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GrANULOCYTE COLONY-STIMULATING FACTOR

GrANULOCYTE COLONY-STIMULATING FACTOR. SC GC-SF 300 mcg od. Stimulation of granulocyte production in chemotherapy-induced neutropenia. Severe chronic neutropenia. P atients undergoing peripheral blood progenitor cell collection. iNDicaTIoN.

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GrANULOCYTE COLONY-STIMULATING FACTOR

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  1. GrANULOCYTE COLONY-STIMULATING FACTOR SC GC-SF 300 mcg od

  2. Stimulation of granulocyte production in chemotherapy-induced neutropenia Severe chronic neutropenia Patients undergoing peripheral blood progenitor cell collection iNDicaTIoN

  3. Stimulates production, maturation and activation of neutrophils Activates neutrophils to increase both motility and cytotoxicity mODeoFAcTion

  4. Subcutaneous Chemotherapy-induced neutropenia : 5 mcg/kg/day, doses may increase by 5 mcg/kg base on duration and severity. Bone marrow transplantation : 10 mcg/kg/day, adjust dose base on duration and severity. Severe chronic neutropenia : 6 mcg/kg twice daily (congenital), 5 mcg/kg/day (cyclic/idiopathy) dosE

  5. Alkaline phosphatase increase Nausea, vomitting Petechiae, rash Splenomegaly Bone pain Epistaxis Fever SiDEefFecTs

  6. First dose should be given no sooner than 24 hours after chemotherapy. In myeloid malignancies, GCSF potentially act as growth factor for any tumor type. pRecauTionS

  7. MAXOLON (metoclopramide) Maxolon tablet 10 mg tds

  8. Symptomatic treatment of diabetic gastric stasis Gastroesophageal reflux iNDicaTIoN

  9. mODeoFAcTion

  10. Oral Gastroesophageal reflux : 10-15 mg/dose up 4 times/day 30 minutes before meals or food and at a bedtime. Single dose of 20 mg for provoking situations. Diabetic gastric stasis : 10 mg 30 minutes before each meal and at bedtime. dosE

  11. Oral Chemorherapy-induced emesis Moderate risk : 0.5 mg/kg every 6 hours or 20 mg 4 times/day on days 2-4. Low risk : 20-40 mg every 4-6 hours. dosE

  12. SiDEefFecTs

  13. Metoclopramide • Extrapyramidal symptoms or risk when • use concurrently with antipsychotic agents • Cyclosporine levels • CNS depression (synergistic with opiate • analgesics and ethanol) Metoclopramide’s actions antagonize by anticholinergic agents inTerActioNs

  14. CIPROFLOXACIN (fluoroquinolone) Ciprofloxacin tablet 500 mg bd

  15. Treat bacterial infection • (gram +ve and –ve) • Urinary tract infection • Lower respiratory infection • Chronic bacterial prostatitis • Acute uncomplicated cystitis (female) • Skin, bone and joint infection iNDicaTIoN

  16. mODeoFAcTion

  17. Oral : 250-750 mg every 12 hours (500 mg twice daily) dosE

  18. COMMON neurologic events (dizzines, insomnia, somnolence,nervousness) Nausea, vomitting, diarrhea SiDEefFecTs

  19. Ciprofloxacin • Serum level of tizanidine • Effects/toxicity of caffeine • Tendon rupture risk, • use with corticosteroids • Risk of seizures, use • with NSAIDs or foscarnet Probenecid increase ciprofloxacin levels inTerActioNs

  20. Ciprofloxacin • Phenytoin levels Ciprofloxacin level • Taken with dairy product • Enteral feedings • Antacids, oral electrolyte • supplement, quinapril, • sucralfate inTerActioNs

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