Académique Documents
Professionnel Documents
Culture Documents
Cyclophosphamide
Docetaxel
Doxorubicin
Fluorouracil
(5FU)
DOSE
150mg/
vial
450mg/
vial
Hematopoietic
Agent (GCSF)
NOTES
Total #: _____________
----
Total #: _____________
- available drug
----
Total #: _____________
- drug given
1g/vial
----
500mg/
vial
80mg/
vial
20mg/
vial
----
Total #: _____________
----
Total #: _____________
----
Total #: _____________
----
Total #: _____________
50mg/
vial
----
20mg/
vial
----
Total #: _____________
----
Total #: _____________
500mg/
vial
1g/vial
Gemcitabine
# OF VIALS/AMPULES
----
200mg/
vial
300ug/
vial
----
----
----
----
Total #: _____________
----
Total #: _____________
----
Total #: _____________
----
----
Hensetron
1mg/
mL
Leucovorin
Calcium
50mg/
ampule
Oxaliplatin
50mg/
vial
Total #: _____________
----
----
----
Total #: _____________
----
----
Total #: _____________
LEGEND
OTHERS:
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________
________________________