Nursing considerations for administering pemetrexed (Alimta) in combination with cisplatin for malignant pleural mesothelioma.
No known cure exists for malignant pleural mesothelioma (MPM). The prognosis for patients with this relatively rare, asbestos-related malignancy of the pleural lining of the lung is quite poor. MPM treatment includes surgery, radiotherapy, and chemotherapy. Few patients, however, are candidates for surgery or radiotherapy, so chemotherapy is the only option for most patients. A phase III study found that pemetrexed and cisplatin chemotherapy significantly improved survival and had greater antitumor activity than cisplatin alone. The U.S. Food and Drug Administration recently approved pemetrexed with cisplatin for treating MPM. Nurses should become familiar with the proper preparation and administration of pemetrexed, including the necessity of supplementation with folic acid and vitamin B12. As with all drugs, careful attention must be paid to patient selection, laboratory monitoring, contraindications, and appropriate interventions in the event of adverse reactions or overdose.
Orbaugh
Kristi K
KK
cmorb@aol.com
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D020714:Maximum Tolerated Dose; D008654:Mesothelioma / Q000188:drug therapy* / Q000451:nursing* / Q000473:pathology; D009730:Nursing Assessment; D009859:Oncology Nursing; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000451:nursing* / Q000473:pathology; D011379:Prognosis; D018570:Risk Assessment; D016896:Treatment Outcome
D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D002945:Cisplatin