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1. 1/2NS 1000 ml IVD 4-6 hrs for hydration 2. Furosemide 20 mg IVA 10 min at the last 200 ml 1/2NS of hydration 3.Dexamethasone 10 mg or Betamethasone.

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Presentation on theme: "1. 1/2NS 1000 ml IVD 4-6 hrs for hydration 2. Furosemide 20 mg IVA 10 min at the last 200 ml 1/2NS of hydration 3.Dexamethasone 10 mg or Betamethasone."— Presentation transcript:

1 1. 1/2NS 1000 ml IVD 4-6 hrs for hydration 2. Furosemide 20 mg IVA 10 min at the last 200 ml 1/2NS of hydration 3.Dexamethasone 10 mg or Betamethasone 8 mg IVA 10 mins at 30 mins before chemotherapy 4.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5.Aprepitant cap 80 mg PO QD x 3 days 6.Gemcitabine 1200 mg/m2 in NS 100 ml IVD for 30 mins 7. Cisplatin 75 mg/m2 in NS 500 ml IVD for 2 hr 8.1/2NS 500ml IVD 2 hrs 9. If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st ( Total IV volume: 1/2NS: 1500 ml, NS: 600 ml) GC

2 GCar 1. NS 500 ml IVD keep line for chemotherapy 2.Dexamethasone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5. Gemcitabine 1200 mg/m2 in NS 100 ml IVD for 30 mins 6. Carboplatin AUC =6 【 dose=AUC X (CCr+25) 】 in NS 250 ml IVD for 1 hr 7. Run out the remaining NS (Total IV volume: NS: 850ml)

3 G 1. NS 500 ml IVD keep line for chemotherapy 2.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR ( 自費 ) Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5. Gemcitabine 1200 mg/m2 in NS 100 ml IVD for 30 mins 6. Run out the remaining NS ( Total IV volume: NS: 500 ml)

4 NC (Q3W) 1. 1/2NS 1000 ml IVD 4-6 hrs for hydration 2.Furosemide 20 mg IVA 10 mins at the last 200 ml 1/2NS of hydration 3. Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 4.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5.Aprepitant cap 80 mg PO QD x 3 days 6.Vinorelbine 25 mg/m2 in NS 100 ml IVD for 10 mins 7.Cisplatin 75 mg/m2 in NS 500 ml IVD for 2 hr 8.1/2NS 500 ml IVD 2 hrs 9.If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st ( Total IV volume: 1/2NS: 1500 ml, NS: 600ml)

5 NCar 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 4. Vinorelbine 25 mg/m2 in NS 100ml IVD for 10 mins 5. Carboplatin AUC = 6 【 dose=AUC X (CCr +25) 】 in NS 250 ml IVD for 1 hr 6. Run out the remaining NS (Total IV volume: NS: 850ml)

6 1. NS 500 ml IVD keep line for chemotherapy 2.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR ( 自費 ) Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5. Vinorelbine 25 mg/m2 in NS 100 ml IVD for 10 mins 6. Run out the remaining NS N ( Total IV volume: NS: 500 ml)

7 1. Vinorelbine (oral): 75 mg/m2 (30mg #, 20mg #) 2. 1/2NS 1000 ml IVD 4-6 hrs for hydration 3. Furosemide 20 mg IVA 10 mins at the last 200 ml 1/2NS of hydration 4.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 5.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 6.Aprepitant cap 80 mg PO QD x 3 days 7.Cisplatin 75 mg/m2 in 500 ml NS IVD for 2 hr 8.1/2NS 500ml IVD 2 hrs 9.If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st Oral N+C ( Total IV volume: 1/2NS: 1500ml, NS: 500ml)

8 Oral N+Carbo 1.Vinorelbine (oral): 75 mg/m2 (30mg #, 20mg #) 2.NS 500 ml IVD keep line for chemotherapy 3.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 4.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5.Carboplatin AUC = 6 【 dose=AUC X (CCr +25) 】 in NS 250 ml IVD for 1 hr 6.Run out the remaining NS (Total IV volume: NS: 850ml)

9 Oral N (Oral dose= IV dose x 2.5 ) 1. Vinorelbine (oral): 75 mg/m2 (30mg #, 20mg #)

10 NC (Weekly) 1. 1/2NS 500 ml IVD for hydration 2.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 4.Vinorelbine 25 mg/m2 in 1/2NS 100 ml IVD for 10 mins 5.Cisplatin 40 mg/m2 in NS 500 ml IVD for 2 hr 6.1/2NS 500 ml IVD for 2 hrs 7.If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st ( Total IV volume: 1/2NS: 1000 ml, NS: 500ml)

11 1.1/2NS 1000 ml IVD 4-6 hrs for hydration 2.Furosemide 20 mg IVA 10 mins at the last 200 ml 1/2NS of hydration 3. Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 4 Chlorampheniramine 5 mg IVA 10 mins at 30 mins before chemotherapy 5 Ranitidine 50 mg or Famotidine 20 mg IVA 15 mins at 30 mins before chemotherapy 6Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 7Aprepitant cap 80 mg PO QD x 3 days 8 Paclitaxel 175 mg/m2 in D5W 250 ml glass bottle x2 IVD with 0.22 um microfilter and NTG tube for 3 hrs ( if it is the first time, paclitaxel should be infused with EKG monitoring ) 9Cisplatin 75 mg/m2 in NS 500ml IVD for 2 hr 101/2NS 500ml IVD 2 hrs 11If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st Q3W TaC ( Total IV volume: 1/2NS: 1500 ml, NS: 500 ml, D5W: 250 ml x2)

12 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3 Chlorampheniramine 5 mg IVA 10 mins at 30 mins before chemotherapy 4 Ranitidine 50 mg or Famotidine 20 mg IVA 15 mins at 30 mins before chemotherapy 5 Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 6. Paclitaxel 175 mg/m2 in D5W 250 ml glass bottle x2 IVD with 0.22 um microfilter and NTG tube for 3 hrs ( if it is the first time, paclitaxel should be infused with EKG monitoring ) 7. Carboplatin AUC = 6 【 dose=AUC X (CCr +25) 】 in NS 250 ml IVD for 1 hr 8. Run out the remaining NS Q3W TaCarbo ( Total IV volume: NS: 750 ml, D5W: 250 ml x2)

13 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3 Chlorampheniramine 5 mg IVA 10 mins at 30 mins before chemotherapy 4 Ranitidine 50 mg or Famotidine 20 mg IVA 15 mins at 30 mins before chemotherapy 5 Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR ( 自費 ) Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 6. Paclitaxel 80 mg/m2 in D5W 250 ml glass bottle IVD with 0.22 um microfilter and NTG tube for 1 hr ( if it is the first time, paclitaxel should be infused with EKG monitoring ) 7. Run out the remaining NS Weekly Taxel ( Total IV volume: NS: 500 ml, D5W: 250 ml)

14 1. 1/2NS 1000 ml IVD 4-6 hrs for hydration 2. Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Chlorampheniramine 5 mg IVA 10 mins at 30 mins before chemotherapy 4.Ranitidine 50 mg or Famotidine 20 mg IVA 15 mins at 30 mins before chemotherapy 5.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR ( 自費 ) Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 6. Paclitaxel 80 mg/m2 in D5W 250 ml glass bottle IVD with 0.22 um microfilter and NTG tube for 1 hr ( if it is the first time, paclitaxel should be infused with EKG monitoring ) 7. Cisplatin 25 mg/m2 in NS 500ml IVD for 2 hr 8. 1/2NS 500ml IVD 2 hrs Weekly TaC ( Total IV volume: 1/2NS: 1500 ml, NS: 500 ml, D5W: 250 ml)

15 Taxotere+ Cisplatin, Q3W 1.1/2NS 1000 ml IVD 4-6 hrs for hydration 2.Furosemide 20 mg IVA 10 mins at the last 200 ml 1/2NS of hydration 3.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 4.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5.Aprepitant cap 80 mg PO QD x 3 days 6. Taxotere 60 mg/m2 in NS 250 ml IVD for 1 hr 7.Cisplatin 75 mg/m2 in NS 500 ml IVD for 2 hr 8.1/2NS 500 ml IVD 2 hrs 9. If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st ( Total IV volume: 1/2NS: 1500 ml, NS: 750 ml)

16 Taxotere+ Carboplatin, Q3W 1. NS 500 ml IVD keep line for chemotherapy 2.Dexamethasone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5. Taxotere 60 mg/m2 in NS 250 ml IVD for 1 hr 6. Carboplatin AUC =6 【 dose=AUC X (CCr+25) 】 in NS 250 ml IVD for 1 hr 7. Run out the remaining NS (Total IV volume: NS: 1000ml)

17 1.NS 500 ml IVD keep line for chemotherapy 2.Dexamethasone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR ( 自費 ) Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 4. Docetaxel 40 mg/m2 in NS 250 ml IVD for 1 hr 5. Run out the remaining NS Weekly Taxotere alone, Q3W ( Total IV volume: NS: 500ml)

18 Alimta, Q3W 1.NS 500 ml IVD keep line for chemotherapy 2.Dexamethsone 10 mg or Betamethasone 8mg IVA 10 mins at 30 mins before chemotherapy 3.Metoclopramide 20 mg IVA 15 mins + Biperiden 2 mg p.o OR ( 自費 ) Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 4. Pemetrexed 500 mg/m2 in NS 100ml IVD for 10 mins st 5. Run out the remaining NS ( Total IV volume: NS: 500ml)

19 1.1. 1/2 NS 1000 ml IVD 4-6 hrs for hydration 2.2. Furosemide 20 mg IVA × 10 mins at the last 200 ml NS of hydration 3.Dexamethasone 10 mg or Betamethasone 8 mg IVA 10 mins at 30 mins before chemotherapy 4.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or alonosetron 0.25 mg IVA × 10 mins at 15 mins before chemotherapy 5.Aprepitant cap 80 mg PO QD x 3 days 6.Cisplatin 75 mg/m 2 in NS 500 ml IVD × 2 hr 7.Etoposide (VP-16) 75 mg/m 2 in NS 500 ml IVD × 2 hrs 8. 1/2NS 500 ml IVD 2 hrs 9. If I>O more than 1500 ml or body weight increase over 1 kg per day, Furosemide 20 mg IVA 10 mins st Cisplatin + VP-16 (EP) ( Total IV volume: 1/2 NS: 1500 ml, NS: 1000 ml)

20 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethasone 10 mg or Betamethasone 8 mg IVA × 10 mins at 30 mins before chemotherapy 3. Metoclopramide 20 mg IVA × 15 mins at 15 mins before chemotherapy 4. Carboplatin AUC =6 【 dose=AUC X (CCr+25) 】 in NS 250 ml IVD for 1 hr 5. Etoposide (VP-16) 75 mg/m 2 in NS 500 ml IVD × 2hrs 6. Run out the remaining NS Carboplatin + VP-16 (CarE) ( Total IV volume: NS: 1500ml)

21 VP-16 (E) 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethasone 10 mg or Betamethasone 8 mg IVA × 10 mins at 30 mins before chemotherapy 3. Metoclopramide 20 mg IVA 10 mins at 15 mins before chemotherapy 4. Etoposide (VP-16) 75 mg/m 2 in NS 500 ml IVD × 2 hrs 5. Lorazepam 1 mg p.o. hs 6. Run out the remaining NS ( Total IV volume: NS: 1000ml)

22 Oral VP-16 (Oral E) Oral Etoposide 50mg QD × 10 days

23 Ifosfamide (I) 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethasone 10 mg or Betamethasone 8 mg IVA × 10 mins at 30 mins before chemotherapy 3. Metoclopramide 20 mg IVA × 15 mins at 15 mins before chemotherapy 4. Ifosfamide 1000 mg/m2 in NS 500 ml IVD × 2hrs 5. Uromitexan 400mg add in NS 100 ml for IVD× 30 mins q2h × 3 doses (at 0,2,4 hrs after Ifosfamide) 6. Lorazepam 1 mg hs ( Total IV volume: NS: 2000ml)

24 Topotecan + Epirubicin (TE) 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethasone 10 mg or Betamethasone 8 mg IVA × 10 mins at 30 mins before chemotherapy 3. Metoclopramide 20 mg IVA × 15 mins at 15 mins before chemotherapy 4. Topotecan 1.5 mg/m 2 IVD in NS 100 ml × 30 mins 5. Epirubicin 30 mg/m 2 in NS 500 ml IVD× 2 hrs 6. Run out the remaining NS ( Total IV volume: NS: 1000ml)

25 Topotecan (T) 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethasone 10 mg or Betamethasone 8 mg IVA × 10 mins at 30 mins before chemotherapy 3. Metoclopramide 20 mg IVA × 15 mins at 15 mins before chemotherapy 4. Topotecan 1.5 mg/m 2 IVD in NS 100 ml × 30 mins 5. Run out the remaining NS ( Total IV volume: NS: 500 ml)

26 Pemetrexed + Cisplatin (Q3W) 1.1/2NS 1000 ml IVD 4-6 hrs for hydration 2.Furosemide 20 mg IVA 10 min at the last 200 ml 1/2NS of hydration 3.Dexamethasone 10 mg or Betamethasone 8 mg IVA 10 mins at 30 mins before chemotherapy 4.Granisetron 3 mg or Tropisetron 5 mg or Ondansetron 16 mg or Palonosetron 0.25 mg IVA 10 mins at 15 mins before chemotherapy 5.Aprepitant cap 80 mg PO QD x 3 days 6.Pemetrexed 500 mg/m2 in NS 100 ml IVD for 10 mins 7.Cisplatin 75 mg/m2 in NS 500 ml IVD for 2 hrs 8.1/2 NS 500ml IVD 2 hrs 9.If I>O more than 1500 ml or body weight increase over 1 kg per day, furosemide 20 mg IVA 10 mins st (Total IV volume: 1/2NS: 1500 ml, NS: 600 ml)

27 Pemetrexed + Carboplatin (Q3W) 1. NS 500 ml IVD keep line for chemotherapy 2. Dexamethasone 10 mg or Betamethasone 8 mg IVA 10 mins at 30 mins before chemotherapy 3. Metoclopramide 20 mg IVA 15 mins and biperiden 2 mg po st before chemotherapy 4. Pemetrexed 500 mg/m2 in NS 100 ml IVD for 10 mins 5. Carboplatin AUC=6 in NS 250 ml IVD for 1 hr 6. Run out the remaining NS (Total IV volume: NS 850 ml)

28 關 Aloxi 健保給付如下 serotonin antagonists (如 ondansetron 、 granisetron 、 tropisetron 、 ramosetron 、 palonosetron (Aloxi) 等) (93/2/1 、 93/9/1 、 98/9 /1 、 99/5/1) 1. 血液幹細胞移植患者接受高劑量化學治療時。 2. 惡性腫瘤患者及風濕免疫疾病(如紅斑性狼瘡、類風濕性關節炎、貝西氏症、皮肌炎 / 多發性肌炎、 硬皮症、血管炎等)患者接受化學治療時,依下述情形使用: (98/9 /1 、 99/5/1) (1) 前述患者處方高致吐性藥品,可預防性使用 ondansetron 8~32mg 、 granisetron 1~3mg 、 tropisetron 5mg 、 ramosetron 0.3mg 一日劑量。必要時,其使用以不得超過 5 日為原則。若發生嚴重延遲性嘔吐, 得直接使用,每療程使用不得超過 5 日為原則。 (2) 前述患者處方中致吐性藥品,可預防性使用 ondansetron 8~32mg 、 granisetron 1~3mg 、 tropisetron 5mg 、 ramosetron 0.3mg 一日劑量。若發生嚴重延遲性嘔吐,使用 dexamethasone 及 metoclopramide 無 效之病例,每療程使用以不得超過 5 日為原則。病歷須有使用 dexamethasone 及 metoclopramide 無效 之紀錄。 (3) 血液腫瘤病患接受化學治療,須使用中、高致吐性抗癌藥品時,得依患者接受抗癌藥品實際使用 天數使用本類製劑。 (93/9/1) (4) Palonosetron 限於中、高致吐化學治療之前使用。 (99/5/1) 1. 高致吐性藥品: cisplatin (>50mg/m 2 /day) , carmustine ( ≧ 250mg/m 2 /day) , cyclophosphamide (>1500mg/m 2 /day) , methotrexate ( ≧ 1.2gm/m 2 /day) 。 2. 中致吐性藥品: cisplatin ( ≧ 30mg/m 2 /day, ≦ 50mg/m 2 /day) , carmustine (<250mg/m 2 /day) , Cyclophosphamide ( ≦ 1500mg/m 2 /day) , doxorubicin ( ≧ 45mg/m 2 /day) , epirubicin ( ≧ 70mg/m 2 /day) , CPT-11 , idarubicin ( ≧ 10mg/m 2 /day) , daunorubicin ( ≧ 60mg/m 2 /day) , dactinomycin (actinomycin-D) , arsenic trioxide , melphalan ( ≧ 50mg/m 2 /day) , cytarabine , carboplatin , oxaliplatin , ifosfamide , mitoxantrone , dacarbazine 且其使用劑量為一般公認治療劑量或上述規定劑量時。 所以原則上 Aloxi 在 carboplatin 也有給付


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