RT Book, Section
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
SR Print(0)
ID 1148581001
T1 Lung Cancer
T2 Pharmacotherapy: A Pathophysiologic Approach, 10e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259587481
LK accesspharmacy.mhmedical.com/content.aspx?aid=1148581001
RD 2024/04/24
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