Drug Card for Filgrastim
Brand name: Neupogen
Classification: Therapeutic: Colony-stimulating factors
Indications: Prevention of febrile neutropenia and associated infection in patients who have recevied bone marrow-depressing antineoplastics. Action: Glycoprotein that binds to and stimulates immature neutrophils to divide and differentiate Pharmacokinetics: Well absorbed with subQ. Distribution, and metabolism and excretion are unknown. Half life is 3.5 hours Time: Route is IV or SubQ. Onset is unknown, Peak is unknown, duration 4 days Contraindiacted: hypersensitivity to filgrastim or E-Coli-derived proteins Side effects: excessive leukocytosis, pain, redness at injection site, medullary bone pain Drug-Drug interactions: Simulataneous use with antineoplastics . Avoid for 24 hours before and after chemo. Lithium may potentiate the release of neutrophils Route/Dosage: IV subQ. After myelosuppressive Chemo: 5mcg/kg/day as single dose for up to 2 weeks. Can be increased by 5mcg/kg during each cycle of chemo. After bone marrow transplant: 10 mcg/ky/day as a 4 or 24 hour infusion or as a continuous subQ infusion. Implications: Monitor vitals before and during, assess bone pain Lab considerations: Obtain a CBC with diff and platelet count before chemo and after chemo, and twice weekly during therapy. Monitor ANC. A rise may be seen 1-2 days after initiation of therapy, but therapy should not be discontiuned until ANC is greater than 10,000/mm. May cause decreased platelets, and transient increases in uric acid, LDH, and alkaline phosphatase concentrations. Nsg Diagnosis: Risk for pain, Risk for infection, Risk for bleeding Implementation: Do not give any earlier than 24 hour after chemo and bone marrow infusion. Refrigerate. Do not shake, if dose requires greater than 1 ml of solution, can be divided into two injections Teaching: Teach how to give injection. Teach not to reuse same needle, and proper handling of used needles. References:
Deglin, J. H., &...
References: Abrams, A.C., Pennington, S.S., Lammon C.B. (2009) Clinical drug therapy: rationales for nursing practice (9th ed.) Philadelphia, PA: Lippincott, Williams, & Wilkins.
Fatigue. (2011, November 11). Retrieved from http://www.cancer.gov/cancertopics/pdq/supportivecare
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