Protocol Index	

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IP CAGT AUTOLOGOUS MOBILIZATION HIGH DOSE CYCLOPHOSPHAMIDE	

Types:      ONCOLOGY TREATMENT
Synonyms:  MESNA, MESNEX, CYTOXAN, CYCLOPHOSPHAMIDE, BMT, CAGT, AUTOLOGOUS, MOBILIZATION, HIGH DOSE

Cycle 1	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Provider Communication
  	ONC PROVIDER COMMUNICATION 64	Interval: Once	Occurrences: --	Comments:	Verify Hep B panel status prior to cycle. Date *** of panel. Result positive/negative/pending/unknown:22867

The required components for the hepatitis B panel includes: Hepatitis B surface antigen (HBsAg), total hepatitis B core antibody (anti-HBc), and hepatitis B antibody (anti-HBs).
			Labs
  	ECG 12-LEAD	Interval: Once	Occurrences: --	Comments:	Perform EKG once on Day 1.  MD to review prior to cyclophosphamide dosing
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: Daily	Occurrences: --	Comments:	Notify MD if RBC > 20/hpf
			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Antiemetics
☑	ondansetron (ZOFRAN) 16 mg, dexamethasone (DECADRON) 10 mg in sodium chloride 0.9% 50 mL IVPB	Dose: 16 mg	Route: intravenous	once over 10 Minutes for 1 dose	Start: S			Ingredients:	Name	Type	Dose	Selected	Adds Vol.	ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION	Medications	16 mg	Main Ingredient	No	DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION	Medications	10 mg	Yes	No	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	50 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	Base	50 mL	No	Yes			☑	ondansetron (ZOFRAN) IV 16 mg	Dose: 16 mg	Route: intravenous	once for 1 dose	Start: S+1				☑	LORAZepam (ATIVAN) injection 0.5 mg	Dose: 0.5 mg	Route: intravenous	once for 1 dose	Start: S				☑	fosaprepitant (EMEND) IVPB 150 mg	Dose: 150 mg	Route: intravenous	once over 30 Minutes for 1 dose	Start: S					Hydration
  	sodium chloride 0.9 % infusion	Dose: 150 mL/hr	Route: intravenous	continuous	Start: S			Instructions:	Starting 4 hours PRIOR to Cyclophosphamide. 
 
Total cumulative volume rate not to exceed 350 mL/hr.			Chemotherapy
  	mesna (MESNEX) 2,000 mg/m2 in sodium chloride 0.9% 100 mL chemo IVPB	Dose: 2,000 mg/m2	Route: intravenous	once over 60 Minutes for 1 dose	Start: S			Ingredients:	Name	Type	Dose	Selected	Adds Vol.	MESNA 100 MG/ML INTRAVENOUS SOLUTION	Medications	2,000 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	QS Base	 	No	Yes			  	cycloPHOSphamide (CYTOXAN) 2,000 mg/m2 in dextrose 5% 500 mL chemo IVPB	Dose: 2,000 mg/m2	Route: intravenous	once over 2 Hours for 1 dose			Offset: 60 Minutes	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	CYCLOPHOSPHAMIDE 1 GRAM INTRAVENOUS POWDER FOR SOLUTION	Medications	2,000 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	No	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes			  	furosemide (LASIX) injection 20 mg	Dose: 20 mg	Route: intravenous	every 6 hours for 2 doses			Offset: 3 Hours	Instructions:	Give initial dose immediately after cyclophosphamide infusion and repeat in 6 hours		  	mesna (MESNEX) 1,000 mg/m2 in sodium chloride 0.9% 100 mL chemo IVPB	Dose: 1,000 mg/m2	Route: intravenous	every 4 hours over 60 Minutes for 6 doses			Offset: 4 Hours	Instructions:	Start 4 hours after loading dose of Mesna	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	MESNA 100 MG/ML INTRAVENOUS SOLUTION	Medications	1,000 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	QS Base	 	No	Yes				Line Flush
  	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN