A prospective observational study on iv compatibility, dose adjustment and ADR of chemotherapy drugs in oncology department at tertiary care hospital

Background: Cancer is the second leading cause of death worldwide. Chemotherapy is a standard modality of cancer treatment that uses chemical agents or drugs to destroy cancer cells in the cell cycles or use chemicals or drugs to inhibit cancerous cells growth and spread. The objective of this study was to assess the IV compatibility of chemotherapy drug in different solution, assess the frequency of ADR, classify ADR according to the class of drug and dose adjustment. Methods: In this study, cancer patients of either gender (aged 21-90) admitted on the oncology department of Bangalore Baptist Hospital were included in the study. Assessment of IV compatibility was done based on the prescription pattern, dose adjustment was done on the basis of body weight, BSA and hepatic and renal parameters. Adverse reactions reported by the patients, assessed by the doctors and nurses and changes in the laboratory parameters were analysed for the assessment of ADR. Results: A total of 43 patients met the inclusion criteria; among which 44% were male and 56% were female. The mean age of the study was 57.49. Breast cancer, stomach cancer and lung cancer were more prevalent. In the study 24 chemotherapy drugs were used among them 20 drugs were compatible in 0.9% normal saline and 4 drugs were compatible in 5% dextrose. Dose adjustment were done for 4 drugs which were Carboplatin, Paclitaxel, Trastuzumab and Ifosfamide. The average dose adjusted for Carboplatin, Paclitaxel, Trastuzumab and Ifosfamide were -0.46±3.3, 0.5±10.6, -10±0 and -50±0 respectively. Total of 25 adverse drug reaction were seen where vomiting, gastritis and anemia were more frequently seen. Alkylating agents showed more number of ADRs. Conclusions: From the study, it can be concluded that most of the chemotherapy drugs were compatible either in 5% dextrose or 0.9% normal saline. Dose adjustments were done on the basis of body weight and BSA. Alkylating agents showed ADR most frequently and least frequent was topoisomerase inhibitor. Vomiting was the most reported ADR.