Ation, dispensing, and administration of antineoplastic therapy, and also the agents, both commercially offered and investigational, employed to treat malignant ailments. Concerns or ideas for subjects must be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: [email protected]; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Division, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: [email protected] Name: CE Origin of Name: CE is an acronym for the 2 medications in the regimen: carboplatin and etoposide. COMMENTS Carboplatin doses are normally calculated employing equations based on the method of Calvert et al.1 Calvert’s group showed that the carboplatin dose in milligrams is usually calculated utilizing a selected carboplatin region beneath the curve (AUC) and the patient’s glomerular filtration rate (GFR) as determined by clearance of a radiopharmaceutical, chromium-51-EDTA. Calvert’s equation is expressed as carboplatin dosemg five AUC x [GFR 1 25]. A frequent practice is always to substitute the GFR of your Calvert equation having a calculated creatinine clearance (CrCl) determined together with the Cockcroft-Gault equation. INDICATION(S) The CE regimen has been studied and is advised for principal therapy of both restricted and extensive-stage small-cell lung cancer (SCLC) (Table 1).2-DRUG PREPARATION Comply with institutional policies for preparation of hazardous medicines when preparing carboplatin and etoposide. A. Carboplatin 1. Use carboplatin injection ten mg/mL, or powder for reconstitution. two. Reconstitute the powder to a concentration of ten mg/mL with sterile water for injection (SWFI), 5 dextrose in water (D5W), or 0.9 sodium chloride (NS). 3. Dilute with one hundred to 1,000 mL of D5W or NS. 4. Carboplatin is much less steady in saline solutions, with up to five degradation inside 24 hours.Formula of 2-(Difluoromethyl)pyridin-4-amine 13 five. When the drug is ready in a saline diluent, the solution must be made use of within 8 hours. B. Etoposide 1. Use etoposide injection, 20 mg/mL. two. Dilute with D5W or NS to a final concentration of 0.2 mg/mL to 0.four mg/mL. 3. Concentrations higher than 0.four mg/mL aren’t stable and may possibly precipitate through infusion. DRUG ADMINISTRATION A. Carboplatin: Administer by intravenous (IV) infusion over 30 to 60 minutes.*Mr. Rutledge is Chief, Hematology-Oncology Pharmacy Service, Division of Pharmacy, Madigan Army Healthcare Center, Tacoma, Washington. The opinions or assertions contained herein would be the private views of your authors and usually are not to be construed as official or reflecting the views from the US Division on the Army or the Department of Defense.Volume 48, AprilCancer Chemotherapy UpdateTable 1.113451-59-5 Formula Carboplatin (renally dosed) and etoposide regimen2-Drug Carboplatin Etoposide Dose AUC 5 80-140 mg/m2 Route of administration IV IV Administered on day(s) 1 1-3 Total dose/cycle AUC 5 240-420 mg/mCycle repeats: each and every three to 4 weeks Variations 1.PMID:23381601 Carboplatin AUC six IV day 1 and etoposide 100 mg/m2 IV days 1-3 every three weeks.9,11 two. Carboplatin AUC five IV day 1 and etoposide 100 mg/m2 IV days 1-5 every single 4 weeks.Note: AUC = region below the time vs concentration curve; IV = intravenous.B. Etoposide: 1. Administer by IV infusion more than 45 to 60 minutes. 2. Infusion over significantly less than 30 minutes drastically increases the incidence of hypotension. SUPPORTIVE CARE A. Acute and Delayed Emesis Prophylaxis: The CE regimen is p.