Unique Plan Description: GYNONC Tisotumab vedotin-tftv (Tivdak) (MH)
Plan Selection Display: GYNONC Tisotumab vedotin-tftv (Tivdak) (MH)
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2023-03-14 12:43:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-11-15 15:36:12
Available at all facilities: No

GYNONC Tisotumab vedotin-tftv (Tivdak) (MH)
IV Solutions
Chemotherapy PreHydration
	Sodium Chloride 0.9% IVPB
		100 mL, Solution-Injection, IVPB, Once, 20 ml/hr
			Comment: 20ml/hr (TKO), In Infusion Center
Chemotherapy Agent
	tisotumab vedotin-tftv/NS 100mL
		2 mg/kg, IVPB, Once, infuse over 30 min(s), T;N+30
			Comment: Max dose 200mg
		10 mL, EVERY BAG
		100 mL, EVERY BAG
		1.3 mg/kg, IVPB, Once, infuse over 30 min(s), T;N+30
			Comment: Max dose 130mg
		10 mL, EVERY BAG
		100 mL, EVERY BAG
		0.9 mg/kg, IVPB, Once, infuse over 30 min(s), T;N+30
			Comment: Max dose 90mg
		10 mL, EVERY BAG
		100 mL, EVERY BAG
Medications

Premeds
	brimonidine ophthalmic 0.2% solution
		3 gtt, Eye, Both, Once, T;N+20, duration: 1 Dose(s)/Time(s)
			Comment: Begin administration 10 minutes before tisotumab infusion. Allow each drop to absorb before administering next drop. Wait 5-10 minutes after administering prednisolone eye drops before administering brimonidine (vasoconstricting) eye drops. Check for patient supply.
	prednisoLONE ophthalmic acetate 1% suspension
		1 gtt, Eye, Both, Once, T;N
			Comment: Give approximately 30 minutes prior to infusion; Wait 5-10 minutes after administering prednisolone eye drops before administering brimonidine (vasoconstricting) eye drops. Check for patient supply.
	ondansetron
		8 mg, Tablet-Disintegrating, By Mouth, Once, T;N
			Comment: Give 30 minutes before Chemotherapy
	LORazepam
		0.5 mg, Tab, By Mouth, Once, T;N
			Comment: Give 30 minutes before Chemotherapy
Patient Care

	Cold Therapy
		T;N
			Comment: Apply cold pack over eyes and bridge of nose after last brimonidine eye drop. Continue cold pack throughout infusion and approximately 20 minutes post infusion for a total of 60 minutes.
	Notify MD
		T;N, Contact Provider for further orders if allergic reaction protocol initiated.
	Initiate MD Plan for:
		T;N, Allergy Reaction protocol if patient experiences reaction to treatment.

CHEMO Reaction Protocol
Vital Signs
	Vital Signs
		Assess vital signs every 2 to 5 minutes until the patient is stable. Place patient into a recumbent position with elevation of the lower extremities if hypotensive
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		Reassess vital signs every 15 minutes x 2, then q30min x 2, or more frequently as needed, I&O, etc until stable
Activity
	Position Patient
		T;N
			Comment: If hypotensive, keep patient supine with legs elevated or bed in Trendelenburg.
IV Solutions
	Sodium Chloride 0.9% IVPB
		500 mL, IV Large Volume, IVPB, DAILY, PRN for see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
		1,000 mL, IV Large Volume, IVPB, DAILY, PRN for see comment, 999 ml/hr
			Comment: for reaction to chemotherapy
Medications
	Benadryl
		50 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy
		25 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy
	Decadron (MH/WH)
		20 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 1st choice steroid
	SOLU-Medrol
		125 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 2nd choice steroid
	Solu-CORTEF
		100 mg, Injection, IV Push, DAILY, PRN see comment
			Comment: for moderate to severe reaction to chemotherapy, 3rd choice steroid
	EPINEPHrine
		0.5 mg, Injection, SUBCUTANEOUS, DAILY, PRN see comment
			Comment: for hypersensitivity reaction not resolved by diphenhydramine and/or anaphylactic				reactions to chemotherapy, may repeat every 10 minutes for up to 3 doses
		0.5 mg, Injection, IM-Intramuscular, DAILY, PRN see comment
			Comment: for hypersensitivity reaction not resolved by diphenhydramine and/or anaphylactic				reactions to chemotherapy, may repeat every 10 minutes for up to 3 doses
	meperidine
		25 mg, Syringe, IV Push, Once, PRN for see comment
			Comment: For chills and rigors
	morphine  IV
		2 mg, Syringe, IV PUSH, Once, PRN for see comment
			Comment: For chills and rigors
Patient Care
	Notify MD
		T;N, Contact the oncologist if any of the reaction protocol medications are administered to the patient.

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase