Hypersensitivity reaction to paclitaxel: nursing interventions.
Paclitaxel, a mitotic inhibitor, is used to treat a variety of cancers. A significant incidence of paclitaxel-related hypersensitivity reactions (HSRs) occurs because of the diluent used. Premedication with dexamethasone, diphenhydramine, and H2-histamine antagonists has markedly decreased the incidence of HSRs. Paclitaxel-related HSRs should be managed immediately and appropriately by (a) stopping the infusion, (b) administering oxygen, (c) infusing fluids, (d) continuously monitoring blood pressure, pulse, and oxygenation, and (e) initiating standing orders for i.v. corticosteroids and diphenhydramine or other emergency medications. Oncology nurses are key to the rapid recognition and treatment of paclitaxel-related HSRs.
Research Medical Center, c/o 7 East Oncology, 2316 East Meyer Boulevard, Kansas City, MO 64132, USA. jsmyers@healthmidwest.org
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D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D004155:Diphenhydramine / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D016903:Drug Monitoring; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D009730:Nursing Assessment / Q000379:methods; D009859:Oncology Nursing / Q000379:methods*; D017239:Paclitaxel / Q000009:adverse effects*; D011292:Premedication / Q000379:methods
D000893:Anti-Inflammatory Agents; D000972:Antineoplastic Agents, Phytogenic; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D003907:Dexamethasone; D004155:Diphenhydramine; D017239:Paclitaxel