Methotrexate and Fluorouracil Toxicities: What Advanced Practitioners in Oncology Need to Know
© 2015 Harborside Press®
ABSTRACT
Introduction
The collaborative practice model is well known to improve patient care and enhance health-care delivery. Many different scenarios of collaborative practice have been described in the literature, often combining the teamwork of physicians, nurse practitioners, physician assistants, pharmacists, and nurses. The collaborative practice approach is optimal to educate patients and all members of the health-care team regarding potential adverse effects and to implement strategies to prevent and manage them.
Additionally, collaborative practice models are essential to the care of patients in the management of rare toxicities or complications resulting from cancer treatment. In these settings, it is essential to develop strategies for team-based prevention, early recognition, and toxicity management. Based on an expert collaborative roundtable panel discussion—featuring Julie M. Vose, MD, MBA, FASCO; Wendy H. Vogel, MSN, FNP, AOCNP®; and Christopher J. Campen, PharmD, BCPS, BCOP—at the JADPRO Live at APSHO (Advanced Practitioner Society for Hematology and Oncology) conference in Orlando, Florida, in October/November 2014, the content of this supplement to JADPRO is intended to review collaborative strategies that should be employed to improve the care of patients treated with fluorouracil (5-FU) and high-dose methotrexate.
Both 5-FU and methotrexate are widely used agents in oncology, with unique toxicity profiles that require collaborative prevention and management for optimal patient care. These agents and their associated toxicities will be reviewed extensively in this supplement, especially with regard to proper dosing, monitoring, and prompt intervention. In addition, expanded access programs, including their purpose, benefits, and potential concerns, will be discussed.
The focused goal of the JADPRO Live at APSHO conference was for advanced practitioners and physicians to come together to discuss current treatment options and advances in the care of cancer patients and to help identify means to improve collaboration. With this goal in mind, BTG International Inc. provided an educational grant to assemble this distinguished panel to review preventive and management strategies for patients who experience toxicities related to treatment with 5-FU and methotrexate.
–Christopher J. Campen, PharmD, BCPS, BCOP
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