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Oncology - care of the oncology patient admitted to PICU - drugs

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General Points

  • DO NOT give steroids to patients with leukemia unless expressly prescribed by Oncology and post their initial BMA/LP
  • When receiving chemotherapy or having radiation give all antiemetic regularly and continue at least 5 days after treatment
  • Post chemotherapy, some patients receive G-CSF (except for example patients with AML)
  • Consider PCP prophylaxis (once daily for three consecutive days each week)
  • Newly diagnosed or recently relapsed patients should receive either allopurinol or rasburicase (see tumour lysis protocol)
  • See outliers folder for information about chemotherapy and other supportive case medications

Post Transplant Patients

Could be receiving some of the following drugs:

  • MMF
  • Tacrolimus
  • Cyclosporin
  • Acyclovir
  • Gancyclovir (if CMV+ve)
  • G- CSF (day +8 and by oncology preference)
  • Itraconazole Syrup on empty stomach 1 hr before food
  • Ranitidine or omeprazole (if on high-dose steroids)

Chemotherapy

  • When patient is receiving chemotherapy follow the Safe Administration of Chemotherapy Checklist
  • When touching any body fluids please wear chemo gown and gloves, personal protective equipment (PPE). Body fluids are blood, stool, vomit, saliva, sweat, bile, and secretions.
  • When suctioning or flushing any body fluids please wear mask and goggles
  • When disposing or blood, nappies or any chemotherapy lines please put in purple cytotoxic bins.
  • Emesis, urine from IDC and stool can be flushed while wearing PPE.
  • When there is a chemotherapy spill please use spill kit and follow protocol
  • If extravasation happens please notify 27B and follow protocol.
  • Prolonged exposure to small amounts of chemotherapy can cause cancer
  • If pregnant it is up to the individual health care provider if they would like to care for the patient.
  • If family members are educated about the side effects of contact with cytotoxic material it is their choice to glove or not.

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Document Control

  • Date last published: 10 June 2016
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Intensive Care Unit
  • Owner: Fiona Miles
  • Editor: John Beca
  • Review frequency: 2 years