2.50
Hdl Handle:
http://hdl.handle.net/10755/164830
Category:
Abstract
Type:
Presentation
Title:
Chemotherapy Desensitization in the Outpatient Setting
Author(s):
Tully, Dorothy
Author Details:
Dorothy Tully, RN, BSN, Dana Farber Cancer Institute, Boston, Massachusetts, USA, email: dorothytully@dfci.harvard.edu
Abstract:
Education: A significant number of individuals with cancer are unable to obtain first line chemotherapy due to hypersensitivity reactions (HR) that are unmanageable with standard pre medications. Consequences are often that patients are unable to receive a potentially life-saving therapeutic regimen. Rapid desensitization (RD), in the form of a 12-step protocol, creates a temporary toleration of the chemotherapy drug, allowing patients to receive the full chemotherapy regimen, often increasing life expectancy and quality of life. The purpose of this presentation is to educate oncology nurses about the outpatient desensitization process and the associated risks and benefits. The rapid desensitization protocol was developed by Dr. Marina Castells, an allergist at Brigham and Women's Hospital. To safely administer the protocol in the outpatient setting a nursing policy was developed. The protocol and premedications are individualized and based on the patients previous history of reactions. Premedications may be a combination of antihistamines, H2 inhibitors, steroids, aspirin and or Montelukast Sodium. The 12 step desensitization protocol consists of the increasing titration of 3 different concentrations of drug over approximately 6 hours. Continuous observation and patient assessment allow for early identification and intervention to reactions. The first step in the management of a reaction is to stop the drug and administer appropriate medication, per desensitization protocol. Intervention is based upon the type of reaction, described as mild or severe. The infusion is resumed once the reaction has resolved or subsided. Throughout 413 desensitizations performed, 94% induced only mild or no reactions. No life-threatening HSRs or deaths occurred during the procedure, and all patients received their full target dose. The protocol, guidelines and policy at DFCI/BWH allow the nurses to successfully and safely administer first line chemotherapy on outpatient basis. Sharing our knowledge of this process with other Oncology Nurses can be beneficial to many oncology patients who have allergies and are unable to receive first line therapy.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleChemotherapy Desensitization in the Outpatient Settingen_GB
dc.contributor.authorTully, Dorothyen_US
dc.author.detailsDorothy Tully, RN, BSN, Dana Farber Cancer Institute, Boston, Massachusetts, USA, email: dorothytully@dfci.harvard.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/164830-
dc.description.abstractEducation: A significant number of individuals with cancer are unable to obtain first line chemotherapy due to hypersensitivity reactions (HR) that are unmanageable with standard pre medications. Consequences are often that patients are unable to receive a potentially life-saving therapeutic regimen. Rapid desensitization (RD), in the form of a 12-step protocol, creates a temporary toleration of the chemotherapy drug, allowing patients to receive the full chemotherapy regimen, often increasing life expectancy and quality of life. The purpose of this presentation is to educate oncology nurses about the outpatient desensitization process and the associated risks and benefits. The rapid desensitization protocol was developed by Dr. Marina Castells, an allergist at Brigham and Women's Hospital. To safely administer the protocol in the outpatient setting a nursing policy was developed. The protocol and premedications are individualized and based on the patients previous history of reactions. Premedications may be a combination of antihistamines, H2 inhibitors, steroids, aspirin and or Montelukast Sodium. The 12 step desensitization protocol consists of the increasing titration of 3 different concentrations of drug over approximately 6 hours. Continuous observation and patient assessment allow for early identification and intervention to reactions. The first step in the management of a reaction is to stop the drug and administer appropriate medication, per desensitization protocol. Intervention is based upon the type of reaction, described as mild or severe. The infusion is resumed once the reaction has resolved or subsided. Throughout 413 desensitizations performed, 94% induced only mild or no reactions. No life-threatening HSRs or deaths occurred during the procedure, and all patients received their full target dose. The protocol, guidelines and policy at DFCI/BWH allow the nurses to successfully and safely administer first line chemotherapy on outpatient basis. Sharing our knowledge of this process with other Oncology Nurses can be beneficial to many oncology patients who have allergies and are unable to receive first line therapy.en_GB
dc.date.available2011-10-27T12:07:47Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:07:47Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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