What chemo drugs cause extravasation?
Manifestations of some commonly used chemotherapeutic drugs. Anthracyclines: Although all vesicants can cause tissue damage upon extravasation, anthracyclines, such as daunorubicin, doxorubicin, epirubicin, and idarubicin, have the greatest vesicant potential when compared to other chemotherapeutic agents.
What drug treats extravasation?
Phentolamine (Oraverse, Regitine, generic) may be given in cases of vasopressor extravasation (dopamine, norepinephrine [Levophed, generics], epinephrine). Hyaluronidase (Amphadase, Vitrase) has been used off label for vesicant drug extravasation, but it should not be used for infiltration of vasopressors.
How is extravasation of chemotherapy treated?
Hyaluronidase has been used for the treatment of vinca alkaloid and taxane extravasations. Doses of hyaluronidase ranging from 150 to 1,500 units diluted in 1 mL of normal saline subcutaneously or intradermally within 1 hour of extravasation have been used.
How do you treat extravasation of an antineoplastic medication?
When an extravasation occurs or is suspected, the first action to take is to stop the infusion (AII). Leave the cannula in position and attempt to aspirate as much of the vesicant as possible from the device; if an antidote is available, an appropriate amount should be instillated through the existing i.v. (AIII).
Is carboplatin a vesicant?
Carboplatin is a platinum chemotherapeutic agent commonly used in veterinary oncology that is currently classified as an irritant to local tissues when extravasated. To the authors’ knowledge, there are no reports of vesicant injuries associated with carboplatin administration reported in the veterinary literature.
Is vancomycin an extravasation?
Vancomycin is acidic (pH 2.5–4.0) and hyperosmolar (328 mOsm/L), which may make it a vesicant when administered through a peripheral line. Bohm and Wong describe bullous dermatitis as a result of vancomycin extravasation.
Is extravasation a medical emergency?
Extravasation injuries are considered to be medical emergencies. Early detection of the condition is best to avoid complications. Immediate treatment will be to stop the flow of medicine and review the possible injury caused. Depending on the severity of the injury, a plastic surgeon may come and examine it.
What is the best method of extravasation prevention?
Elevate the affected arm. Apply either ice packs or warm compresses to the affected area, depending on the type of vesicant. For most extravasations, apply ice for 20 minutes four to six times a day for 24 to 48 hours.
Is Remdesivir a vesicant or irritant?
One of the most common adverse events with remdesivir use is skin rashes. The chemotherapeutic drugs are commonly known for their vesicant effect causing infusion site reactions. The severe type of reaction occurs due to drug extravasation which can occur immediately or may be delayed up to 6–12 hours.
Is liposomal doxorubicin a vesicant?
Although the package insert states that Doxil® is an irritant, we took all necessary precautions and administered all the treatments currently available in Japan because the extravasation was massive, and doxorubicin per se is classified as a vesicant.
What does extravasation mean in terms of cancer treatment?
Definition Extravasation is the leakage of an injected drug out of the blood vessels, damaging the surrounding tissues. In terms of cancer therapy, extravasation refers to the inadvertent infiltration of chemotherapeutic drugs in the tissues surrounding the IV site.
Which is the best antidote for extravasation chemotherapy?
For the purposes of this document, we will focus upon five commonly used chemotherapeutics and their antidotes: doxorubicin, vincristine, vinblastine, carboplatin, and L-asparaginase. TABLE 1. MANAGEMENT OF EXTRAVASATION *No recommended antidote. †Recommended antidote: dexrazoxane or dimethyl sulfoxide (DMSO).
Why are chemotherapeutic agents at high risk for extravasation?
Chemotherapeutic agents are at highest risk for complications due to the nature of the agents and the potential to cause high cellular damage when extravasated. The severity of tissue damage can be limited by quick detection of extravasations and swift treatment.
What are the guidelines for the management of extravasation?
For prevention of extravasation, health professionals should be familiar with the extravasation management standard guidelines. They should regularly check the extravasation kit, assess patients’ sensory changes, tingling or burning, and always pay attention to patients’ words.