CARFILZOMIB (KYPROLIS) FOR AMR		version 1/23/2025		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		
	☑	Nursing communication	Every visit	S	Until discont'd	
		Please continue to schedule subsequent infusion appointments manually as appropriate.		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		No details available for preview		
	☐	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	0.9%  NaCl solution	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	HEParin, porcine (PF) 100 unit/mL injection 500 Units	Every visit	S	Until discont'd	
		500 Units, intra-catheter, once PRN, line care, Starting when released, Until Discontinued
	Heparin flush for Implanted Vascular Access Device Maintenance.		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Nursing communication	Every visit	S	Until discont'd	
		- Pre-medication for carfilzomib (to be given starting 30 minutes before): APAP, diphenhydramine, dexamethasone, oral Mucomyst, and pre-hydration fluid.
	
	- Post-medications for carfilzomib: oral Mucomyst and post-hydration fluids.		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	B natriuretic peptide	Every visit	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Basic metabolic panel	Every visit	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	CBC with platelet and differential	Every visit	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	FK506 Tacrolimus level, trough	Every visit	S	Until discont'd	
		Routine, Normal, Clinic Collect		
	☐	Hepatic function panel	Every visit, at least 1 day apart	S	Until discont'd	
		Routine, Normal, Clinic Collect		

Pre-Hydration 	

	
	Interval	Defer Until	Duration	
	☐	sodium chloride 0.9 % bolus 250 mL	Every visit	S	Until discont'd	
		250 mL, intravenous, Administer over: 30 Minutes, once, Starting when released
	Administer 30 minutes prior to carfilzomib.		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	Every visit	S	Until discont'd	
		650 mg, oral, once, Starting when released
	Pre-op.  Give 30 minutes prior to carfilzomib.
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	Every visit	S	Until discont'd	
		25 mg, oral, once, Starting when released
	Give 30 minutes prior to carfilzomib.		
	☐	dexAMETHasone (DECADRON) tablet 8 mg	Every visit	S	Until discont'd	
		8 mg, oral, once, Starting when released
	Give 30 minutes prior to carfilzomib.		
	☐	acetylcysteine 200 mg/mL (MUCOMYST) oral solution 1,200 mg	Every visit	S	Until discont'd	
		1,200 mg, oral, once, Starting when released
	Give 30 minutes prior to carfilzomib.		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	carfilzomib (KYPROLIS) 20 mg/m2 in dextrose 5% 50 mL chemo IVPB	Every visit	S	Until discont'd	
		20 mg/m2, intravenous, Administer over: 30 Minutes, once, Starting when released
	HAZARDOUS

	Handle with care		

Post-Hydration 	

	
	Interval	Defer Until	Duration	
	☐	sodium chloride 0.9 % bolus 500 mL	Every visit	S	Until discont'd	
		500 mL, intravenous, Administer over: 60 Minutes, once, Starting when released
	Give after completion of carfilzomib.		

Post-Medications 	

	
	Interval	Defer Until	Duration	
	☐	acetylcysteine 200 mg/mL (MUCOMYST) oral solution 1,200 mg	Every visit	S	Until discont'd	
		1,200 mg, oral, once, Starting when released
	Give after completion of carfilzomib.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 4 hours PRN, headaches, fever, infusion reaction, Starting when released, Until Discontinued
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, itching, For minor infusion reaction, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 50 mg	PRN	S	Until discont'd	
		50 mg, intravenous, once PRN, itching, For severe infusion reaction, Starting when released, Until Discontinued		
	☐	EPINEPHrine (ADRENALIN) 1 mg/mL injection FOR IM/SQ USE 0.5 mg	PRN	S	Until discont'd	
		0.5 mg, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	Until discont'd	
		100 mg, intravenous, once PRN, For infusion reaction, Starting when released, Until Discontinued		
	☐	promethazine (PHENERGAN) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, nausea, vomiting, Starting when released, Until Discontinued