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IP VYXEOS INDUCTION	

Types:      ONCOLOGY TREATMENT
Synonyms:  DAUNORUBICIN CYTARABINE LIPOSOMAL

Cycle 1	Repeat 1 time	Cycle length: 28 days	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).
			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: Until discontinued	Occurrences: --	Comments:	Use baseline weight to calculate dose. Adjust dose for weight gains OR losses of greater than or equal to 10%.
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: Once	Occurrences: --		  	COMPREHENSIVE METABOLIC PANEL	Interval: Once	Occurrences: --			Labs
  	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Pre-Medications
  	acetaminophen (TYLENOL) tablet 500 mg	Dose: 500 mg	Route: oral	once for 1 dose	Start: S				  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	once for 1 dose	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 50 mg	Dose: 50 mg	Route: intravenous	once for 1 dose	Start: S				  	ondansetron (ZOFRAN) 16 mg, dexamethasone (DECADRON) 6 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	Yes	DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION	Medications	6 mg	Yes	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	50 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	Base	50 mL	No	Yes				Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: Until discontinued	Occurrences: --	Comments:	Please administer Vyxeos on days 1, 3, and 5. Patient will not receive any chemotherapy on rest days 2 and 4.
			Chemotherapy
  	DAUNOrubicin-cytarabine liposome (VYXEOS) 44 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 44 mg/m2	Route: intravenous	once over 120 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Dose is based on mg of daunorubicin.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION	Medications	44 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	QS Base	500 mL	No	Yes				Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.				Day 2	Perform every 1 day x1		Day of Rest
  	ONC NURSING COMMUNICATION 48	Interval: Until discontinued	Occurrences: --	Comments:	Rest day for the patient.
				Day 3	Perform every 1 day x1		Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Pre-Medications
  	acetaminophen (TYLENOL) tablet 500 mg	Dose: 500 mg	Route: oral	once for 1 dose	Start: S				  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	once for 1 dose	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 50 mg	Dose: 50 mg	Route: intravenous	once for 1 dose	Start: S				  	ondansetron (ZOFRAN) 16 mg, dexamethasone (DECADRON) 6 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	Yes	DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION	Medications	6 mg	Yes	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	50 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	Base	50 mL	No	Yes				Nursing Orders
  	ONC NURSING COMMUNICATION 2	Interval: Until discontinued	Occurrences: --	Comments:	Have patient sign name as cerebellar assessment prior to each dose of DAUNOrubicin-Cytarabine Liposomal (Vyxeos).
			Chemotherapy
  	DAUNOrubicin-cytarabine liposome (VYXEOS) 44 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 44 mg/m2	Route: intravenous	once over 120 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Dose is based on mg of daunorubicin.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION	Medications	44 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	QS Base	500 mL	No	Yes					Day 4	Perform every 1 day x1		Day of Rest
  	ONC NURSING COMMUNICATION 48	Interval: Until discontinued	Occurrences: --	Comments:	Rest day for the patient.
				Day 5	Perform every 1 day x1		Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Pre-Medications
  	acetaminophen (TYLENOL) tablet 500 mg	Dose: 500 mg	Route: oral	once for 1 dose	Start: S				  	diphenhydrAMINE (BENADRYL) tablet 25 mg	Dose: 25 mg	Route: oral	once for 1 dose	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	once for 1 dose	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 50 mg	Dose: 50 mg	Route: intravenous	once for 1 dose	Start: S				  	ondansetron (ZOFRAN) 16 mg, dexamethasone (DECADRON) 6 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	Yes	DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLUTION	Medications	6 mg	Yes	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	Base	50 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	Base	50 mL	No	Yes				Provider Communication
  	ONC PROVIDER COMMUNICATION 23	Interval: Until discontinued	Occurrences: --	Comments:	Schedule prophylactic antibiotics to start on day 5.
			Nursing Orders
  	ONC NURSING COMMUNICATION 2	Interval: Until discontinued	Occurrences: --	Comments:	Have patient sign name as cerebellar assessment prior to each dose of DAUNOrubicin-Cytarabine Liposomal (Vyxeos).
			Chemotherapy
  	DAUNOrubicin-cytarabine liposome (VYXEOS) 44 mg/m2 in sodium chloride 0.9% 500 mL chemo IVPB	Dose: 44 mg/m2	Route: intravenous	once over 120 Minutes for 1 dose			Offset: 30 Minutes	Instructions:	Dose is based on mg of daunorubicin.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION	Medications	44 mg/m2	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	500 mL	Yes	Yes	DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION	QS Base	500 mL	No	Yes