abiraterone

Assessment Monitor prostate specific antigen (PSA), serum potassium, serum bilirubin Monitor liver function tests (AST/ALT) baseline and every 2 wk for 3 mo and monthly thereafter in those with no known hepatic disease; interrupt treatment in patients without known hepatic disease at baseline who develop ALT/AST >5 times ULN or total bilirubin >3 times ULN; in baseline moderate hepatic disease, measure ALT, AST, and bilirubin before the start of treatment, every week for the first month, every 2 weeks for the following 2 months, and monthly thereafter; if elevations in ALT and/or AST >5 times ULN or total bilirubin >3 times ULN occur in patients with baseline moderate hepatic impairment, discontinue and do NOT restart. Measure serum total bilirubin, AST, and ALT if hepatotoxicity is suspected. Elevations of AST, ALT, bilirubin from baseline should prompt more frequent monitoring. Monitor musculoskeletal pain, joint swelling, discomfort: Arthritis, arthralgia, joint swelling, and joint stiffness, some severe. Muscle discomfort that included muscle spasms, musculoskeletal pain, myalgia, musculoskeletal discomfort, and musculoskeletal stiffness may be relieved with analgesics Assess for signs and symptoms of adrenocorticoid insufficiency; monthly for hypertension, hypokalemia, and fluid retention Monitor ECG for QT prolongation, ejection fraction in those with cardiac disease, small increases in the QTc interval such as < 10 ms have occurred; monitor for arrhythmia exacerbation such as sinus tachycardia, atrial fibrillation, supraventricular tachycardia (SVT), atrial tachycardia, ventricular tachycardia, atrial flutter, bradycardia, AV block complete, conduction disorder, and bradyarrhythmia

Patient/family education Teach patient that women must not come in contact with tabs, wear gloves if product needs to be handled, pregnancy (X) Instruct patient to report chest pain, swelling of joints, burning/pain when urinating

Evaluation

Positive therapeutic outcome: Decrease in B/P