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. 2022 Apr 6;7(2):100462. doi: 10.1016/j.esmoop.2022.100462

Table 2.

Overview of relevant AEs seen with naxitamab infusion and corresponding supportive treatments, including nurse action employed by the HSJD team

Category AE Premedication (30-60 min pre-infusion) Supporting medication (PRN) Nurse action
Skin Erythema, pruritus, or urticaria (hives) Cetirizine 2.5-10.0 mg p.o.
H2 blocker e.g. ranitidine 2 mg/kg p.o.		 Dexchlorpheniramine 0.15 mg/kg i.v.
Hydroxyzine 0.5-1.0 mg/kg i.v. or p.o.		 Apply an ice pack locally to soothe pain or pruritus
Cardiovascular Hypotension Saline bolus Saline bolus
Naloxone 1 μg/kg i.v.; repeated every 2-3 min
Adrenaline 0.1 mg/kg i.v. or i.m.		 Use Trendelenburg position
Peripheral i.v. where more fluids are required
Hypertension Enalapril starting at 0.08 mg/kg/day p.o.
Nifedipine 0.25-0.50 mg/kg/dose p.o. (max. 10 mg/dose)
Hydralazine 0.3-0.5 mg/kg/dose i.v. (max. 20 mg/dose)
Respiratory Bronchospasm

  • Salbutamol nebulizer:

  • •

    <20 kg: 2.5 mg

  • •

    >20 kg: 5.0 mg

  • Add if needed: Ipratropium bromide nebulizer:

  • •

    <10 kg: 125 μg

  • •

    10-30 kg: 250 μg

  • •

    >30 kg: 500 μg

  • Position the patient correctly for effective nebulizer use
Edema of tongue Dexchlorpheniramine 0.15 mg/kg i.v.
Apnea Naloxone 1 μg/kg i.v.; repeated every 2-3 min Position the patient correctly for assisted ventilation
Laryngitis or laryngotracheitis Adrenaline nebulizer
0.5 mg/kg/dose (max. 5 mg)
Add if needed:
Budesonide nebulizer
2 mg
Grade 3: add dexamethasone
0.15 mg/kg/dose i.v. (max. 10 mg)		 Position the patient correctly for effective nebulizer use
Anaphylaxis Airway or cardiovascular compromise Adrenaline 0.1 mg/kg i.m. or i.v.
Pain Standard supportive pain protocol during naxitamab infusion Paracetamol 15 mg/kg p.o.
Gabapentin 5-10 mg/kg every 8 h p.o. (max. 600 mg)
Morphine chloride
25-100 μg/kg i.v.		 Morphine chloride
25-100 μg/kg i.v.		 Apply cold/hot packs to painful areas
O2 mask may be helpful
Residual post-infusion pain Metamizole 30 mg/kg/dose i.v. (max. 2 g/dose)
Dexketoprofen 1 mg/kg/dose (max. 50 mg/dose)
Gastrointestinal disorders Nausea Ondansetron 5 mg/m2 i.v.
Fosaprepitant 5 mg/kg (max. 150 mg) i.v.a
Other Anxiety, nausea Lorazepam 0.01-0.02 mg/kg i.v. Lorazepam 0.01-0.02 mg/kg i.v. or p.o. (max. 1 mg)

AE, adverse events; HSJD, Hospital Sant Joan de Déu; i.m., intramuscular; i.v., intravenous; p.o., oral; PRN, as needed.

a

Day 1 of chemotherapy.