Editing Pharmacology (section)

=== Oncology and Immune ===

Cytotoxic chemotherapy causes bone marrow suppression with a nadir typically 7 to 14 days after administration, mucositis, alopecia, nausea, and infertility. Teach infection precautions and report a temperature of 38 degrees Celsius or 100.4 degrees Fahrenheit or higher as a potential neutropenic emergency. Many agents are vesicants requiring immediate action for extravasation. Doxorubicin is cardiotoxic with a lifetime cumulative dose limit, cisplatin is nephrotoxic and ototoxic, vincristine causes peripheral neuropathy and is '''fatal if given intrathecally''', and methotrexate is rescued with leucovorin. Preparation and administration of chemotherapy require specialized certification.