jodpers

OK to put this in context I am replying from Australia. I work on an oncology unit that also at times has to administer antineoplastic therapies on other wards and our practice is to treat all therapies the same. Also to add to this the Cancer Nurses Society of Australia put out a statement several years ago in relation to the administration of immunotherapies that basically said that due to the newness of these therapies and therefore the lack of long term data on incidental exposure to these agents that they should be treated the same as cytotoxic chemotherapies. In other words best to be safe than sorry and treat it like chemotherapy. We also wouldn't let anyone administer this that hasn't done appropriate courses to be qualified to administer this type of therapy. Hope this helps

We always hang the doxorubicin first then the cyclophosphamide. Rationale is simple doxorubicin is a vesicant so likely to do more damage if it extravasates so it needs to be given while you are sure the line is still good and Cyclophosphamide is an irritant so not such a drama. This is especially important if the patient has a peripheral line in but we still follow a policy of giving vesicants before irritants if the patient has a central line as it's all about safety for the patient. I work in a small private hospital and the doctors don't always have specific orders regarding in what order the chemo is to be given. Hope this helps