A prospective observational study on iv compatibility, dose adjustment and ADR of chemotherapy drugs in oncology department at tertiary care hospital

Abhishek Kumar Sinha; Kreeti Sapkota; Sonaxi Agrahari; B. R. Prabhudev; Balakeshwa Ramaiah

doi:10.18203/2319-2003.ijbcp20243841

Authors

Abhishek Kumar Sinha Doctor of Pharmacy, Karnataka College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
Kreeti Sapkota Doctor of Pharmacy, Karnataka College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
Sonaxi Agrahari Doctor of Pharmacy, Karnataka College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
B. R. Prabhudev Department of Pharmacy Practice, Karnataka College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India
Balakeshwa Ramaiah Department of Pharmacy Practice, Karnataka College of Pharmacy, Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20243841

Keywords:

Chemotherapy, Oncology, Adverse effects, Compatibility, Dose adjustment, Cancer

Abstract

Background: Cancer is the second leading cause of death worldwide. Chemotherapy is a standard modality of cancer treatment that uses chemical agents or drugs to destroy cancer cells in the cell cycles or use chemicals or drugs to inhibit cancerous cells growth and spread. The objective of this study was to assess the IV compatibility of chemotherapy drug in different solution, assess the frequency of ADR, classify ADR according to the class of drug and dose adjustment.

Methods: In this study, cancer patients of either gender (aged 21-90) admitted on the oncology department of Bangalore Baptist Hospital were included in the study. Assessment of IV compatibility was done based on the prescription pattern, dose adjustment was done on the basis of body weight, BSA and hepatic and renal parameters. Adverse reactions reported by the patients, assessed by the doctors and nurses and changes in the laboratory parameters were analysed for the assessment of ADR.

Results: A total of 43 patients met the inclusion criteria; among which 44% were male and 56% were female. The mean age of the study was 57.49. Breast cancer, stomach cancer and lung cancer were more prevalent. In the study 24 chemotherapy drugs were used among them 20 drugs were compatible in 0.9% normal saline and 4 drugs were compatible in 5% dextrose. Dose adjustment were done for 4 drugs which were Carboplatin, Paclitaxel, Trastuzumab and Ifosfamide. The average dose adjusted for Carboplatin, Paclitaxel, Trastuzumab and Ifosfamide were -0.46±3.3, 0.5±10.6, -10±0 and -50±0 respectively. Total of 25 adverse drug reaction were seen where vomiting, gastritis and anemia were more frequently seen. Alkylating agents showed more number of ADRs.

Conclusions: From the study, it can be concluded that most of the chemotherapy drugs were compatible either in 5% dextrose or 0.9% normal saline. Dose adjustments were done on the basis of body weight and BSA. Alkylating agents showed ADR most frequently and least frequent was topoisomerase inhibitor. Vomiting was the most reported ADR.

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References

Arunachalam SS, Shetty AP, Panniyadi N, Meena C, Kumari J, Rani B, et al. Study on knowledge of chemotherapy’s adverse effects and their self-care ability to manage - The cancer survivor’s impact. Clin Epidemiol Glob Health. 2021:1;11.

Anand U, Dey A, Chandel AKS, Sanyal R, Mishra A, Pandey DK, et al. Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics. Genes and Diseases. KeAi Communications Co. 2023;10:1367–401.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.

Kim HI, Lim H, Moon A. Sex differences in cancer: Epidemiology, genetics and therapy. Biomolecules and Therapeutics. Korean Soc Pharmacol. 2018;26:335–42.

Behera SK, Kishtapati CR, Gunaseelan V, Dubashi B, Chandrasekaran A, Selvarajan S. Chemotherapy induced adverse drug reactions in cancer patients in a tertiary care hospital in South India. J Young Pharm. 2017;1;9(4):593–7.

Beumer JH, Chu E, Salamone SJ. Body-surface area-based chemotherapy dosing: Appropriate in the 21st century. J Clin Oncol. 2012;30:3896–7.

Sun N, Shen B, Zhu J, Zhang X, Zhu H, Liang G, et al. Clinical application of the AUC-guided dosage adjustment of docetaxel-based chemotherapy for patients with solid tumours: A single centre, prospective and randomised control study. J Transl Med. 2020;18:539.

Akgül S, Chan BA, Manders PM. Carboplatin dose calculations for patients with lung cancer: significant dose differences found depending on dosing equation choice. BMC Cancer. 2022;1;22(1):432-8.

Krishnarajan D, Sivasakthi K, Ariyamol R, Kumar D, Varghese S. A prospective observational study of chemotherapy-induced adverse drug reaction and the quality of life in cancer patients in a tertiary care hospital. J Can Res Therap. Wolters Kluwer Medknow Publications; 2021;17: 530–6.

Wolfe JL, Thoma LA, Du C, Goldspiel BR, Gallelli JF, Grimes GJ, et al. Compatibility and stability of vincristine sulfate, doxorubicin hydrochloride and etoposide in 0.9% sodium chloride injection. Am J Health-Syst Pharm. 1999;56:43-8.

Priston MJ, Sewell GJ. Stability of three cytotoxic drug infusions in the Graseby 9000 ambulatory infusion pump. J Oncol Pharm Pract. 1998;4;3:143-9.