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onc exam 1 treatment

diseasetreatment
TLS: Hyperkalemia Insulin, albuterol, calcium gluconate, furosemide, patiromer (veltassa), sodium zirconium cyclocilicate (lokelma)
TLS: Hypocalcemia Calcium gluconate, only treat when symptomatic, caution with hyperposphatemia
TLS: hyperphosphatemia hydration and phospahte binders, avoid ca products in hypercalemia
TREATMENT OF TLS Hydration 2-3 L/day (target 80-100 ml/hr output) allopurinol PO (1-3 doses 800mg max per day) Rasburicase 6mg Iv ONCE, repeat if UA not below 8
PREVENTION OF TLS START 2 DAYS BEFORE CHEMO Hydration 2-3 L/day (target 80-100 ml/hr output) allopurinol PO (1-3 doses 800mg max per day) of febuxostat 120mg PO daily Rasburicase 6mg Iv ONCE, only if UA above 8 in prevention.
Lab def TLS - 2 or more UA 8mg/dl or over K 6mEq/lor over P 4.5mg/dl or over in adults, 6.5md/dl or over in childern Ca 7md/dl or below
Clinical TLS -2 or more + high Scr UA 8mg/dl or over K 6mEq/lor over P 4.5mg/dl or over in adults, 6.5md/dl or over in childern Ca 7md/dl or below + Scr 1.5 or over
D/C in hypercalcemia lithium calcium thiazides vit D
Ca < 12 no symtpoms no treatment
Ca 12-14 some symptoms aggresive hydration
Ca > 14 hydration, calcitonin (drops Ca 1-2 in 4-6 hours), denosumab (guideline recommended) or zoldronic acid
Day 1 Day 2 Day 3 NS calcitonin and bisphosphonates NS and calcitonin NS and calcitonin
Created by: beezy41
 

 



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