Order Chemotherapy—Adjust Dosing of PO Chemo

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• Select the patient

• Start the chemo order session

• Set up the treatment—Regimen/protocol, diagnosis, numbering, day 1/day 0, patient height and weight

• Confirm treatment setup

• Reusing previous order parameters

• Open the chemo player

• Check information on the actual treatment administered previously —access the LMR Oncology Infusion Flowsheet

• Non-chemo orders—select, edit, add

• Chemo orders—select

• Edit a chemo order

• Click the line for an order to highlight it and display its parameters in the section beneath the order list.

• Dose modifications

• AUC dose modifications

• Change the preset weight

• Adjust dosing of oral medications

Reasons and orders for dosing options

1. If you haven't already:

• From the chemo folder in the chemo player, click to select the order, then click Dosing Options on the Chemo Med tab.

• For exception orders, click Dosing Options on the Chemo Medication order form.

2. For each dose (up to 6), type an amount. Units are displayed to the left of the field.

3. For each dose (up to 6), click to select an option from the frequency drop-down list. For Other, type a description when prompted, then click OK (ALT+O).

4. For each dose (up to 6), type to indicate which day(s) to schedule the dose. Number days before day 1/day 0 as negative (for example, -3); define a range of consecutive days with the first and last day inclusive, and a colon between (for example, starting on day 1, administering each day through 6, is 1:6).

5. Type instructions as needed.

6. Click OK (ALT+O).

7. If the total amount of the dose or doses you ordered does not add up to equal exactly the total dose calculated for the order, you are required to provide a reason. Check that your order is correct.

• If the reason for the difference is that the available strength of the medication doesn't exactly match the calculated dose, or if you rounded the amount, just click OK. "To accommodate dose rounding/tablet size" is the reason entered by default.

• If you need to add to or change the reason provided, type and/or delete text, then click OK.

• This entry becomes part of the order.

• If needed, make limited changes to the scheduled day(s)

• If needed, prevent recalculation of dosing of chemotherapeutics at activation—based on adjustments made to the patient's weight, height, or creatinine

• Order desensitization

• Update administration instructions

• Write or Edit a prescription for an oral investigational chemo med

• Add a chemo exception order (MD only)

• Complete the session

• Add a memo as needed (which is saved as a General Care order)

• As needed, view order details, view or print a list of chemo and medication orders only, or make changes before signing.

• Sign the session

• Check the orders awaiting activation

• See also Overview of Chemo Order Entry .