Chemotherapy monitoring

During chemotherapy, monitor myeloma monoclonal protein in urine and serum, renal function, hemoglobin, and platelets. 

Dicoumarol, warfarin + sulfadimethoxine, sulfamethoxypyridazine, sulfaphenazole Increased anticoagulant blood levels with risk of haemorrhage Displacement from protein by strongly bound sulfonamide Use alternative chemotherapy. Monitor patient with initiation of cessation of therapy... 

Clinicians should play a role in chemotherapy safety, patient education, and monitoring patient response to therapy. For example, cumulative doses of anthracyclines should be monitored along with signs and symptoms of heart failure. Clinicians also should monitor concurrent medications along with chemotherapy for drug interactions. 

What should be monitored while she is receiving her chemotherapy ... 

Monitor patient for other known toxicities of the chemotherapy regimen, and decrease the dose or discontinue the regimen if necessary. 

Early breast cancer is resected completely with curative intent, and adjuvant chemotherapy and hormonal therapy are initiated to prevent recurrence. During adjuvant chemotherapy, laboratory values to monitor chemotherapy toxicity are obtained prior to each cycle of chemotherapy. After completion of adjuvant therapy, patients are monitored every 3 months for the first few years after diagnosis, with intervals between exams extended as time from diagnosis lengthens. 

Monitor patients for chemotherapy-associated toxicity, and recommend appropriate management. 

Laboratory monitoring is performed before initiating therapy and before each cycle of chemotherapy. A complete blood count should be obtained prior to each course of chemotherapy to ensure that hematologic values are adequate. In particular, white blood cell counts and absolute neutrophil counts can be decreased in patients receiving chemotherapy such as irinote-can and 5-FU and increase the risk of infection. Baseline liver function tests and an assessment of renal function should be done prior to and periodically during therapy. Other selected laboratory tests include checking for the presence of protein in the urine in patients receiving oxaliplatin and bevacizumab. 

Long-term follow-up monitors patients for continued disease remission or relapse with careful physical examination of the lymph nodes and sites of prior disease involvement and imaging studies. Patients will have routine chest x-rays and CT scans administered to screen for recurrence of disease. Patients require long-term monitoring for toxicities of their primary treatment, either chemotherapy or radiation therapy. 

Monitor patient for signs of response of tumor to chemotherapy. 

Overall survival is affected by the success of the initial surgery to debulk the tumor to less than 1 cm of disease and response to first-line chemotherapy. The CA-125 level should be monitored with each cycle, and at least a 50% reduction in CA-125 after four cycles of taxane/platinum chemotherapy is related to an improved prognosis. Patients who achieve a complete response should have follow-up examinations every 3 months, including CA-125 determination, physical examination, pelvic examination, and appropriate diagnostic scans (e.g., CT scan, MRI, or PET scan) and should be evaluated for the detection of disease. Evaluate patients for resolution of any residual chemotherapy-related side effects, including neuropathies, nephrotoxicity, ototoxicity, myelosuppression, and nausea/vomiting. 

Monitor the patient for signs of hypersensitivity reactions to taxane or platinum chemotherapy regimens. 

The major measure of outcome of treatment of SVCS is the relief of symptoms, regardless of the therapy used. SVC stenting provides rapid relief of symptoms within 1 to 7 days of stent placement.15 Patients who receive chemotherapy and/or radiotherapy generally will experience symptom relief within 1 to 2 weeks. Monitor the patient for relief of symptoms by... 

Treatment involves surgical removal of one or both ovaries, the uterus, and fallopian tubes. Radiation is also commonly employed, which may consist of placing a radioactive liquid in the abdomen. Sometimes chemotherapy is also used along with CA 125 monitoring in response to therapy. 

To optimize chemotherapy administration, the clinician must identify, monitor, treat, and prevent or minimize treatment-related toxicity. Pertinent laboratory data and other procedures should be reviewed to establish a baseline for monitoring purposes. Major organ and system toxicities to be monitored include hematologic, neurologic, skin, pulmonary, GI, renal, and cardiac. 

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