Info

🌱 來自: HD-MTX containing regimen

examlpe of HD-MTX containing regimen

HD-MTX protocol

also look at R-MPV_WBRT_HD-AC

Daily IV Fluid

Set up IV line with N/S 500 ml IVF 每日一次 x 4 days for pre-medication, at (time) 12:05 (D1)09:00(D2-4)

Set up IV line with N/S 500 ml IVF 每日一次 x 2 days for chemotherapy drug, at (time) 12:05(D1)09:00(D2)

Pre-hydration

{ 5% Dextrose 3000 ml+ KCl (2 mEq/ml) 15 ml+ NaHCO3 (0.83 mEq/ml) 180 ml } IVF Continuously (Pre-Methotrexate)

Pre-medication

Granisetron 1 mg IV PUSH, 30 mins before Methotrexate

Chemotherapy

Methotrexate 3000 mg/m2 /D2

• give 4900 mg Mixed in 5% Dextrose 1000 ml IVF over 4 hrs, rate 299 ml/hr

• under urine PH ≧ 7.0 (Please divided half doses into 5% Dextrose 500 ml x 2 bags), at (time) 08:00(D2)

  and

Vincristine 1.4 mg/m2 /D1

• give 2 mg IV PUSH , at (time) 17:45(D1) and Mercaptopurine (專案進口) /D1-D7
• give 100 mg PO 每日一次 x 7 days , at (time) 13:00(D1)09:00(D2-7)

Post-hydration

{ 5% Dextrose 2000 ml+ KCl (2 mEq/ml) 10 ml+ NaHCO3 (0.83 mEq/ml) 120 ml } IVF over 16 hrs, rate 125 ml/hr , at (time) 12:00(D2)

n.b. 50mEq in 1000mL 水

{ 5% Dextrose 3000 ml+ KCl (2 mEq/ml) 15 ml+ NaHCO3 (0.83 mEq/ml) 180 ml } IVF over 24 hrs, rate 125 ml/hr 每日一次 x 2 days , at (time) 04:00(D3)

Others

Leucovorin 30 mg PO Q6H x 5 days , at (time) 06:00(D3)

Notation

Check urine pH at 21:00 (D1), 06:00 (D2) then BID (06:00, 18:00) Check MTX level at the 4 hrs(12:00_D2), 24 hrs(08:00_D3) and 48 hrs(08:00_D4) after the start of MTX infusion Check CBC/DC, BCS at 8AM on D4 Record U/O nad BW QD Please check HBsAg, Anti-HCV before first chemotherapy and follow up 6 months later.