Chemo drugs

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    I am a new ADON at a ALF. A resident is starting Xeloda tomorrow. Seven days on and seven days off. It has it's own mediset and I spoke with the med techs about wearing gloves and giving within 30 min of breakfast and dinner. The DON was with me when the family was giving us the medication. The MD educated the family regarding the side effects I did too. Still makes me very nervous about giving a chemo drug in a assisted living facility. We do not have nurses in house 24/7. Any advise?
  2. 6 Comments so far...

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    Yikes. In my facility, a chemo certified nurse has to verify the drug and the drug rights with another chemo certified nurse. Appropriate precautions are taken and an RN --not a med tech-- must provide the dose to the patient. Especially with PO chemo, patients must be taught how to dispose of their bodily fluids (chemotherapy can be excreted in sweat, urine, BMs, etc. for a certain amount of time based on the drug's half-life) and how to protect other people from exposure to the drug. Med techs? Part-time RN staffing? I'd be worried, too!
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    This drug was sent home by his oncologist. Drug is Xeloda only precaution is to use gloves when administering and must take within 30 minutes of breakfast and dinner. I work in a personal care home and we use med tech have a RN as DON and I am RN ADON. I seem to be the only one worried about this.
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    He starts this on Labor day I called the med techs and reviewed the precautions having them take vitals throughout the day. And they are to call me if he starts vomiting.
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    I understand you've reviewed the protocols. It's great that your patient has been educated and that the med techs working with you are willing to learn about the safety precautions for this drug. However, Xeloda is an antineoplastic agent and should be treated as nothing less. The side effects, as you've noted, are extensive and can be very rapidly deadly. Improper handling can be dangerous for both the patient and your staff.

    Xeloda is a brand name for capecitabine, a rather nasty chemo drug that I have administered myself to patients under my care. Its main excretion mode is through the urine (95% XELODA® (capecitabine)TABLETS ) and thus, anyone who comes into contact with the patient's urine needs to be aware of how to safely handle it. This includes anyone who has to change the patient (if bedbound) or even flush the patient's toilet.

    Those are just the basics. The big stuff--ie, how the assessment of a patient on chemo differs from your average patient--is absolutely vital. The small stuff--low grade fevers, a sore in their mouth, a little bit of fatigue, an ache or pain here or there--can be life threatening. I have no doubt that the folks you have on staff are very good at what they do, but this is a specialty for a reason. I went through a 3-day chemo course, final exam, 1 week in the chemo clinic and a 3 month orientation on my ward before I was allowed to give chemotherapy. It was rigorous for a very good reason. I have seen young, otherwise healthy patients in full remission die from chemotherapy literally overnight. I cannot imagine imposing a responsibility of this magnitude on anyone less than a trained and willing RN.
    Last edit by SoldierNurse22 on Sep 2, '12
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    Not sure what I can do. My DON was with me when the family gave us the drug. Did not say anything about care of urine just to use gloves when administering it and no pregnant caretakers. But we did not discuss with the general manager. I looked at the Xeloda website. Stated pt can even take med while at work. I will go check on resident tomorrow afternoon to see how he is.
  8. 0
    It is quite scary how LTC is expanding into areas that it is properly prepared for.


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