| |
9.1
Steroids, androgens, or other progestational agents should not
be used unless needed (i.e. steroids for CNS metastases). Short-term
use of dexamethasone around days of intravenous chemotherapy
is allowed for protection against emesis. If these agents are
utilized, they should be clearly recorded. Analgesic, antiemetic,
or narcotic drugs may be used accordingly and recorded on the
flow sheets. Barbiturates are not to be used.
9.2
This study should not interfere with any treatment decisions regarding
antitumor therapy. Diuretics may be used as clinically indicated
but should be recorded on the flow sheets.
9.3
New data suggest that Megace can lead to clinically significant
adrenal suppression in rare situations (Leinung
et al., 1995; Loprinzi
et al., 1992). Thus, if a patient is in a medical crisis situation
(e.g. infection, trauma, or surgery), the code should be broken
and, if they were receiving Megace, they should receive stress
doses of steroids. 
9.4
When Megace is discontinued, patients should be warned about potential
Addisonian-type symptoms (e.g. weakness, fatigue, hypotension)
and that they may need short-term corticosteroids if they develop
such symptoms.
|