bolus.

l        MTX 200 mg/m², total _____mg, divided in each #2, #3, #4 run 125 c.c./hr for 12 hrs.

Day 2:

l        Actinomycin D 0.5 mg IV push.

l        Etoposide 100 mg/m², total ____ mg in 250 c.c. N/S IV infusion 1 hr.

l        Folinic acid 15 mg IM ql2h x 4 doses beginning 24 hours after starting MTX.

l        Check CBC, DC, Platelet, BUN, Cr, GOT, Na, K, Cl, QD.

Course 2 (the 8th day)

Day 1

1.        Vincristine 1.0 mg/m², total _____ mg IV bolus.

2.        Cyclophosphamide 600 mg/m² in 100 c.c. N/S IV infusion over 30 minutes.

l        Novamin 1 Amp IM q4h prn.

l        Dexamethasone 10 mg iv prn, then q4h x 3 doses.

l        Check BUN Cr, GOT, Na, K, Cl, CBC, DC, Platelet QD.

l        Please notified Dr. if urine < 200cc/8hrs, high fever, conscious change, or dyspnea.

l        Oral medications:

(a)Primperan 3# qid.

(b)Ativan 1# qid prn nausea or emesis.