PERHITUNGAN DASAR PERESEPAN OBAT KEMOTERAPI

LUCIANA
Chemotherapy Dose

■ Doses are individualized

■ Measured weights should be obtained at the time the
chemotherapy is prescribed to help ensure accurate dosing,
doses adjusted for weight gain or loss
Determine chemotherapy doses
Body Surface Area (m₂)
BSA, which formula should we use ?
Why Mosteller become standard for determining BSA?

■ It has been validated against other BSA formulas

■ It removes the chance of mathematical error if the patient’ height and weight are
inadvertently switched in the calculation
■ It is much easier to remember and therefore will find more widespread use in
clinical practice
■ It is applicable to children
How to calculate chemotherapy dose

■ Mr. X , colorectal carcinoma , chemotherapy protocol XELOX, height = 168 cm,

weight = 57 kg

XELOX
Oxaliplatin 130 mg/m2 D1
Capecitabine 1000 mg/m2 bid po D1-14
Calculation

XELOX
Oxaliplatin 130 mg/m2 130 x 1.63 = 211.9 mg
Capecitabine 1000 mg/m2 bid 1000 x 1.63 = 1630 mg
po
Calculation of safe dosage by BSA

■ Pasien anak ST, usia 7 tahun, TB : 126 cm, BB : 23 kg

■ Rencana pemberian Oncovin 1,8 mg iv ( jam 8 pagi )
■ Apakah dosis tepat ?
■ Dosis yang direkomendasikan 2 mg/m2
Calculation of safe dosage by BSA
Calculation of Safe Dosage by BSA

■ Evaluasi dosis :
■ Determine BSA

■ Calculate recommended dosage :

mg per m2 x m2 = 2 mg/m2 x 0,9 m2 = 1.8 mg
Pertanyaan :

■ Apakah dosis tepat/tidak tepat ?

■ Berapa ml oncovin yang harus diambil untuk dosis tersebut ?

■ Oncovin 1,8 ml
AUC, Carboplatin
Carboplatin Dose Calculation
Other Calculation
GFR : Estimation Of Renal Function
Formula :
Menghitung GFR
■ Ny SY 54 tahun; BB : 65 kg, TB : 165 cm
■ Hasil pemeriksaan lab :
■ Hitung estimated GFR

Jenus Pemeriksaan 4/4/2022 Nilai normal

Ureum 25,4 mg/dl 20-50 mg/dl
Kreatinin 1,43 mg/dl 0,8-1,1 mg/dl
Asam urat 3,6 2,3-6,1 mg/dl
Anthracycline Cumulative Dose
 Perhitungan :
Pasien NY. NV dengan Non-Hodgkin’s Lymphoma telah menjalani 6x siklus kemoterapi
R-CHOP dan 2x IVE. BB : 60 kg. Berapa dosis masing-masing rejimen kemoterapi
tersebut ?

R-CHOP, to be repeated every 3 weeks ( 6 course )

Cyclophosphamide 750 mg/m2 I.V D1

Doxorubicin 50 mg/m2 I.V D1

Vincristine 1.4 mg/m2 ( max 2 mg ) I.V D1

Prednisone 100 mg/m2 PO D 1-5

Rituximab 375 mg/m2

 IVE
Ifosfamide 2500 mg/m2 I.V D 1-3
Etopiside 150 mg/m2 I.V D 1-3
Epirubicin 50 mg/m2 I.V D1
Jawaban ?
Corticosteroid conversion dose
Absolute Neutrophil Count ( ANC )
Absolute Neutrophil Count ( ANC ) Calculation
Latihan
■ Ny RK usia 65 tahun dengan TB : 165 cm dan BB : 62 kg, saat ini rencana mendapat kemoterapi dengan
protokol Paclitaxel dan Carboplatin. Dokter menginstruksikan :
- Paclitaxel 294 mg + NS 250 ml selama 3 jam
- Carboplatin 589 mg + D5% 250 ml selama 60 menit ( target AUC : 6 )
■ Hasil pemeriksaan laboratprium :
■ Hb : 12,3; LEukosit : 10.160; Trombosit : 314.000; Hematokrit : 36,2%; Ureum : 21; creatinine : 0,92.
■ Sediaan paclitaxel yang tersedia di farmasi adalah 30 mg/5 ml dan 100 mg/16,7 ml; sedangkan sediaan
Carboplatin 450 mg/45 ml dan 150 mg/15 ml.
■ Lakukan pengerjaan melalui tahapan :
a. Identifikasi resep,
b. verifikasi protokol
c. perhitungan dosis
d. rekonstitusi
e. etiket
■TERIMA KASIH