Ifosfamide. Patient care management

Ifosfamide is an antineoplastic drug with efficacy and activity in numerous cancers. This drug can be administered safely in a hospital setting if toxicities and side effects are monitored frequently by a well-informed and educated nursing staff. Problems may occur in any bodily system, such as the kidney, central nervous system (CNS), gastrointestinal tract, and bone marrow. This article reviews appropriate ways to monitor for complications and plan correct nursing interventions. Ifosfamide (Ifex, Mead Johnson) is an alkylating agent that is not cell cycle specific. One of its metabolites, acrolein, is responsible for hematuria. Concurrent administration of mesna (Mesnex, Mead Johnson) is used to prevent this complication. The metabolite chloroacetaldehyde may be responsible for CNS toxicities. When kidney function and electrolytes are within normal limits and psychotropic medications are not given concomitantly, this rarely occurs. Gastrointestinal toxicities are usually not severe, but may include occasional nausea and vomiting. Hematologic toxicity includes platelet-sparing myelosuppression, which can be successfully supported with the administration of growth factors.