Common adverse reaction and nursing of docetaxel
Docetaxel is a new antitumor drug, suitable for patients ineffective treatment with paclitaxel. Used in clinical breast cancer, ovarian cancer, non small cell lung cancer, prostate cancer and other solid tumor chemotherapy.†
Due to the drug's unique role in clinical application, it needs to strengthen the observation and care while applying, as much as possible to reduce toxicity reaction. According to pharmaceutical raw materials suppliers, the main toxicity and nursing intervention measures of docetaxel are as follows.
Hematopoietic system reaction, bone marrow inhibition is the most common toxicity of docetaxel, with dosage and duration of treatment increased, blood toxicity exacerbations, and reversible. Generally show up after administration of 7days, performed for white cell and neutropenia, and thrombocytopenia.
Nursing, during treatment should be closely monitored blood, when the WBC < 1◊ 109/L, should implement protective isolation to patients. Keep the ward air clear, everyday have 2 times 40min UV irradiation, the ground with the 1:200 disinfection solution to wipe. alessening the visitation, prohibition of patients with known to infect visitors or staff contact, preventing cross infection. bThe medical staff should strictly abide by the principles of aseptic technique operation careful washing hand before and after, contact touch patients. cto inform patients pay attention to keep warm, prevent cold, keep the mouth, perianal skin clean. Observe whether the nasal, gums, skin bleeding, prolonged injection siteís pressing time. dif show up fever should pay attention to infection, should also pay attention to a phenomenon that a few patients with less granulocyte count, when severe infection, the body temperature does not rise.
Digestive system reaction, docetaxel on gastrointestinal mucosa stimulation can lead to gastrointestinal disorders, usually occurs in the 1^ 8D of chemotherapy, manifestations of anorexia, nausea, vomiting, abdominal pain, diarrhea and others.
Nursing, patients drinking a large number of water during treatment, reduce the drugs on the gastrointestinal tract mucous membrane irritation. Encourage patients take easily digestible, high-protein, high vitamin and light diet, avoid spicy, fried stimulation food, have more meals a day but less food at each. Followed by doctors to use antiemetics before chemotherapy. After Patients with vomiting, gargle with warm water, cleaning dirt, keep the mouth moist, clean, in order to promote the appetite. If frequent vomiting, should record the vomit nature, color, weight, preventing the electrolyte imbalance. To those eating less patients appropriate rehydration, enteral and parenteral nutrition support therapy if needed.
Researches by docetaxel supplier show that allergy is the most serious adverse reaction of docetaxel, manifestations of type I allergy. Often occur in 10min of medication, even can occur in the medication after 2^ 3min. The light appears pale complexion, urticaria, serious person can appear dyspnea and shock.
Nursing,`giving glucocorticoid before meditation, H2 receptor antagonists and antihistamines can reduce drug allergic reaction. aThe 10min before drug instillation should slowly, preferably using infusion pump infusion speed control in 10 ~ 15 drops per minute. Close observation of patientsí consciousness, complexion, skin color changes, if no adverse reactions can adjust the dropping speed in order within the time prescribed infusion. binfusion during repeated inquiries patients with or without chocking sensations in chest, palpitation, dyspnea, skin itching and discomfort, every half hour measuring vital signs. cIf emergence of flushing, itching skin, heart rate slightly faster, donít need to stop the drugs, slow down the drop and close observation of changes in conditions. If show up chest tightness, dyspnea, generalized urticaria and other serious reaction, should immediately stop the chemotherapy and the corresponding treatment. The use of disposable precise filtering transfusion apparatus can prevent allergic reaction.
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