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Outcomes of Developments Titration in Combination with Premedication Regarding Hypersensitivity Reactions in Lung Cancer Patients Undergoing Paclitaxel Chemotherapy at Rajavithi Hospital |
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| รหัสดีโอไอ | |
| Creator | Kotchukorn Wangnum |
| Title | Outcomes of Developments Titration in Combination with Premedication Regarding Hypersensitivity Reactions in Lung Cancer Patients Undergoing Paclitaxel Chemotherapy at Rajavithi Hospital |
| Contributor | Jetsada Maneejavakajorn |
| Publisher | สำนักวารสารกรมการแพทย์ |
| Publication Year | 2566 |
| Journal Title | Journal of the Department of Medical Services |
| Journal Vol. | 48 |
| Journal No. | 2 |
| Page no. | 38-44 |
| Keyword | Hypersensitivity reactions, Paclitaxel, Premedication, Lung Cancer, Taxanes |
| URL Website | https://he02.tci-thaijo.org/index.php/JDMS |
| Website title | วารสารกรมการแพทย์ |
| ISSN | 2697-6404 |
| Abstract | Background: Achieving optimal nursing practice outcomes in chemotherapy administration is crucial for reducingthe incidence and severity of hypersensitivity reactions, which can lead to fatal anaphylactic shock. Objective: This study aims to compare the outcomes in starting titration rate between 40 ml/hr and 20 ml/hr by giving dexamethasone (20 mg) more than 30 minutes (no longer than 1 hour) before paclitaxel injection and dexamethasone (20 mg) at 30minutes before paclitaxel injection. Method: The study was a cross-sectional observational study design. Participantswere 320 lung cancer patients treated with paclitaxel and carboplatin, aged over 18. Data were collected frompatient's history, risk profile, and medical records from 1 October 2016 - 31 December 2019. Statistical analyses,including chi-square tests, Fisher's exact tests, and independent t-tests, were used to analyze the data. Results: Thegeneral characteristics were not different between the two groups, except hematocrit/hemoglobin in cycles 1-2 wasassociated with HSRs significantly (P<.05). The titration rate of 40 ml/hr was not different by giving dexamethasone(20 mg) for more than 30 minutes and at 30 minutes before paclitaxel injection. However, the titration rate of 20ml/hr, when dexamethasone (20 mg) was administered for more than 30 minutes or at 30 minutes using a smartpump, resulted in a statistically significant reduction in hypersensitivity reactions during cycles 1 and 4. Conclusion: Paclitaxel at the rate of 20 ml/hr was better than the original administration, particularly when the premedicationsare given at 30 minutes before chemotherapy. |
