Canterbury health limited (haematology department)




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CANTERBURY HEALTH LIMITED (HAEMATOLOGY DEPARTMENT)

Page of


MACOP - B

DELIVER TO: 

Patient Category:

Y J A P O 1 3 Z



OSP Group:

1 2 3 4 5 6 7



Doctors Name:      

NZMC Reg. No.:      

Special Authority Number:

     

     

Antiemetics

Ondansetron 8mg po 1hr prior chemotherapy

Metoclopramide 10mg Q6H for 24 hrs.

 Cyclizine 50mg PO/IV TDS prn



Weight      kg

Height      cm

BSA      m2




Dose Modified






Cycle: Repeat for 3 cycles

ADMINISTRATION USE

DAY

DATE

TIME

CHEMOTHERAPY AGENT

DOSE

ROUTE

INSTRUCTIONS

DR SIGN

GIVEN BY

CHECK

TIME

1

     

    

Prednisone 75mg daily

75mg

PO

Prescribe on QMR4/outpatient script(taper from day 70 over last 15 days)




    

Doxorubicin 50mg/m2

     mg

IV

Slow push into fast running 0.9S
















    

Cyclophosphamide 350mg/m2

     mg

IV

Infused in 100ml 0.9S over 30mins













8

     

    

Vincristine 1.4mg/m2 (max 2mg)

     mg

IV

In 50mL 0.9S, free run over 10 mins
















    

Methotrexate 100mg/m2

     mg

IV

Slow push into fast running 0.9S
















    

Methotrexate 300mg/m2

     mg

IV

Infuse in 500ml 0.9S over 4 hours













9

     

+28hrs

    


Folinic acid 15mg q6h

     mg

PO

Prescribe on outpatient prescription or QMR4 for six doses starting 24hrs after the end of methotrexate infusion.

15

     

    

Doxorubicin 50mg/m2

     mg

IV

Slow push into fast running 0.9S
















    

Cyclophosphamide 350mg/m2

     mg

IV

Infused in 100ml 0.9S over 30mins













22

     

    

Vincristine 1.4mg/m2 (max 2mg)

     mg

IV

In 50mL 0.9S, free run over 10 mins
















    

Bleomycin 10 000IU/m2

     mg

IV

Slow push into fast running 0.9S













Chemotherapy rounding: doxorubicin 5mg, cyclophosphamide 20mg, vincristine 0.2mg,methotrexate LD 5mg HD 100mg, bleomycin 3000units

Note: •Full details of this protocol are in the Red Book and must be consulted before this prescription chart is completed

Authorised by Clinical Director: S Gibbons Pharmacist: B Harden

20 November 2007



Ref: 2000



CHEMOTHERAPY

MEDICATION

CHART
C260070










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