Therapeutic Classifcation Notes (ANTINEOPLASTICS)


Cytotoxic drugs and corticosteriods are used as therapy for malignant diseases and as immunosuppressants. Because of the potential toxicity of cytotoxic drugs and the complexity of most dose regimes used in treating malignant diseases, advice on indications and dosage is not given, but should be sought from detailed specialist literature and/or appropriate consultation.

Their use should be undertaken or supervised by clinicians experienced in their use.

It must be emphasized that:-

(i) all tumours are not sensitive to chemotherapy and inappropriate and futile drug administration is to be deprecated as it can only increase morbidity;

(ii) Dosages must be individualised with even more care than usual, with respect to age, weight, liver and renal disease etc.

(i) Chemotherapy has to be administered by doctors/nurses trained/experienced in its usage.

(ii) Extravasation of the injected drug has to be avoided by taking appropriate precautions. Any such accidental event has to be instituted to reduce/minimize the sequelae of such extravasation. An algorithm of management of extravasation should be visibly displayed in the chemotherapy administration area. When in doubt, DO NOT INJECT.

(iii) Flow charts of blood counts and other parameters have to be meticulously maintained.

(iv) Reasons for dose reduction, if any, have to be clearly mentioned.

(v) Patients should be counseled about the side effects of chemotherapy before administering the first dose. It should be administered only after obtaining informed consent from the patient.

(vi) Follow the manufacturer’s recommendations while reconstituting the drug with diluent.

(vii) Adequate antinausea drugs should be prescribed for the patient.

(viii) Colony stimulating factors may have to be considered in some patients.