Protocol Index	

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OP INTRAVESICAL GEMCITABINE / DOCETAXEL PLAN (MONTHLY MAINTENANCE FOR 1 YEAR)	

Types:      ONCOLOGY TREATMENT
Synonyms:  GEMZAR, BLADDER, TAXOTERE

Take Home Medication	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Take-Home Medications Prior to Treatment
  	sodium bicarbonate 650 mg tablet	Dose: --	Route: --		Dispense: 4 tablet	Refills: 12				Instructions:	Take 2 tablets (1300 mg) orally the night before procedure and day of treatment. Take both doses at home.					
Cycle 1	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Provider Communication
  	ONC PROVIDER COMMUNICATION 64	Interval: --	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).
			Nursing Orders
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	o Patient will have Foley catheter placed by urologist or nurse, when patient's clinical assessment is completed and is deemed appropriate to proceed to treatment.
o Please request medication (drawn content into a syringe) from Pharmacy. No laboratory monitoring or orders are necessary.
			Nursing Orders
  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Please verify that patient has taken sodium bicarbonate tablets the night before and day of intravesical chemotherapy.
			Chemotherapy
  	gemcitabine (GEMZAR) 1,000 mg in sodium chloride 0.9% 50 mL chemo BLADDER instillation	Dose: 1,000 mg	Route: intravesical	once over 1 Hours for 1 dose			Offset: 30 Minutes	Instructions:	For BLADDER INSTILLATION ONLY	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION	Medications	1,000 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	23.7 mL	Yes	Yes			  	DOCEtaxeL (TAXOTERE) 38 mg in sodium chloride (NON-PVC) 0.9 % 50 mL chemo BLADDER instillation	Dose: 37.5 mg	Route: intravesical	once over 60 Minutes for 1 dose	Start: S			Instructions:	For BLADDER INSTILLATION ONLY	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION	Medications	37.5 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % IV SOLP (EXCEL;NON-PVC)	QS Base	48.1 mL	Yes	Yes				Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Do NOT need to flush, clamp Foley catheter and send patient back to oruology clinic for catheter disconnect (or disconnect at infusion center by nurses).
					
Cycles 2 to 12	Repeat 11 times	Cycle length: 28 days	Day 1	Perform every 1 day x1		Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	o Patient will have Foley catheter placed by urologist or nurse, when patient's clinical assessment is completed and is deemed appropriate to proceed to treatment.
o Please request medication (drawn content into a syringe) from Pharmacy. No laboratory monitoring or orders are necessary.
			Nursing Orders
  	ONC NURSING COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	Please verify that patient has taken sodium bicarbonate tablets the night before and day of intravesical chemotherapy.
			Chemotherapy
  	gemcitabine (GEMZAR) 1,000 mg in sodium chloride 0.9% 50 mL chemo BLADDER instillation	Dose: 1,000 mg	Route: intravesical	once over 1 Hours for 1 dose			Offset: 30 Minutes	Instructions:	For BLADDER INSTILLATION ONLY	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION	Medications	1,000 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	23.7 mL	Yes	Yes			  	DOCEtaxeL (TAXOTERE) 38 mg in sodium chloride (NON-PVC) 0.9 % 50 mL chemo BLADDER instillation	Dose: 37.5 mg	Route: intravesical	once over 60 Minutes for 1 dose	Start: S			Instructions:	For BLADDER INSTILLATION ONLY	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION	Medications	37.5 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % IV SOLP (EXCEL;NON-PVC)	QS Base	48.1 mL	Yes	Yes				Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	Do NOT need to flush, clamp Foley catheter and send patient back to oruology clinic for catheter disconnect (or disconnect at infusion center by nurses).