l    PE :       chemotherapy order

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

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

On diet as tolerable.

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

Set up IV line on day 1 with

#1    D5W 500 cc.

#2    D5S 500 cc.

#3    D5W 500 cc.                   each run 500 c.c./hr.

#4　Cisplatin 100 mg/m², total _____ mg in 500 cc. N/S IV drip in 1 hr.

#5    20% mannitol 300 c.c. IV drip in 30 min.

#6,7        D5S 500 c.c.           run 500 cc./hr.

Antiemetics with

□ #2 100 cc,        #3 100 cc. left for antiemetic solvent

Zofran 8 mg in 100 cc D5S (#2) IV drip in 10 min.

Dexan 10 mg in 100 cc. D5W (#3) IV drip in 10 min.

(1),(2). at 30 min. before cisplatin begins and repeat q8h x 2 doses.

Etoposide 100 mg/m², total _____ mg in N/S 500c.c bottle on D1, D2, D3.

Akineton 1 Amp IM prn if EPS attack.

Novamin 1 Amp IM q4h prn.

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

Oral medications:

Primperan 3# qid.

Ativan 1# qid prn nausea or emesis.

Dexan 2# bid x 3 days, 1# bid x 2days.