TY - CHAP M1 - Book, Section TI - Lung Cancer A1 - Adams, Val R. A1 - Scarpace Peters, Sarah A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael Y1 - 2017 N1 - T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - Patient Care Process for the Management of Lung CancerCollectPatient characteristics (e.g., age, race, sex)Patient history (past medical, family, social—dietary habits, tobacco use)Current medications and prior chemotherapy or targeted therapySymptoms of pain, pain score, pain managementSymptoms of venous or arterial thromboembolismClinical and objective evaluation of tumor statusObjective dataBP, heart rate (HR), height, weight, respiratory rateLabs (e.g., serum electrolytes, complete blood count, Scr, BUN)Histology (NSCLC squamous or nonsquamous (Table 129-1) and stage (Table 129-2)Tumor markers (PD1 expression, EML4-ALK rearrangements, EGFR exon 19 or 21 mutations)AssessType of and response to prior treatmentsDrug therapy options given the patient's histology, stage, and tumor markers Need for any dose adjustments based on renal or hepatic function or potential drug interactionsSide effects from current anti-cancer regimen if this is second dose or second cycleAdherence to oral anti-cancer regimensPlan*Goals of treatment (initial and continued)Drug therapy regimen including specific oral anticancer agent, dose, route, frequency, and duration Supportive care plan (e.g., antiemetics, premedications, drugs to prevent or treat constipation/diarrhea, and medications for specific drugs [folic acid and vitamin B12 for pemtrexed])Patient education (e.g., purpose of treatment (curative versus palliative); side effects and how to manage) Provide tools to support adherence to oral anticancer agents and supportive care medicationsEncourage use of a diary to track pain medication and diarrhea/constipation medication useReferrals to other providers when appropriate (e.g., physician, dietician, spiritual and/or psychological support, social work, nursing, palliative care or hospice)Implement*Provide patient education regarding all elements of treatment plan Use motivational interviewing and coaching strategies to maximize adherenceSchedule follow-upFollow-up: Monitor and EvaluatePresence of adverse effectsMeasure complete blood count, renal/hepatic function, and electrolytes to determine the presence of serious side effects that warrant dose adjustments, delays, or discontinuation at next cycleInquire about pain symptomsVerify patient adherence to treatment plan*Collaborate with patient, caregivers, and other health professionals SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/24 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1148581001 ER -