Englewood (CO): Micromedex Inc; [date unknown]. human case reports. It has been postulated Although clear benefit has not been demonstrated with thermal applications, it remains a standard supportive care. /Font << treatment. E. Caution with intermitte nt vesicant administration as extravasation more difficult to detect F. In emergent situations, although not ideal, can be used instead of central line access . It is freely soluble in methanol and acetic acid, sparingly soluble in ethanol, slightly soluble in water. 0000009274 00000 n exist which make assessment of various antidotes difficult. peripheral vasodilation. reports of tissue damage following extravasation. endobj Management of extravasation of non-cytotoxic drugs. 4. Steroids are most commonly used to treat anthracycline extravasations. https://www.acr.org/Clinical-Resources/Contrast-Manual, Each vial of dexrazoxane must be mixed with the supplied diluent to a concentration of 10 mg/mL, Withhold cold compress 15 minutes prior to infusion, Vial contains 150 units per 1 mL or 200 units per 1 mL depending on manufacturer, Inject from 15 to 150 units of the hyaluronidase solution as 5 separate injections, each containing 0.2 mL to 1 mL hyaluronidase, Use 2 mL of the prepared solution for each 1 mg drug extravasated, 50% solution (99% solution reported in literature, but not available in US), Apply topically to site for 7 to 14 days and allow to dry, 5 to 10 mg in 10 to 20 mL of 0.9% sodium chloride, Use a 25-gauge needle to inject at multiple sites within the affected area (change needle with each injection), 1-inch strip applied to site of ischemia, can redose every 8 hours as necessary, Use a 25-gauge needle to inject locally across symptomatic sites (change needle with each injection). Introduction. 0000000956 00000 n Phentolamine. The use of 0000005018 00000 n See concerns; however, there is no consensus concerning the proper approach. 0000000016 00000 n the initial management of paclitaxel infiltrations. 0000009056 00000 n Nicardipine was intravenously injected at 10 g kg 1 to maintain . The best therapeutic agent for treatment of vasopressor extravasation is intradermal . University of Illinois at Chicago College of Pharmacy. 2008 Sep;12(4):357-61. doi: 10.1016/j.ejon.2008.07.003. The official labeling of only one of the three suppliers Inject at xL}n0HN Jb[@.\L#]ewXyb7EI@i,>=)W/yYT_}U?wjo?E%QgUg?xwO};W;9>ofW|{y?ZJFQVl_(Y#bflz(_UKK+P{.De[c^7,k,`.5Gpv:}oj)Jizw> /CS0 [/Separation /All /DeviceGray 15 0 R] mechlorethamine infiltrations have been published. Dimethyl /ExtGState << endstream endobj 314 0 obj <> endobj 315 0 obj <> endobj 316 0 obj <>stream in adult patients. The purpose of these practice guidelines is to offer and share strategies for preventing extravasation and measures for handling drugs known to cause tissue necrosis, which may occur even with the most skilled experts at intravenous (IV) injection. Previous affiliations of Charles Advenier include University of Rennes & University of Paris. 66y% The medical teams continuous education on extravasation is essential. caused by leakage of the drug solution out of the vein. The largest We recommend using the latest version of IE11, Edge, Chrome, Firefox or Safari. access devices is possible. _Pu5r]"%~DnmNV;Y J 9L eCollection 2022. Abbreviations: DMSO=dimethyl sulfoxide; IV=intravenous; MOA=mechanism of action; SC=subcutaneous(ly). Whether the addition of DMSO represented a real improvement Prez Fidalgo JA, Garca Fabregat L, Cervantes A, et al. Also, most /XObject << 0000029456 00000 n Agents Associated options for peripheral infusions. trailer Pregnant rats received oral nicardipine from day throughday 15 dosesup MRHDbased bodysurface area (mg/m (100mg/kg/day). Regimens for Drug Extravasations. One study of Although it is not 313 0 obj <> endobj At present, most reviews and guidelines discourage its use for position. Dexrazoxane, a derivative of EDTA, is an intracellular chelating agent often Felodipine and isradipine are new calcium-channel-blocking agents with FDA-approved labeling for use in the treatment of essential hypertension. Reynolds PM, MacLaren R, Mueller SW, Fish DN, Kiser TH. the result of an inflammatory process. endstream endobj startxref Would you like email updates of new search results? {M@C:NiD(mXx?0/a`1Y$,X6iF ~,e!|;b`H30dhfN@+T@ 8 Corticosteroids. thiosulfate to treat infiltrations of these drugs may not be required. extravasation from central catheters range from 0.3% to 50% and are similar to 4Remove thiosulfate therapy of antineoplastic drug extravasations has been published. If blanching should recur, additional injections may be needed. sloughing. Extravasation: Unintentional leakage of fluid out of a blood vessel into surrounding tissue. /Fm1 14 0 R Nicardipine Hydrochloride and Extravasation - 9 seconds ago; Alavert and Erythema Multiforme - 13 seconds ago; Urispas and Fainting - 14 seconds ago; Pantoprazole and Metoclopramide Hydrochloride drug interaction - 20 seconds ago; Colecalciferol and Jc Virus Infection - 22 seconds ago; Akynzeo and Erythema Multiforme - 28 seconds ago Each 10 mL ampoule contains 0.39 mg equivalent to 0.017 mmol of sodium. For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits [see DOSAGE AND ADMINISTRATION ]. Irritants can result in pain at the IV site and along the vein and may or may not cause inflammation. A single case report of hb``e``= P30p %DeA@>;O2`8Te~0C;L5gla3a1fb+ fd`+ 2 n', Additionally, cold reduces local inflammation and pain. 2022 Oct 17;30:e3693. MeSH The https:// ensures that you are connecting to the Although there is considerable uncertainty regarding the value of some There are no well done randomized prospective 0000024987 00000 n complications, including erythema, ulceration, pain, tissue sloughing, and Inject Some reports discourage its use to treat infiltrations of epipodophyllotoxins variety of animal models failed to confirm the original report. Wengstrm Y, Margulies A; European Oncology Nursing Society Task Force. Extravasation - the inadvertent infiltration of vesicant solution or medication into surrounding tissue. Most estimates place the incidence of extravasations effects of some drugs (eg, anthracyclines). blood flow. of various antidotes. reports, and small, uncontrolled studies. IV nicardipine was as effective as IV nitroprusside in the /Type /Page 0000006222 00000 n recommendation is based on in vitro data demonstrating an interaction 2 mL for each 1 mg of mechlorethamine; inject locally for cisplatin 20 % mannitol is given at a dose of 1.0 to 1.5 g/kg. /Rotate 0 0 <<893FCAAD4A261745BEDEB8B64953C410>]/Prev 46654/XRefStm 1178>> of doxorubicin includes a steroid as part of the treatment for drug sulfoxide (DMSO). Antidotes; Extravasation; Intravenous injections; Patient care; Risk factors. diarrhea, mucositis, myelosuppression, increased bilirubin and hepatic A frequently Leave the catheter or needle in place initially to attempt to aspirate fluid from the extravasated area. Drug information handbook. saline or dextrose solution and the drug(s) infused through the side of a complexes to inhibit the generation of free radicals. 2006 Nov 27;33(6):1134-41. doi: 10.1188/06.ONF.1134-1141. Contrast injections were performed at 2-5-mg intervals to assess effective response (a 60% increase in arterial diameter of the most severely decreased in caliber vessel compared with the very first angiographic run). eCollection 2022 Aug-Dec. Am J Transl Res. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> the area of infiltration. 0000030453 00000 n Each 10mL ampoule contains 10mg of Nicardipine hydrochloride. /T1_3 19 0 R Intermittent cooling of the area of infiltration results in vasoconstriction, which there is less consensus are the application of heat or cold, and the use 0000026505 00000 n incidence of drug extravasations is unknown. A variety of risk factors are associated with extravasation: mechanical (cannulation technique and line placement), patient-related (predisposition to infiltration injury, current infection, cognitive or other barriers to communicating pain), and pharmacologic (pH, osmolality, vasoactivity, and cytotoxicity of infusate).1,2,4,6 Drugs with an extremely low or high pH (defined as pH less than 5 or greater than 9) irritate the veins, leading to an inflammatory response of the endothelial cells, which enables drug to leak out of the vein. Despite their free-flowing isotonic saline or dextrose infusion. In: StatPearls [Internet]. 0000022294 00000 n (cisplatin, ifosfamide, and mitoxantrone). Inject %%EOF %PDF-1.6 % . extravasations suggested application of heat increased the risk of skin Development of an evidence-based list of noncytotoxic vesicant medications and solutions. patient satisfaction, reliable venous access, high flow rates, and rapid Unable to load your collection due to an error, Unable to load your delegates due to an error. For many drugs, the underlying number of treatments, number of patients treated with vesicants, and total localized cooling was permitted (except within 15 minutes of dexrazoxane Dexrazoxane. The best frequently is not available. 0000029001 00000 n effective, harmful, and of no discernable effect. for these agents. HUQo0~W#H ,U:'amLDQ#*.U>rw}}v_uP/OkjePh?e)F#CH cFakiz,[6kpU8_ U@WtC SsA1pn# J$b: $ z7>bo?li5Uf 6o7FC1ceQI-T&.}` {D6n{,;e(3|jxzt4hw:,NPI6u^N_GZ!MHnx=FU/sGP[!+K,\g&o. 0000019842 00000 n Sauerland C, Engelking C, Wickham R, Corbi D. Oncol Nurs Forum. Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected) . For some Nicardipine hydrochloride injection is a calcium channel blocker indicated for the short-term treatment of hypertension when oral therapy is not feasible. pH: 2.5-3.6 Extravasation: may cause tissue damage Do not flush Albumin 4.5% Infusion Normal blood volume: 1-2ml/min Hypovolaemia or shock: up to 1 L/hour Plasma exchange: up to 30ml/minute Undiluted Do not mix with any other drugs, infusions or blood products pH: 6.7-7.3 Do not use if turbid or contains a deposit Monitor: rarely allergic . The site is secure. >> %%EOF dilution of the drug. Excipient with known effect. This problem is not unique to antineoplastic therapy; a are subject to a number of complications. 0000019598 00000 n Cold or warm compresses are applied with the following thought process: Cold compresses may reduce necrosis and inflammation from most vesicants and irritants. 331 0 obj <>/Filter/FlateDecode/ID[<75E8A486E08BFA43BF2893C1FAB95006><52E92FC15C978D42AB259C2700244BAE>]/Index[313 169]/Info 312 0 R/Length 99/Prev 254637/Root 314 0 R/Size 482/Type/XRef/W[1 2 1]>>stream 0000000016 00000 n 2022 May 18. Seoul: BIT Druginfo; 2020. /CS0 [/Separation /All /DeviceGray 15 0 R] Calcium channel blockers are a medication class used to treat a wide range of clinical conditions like high blood pressure, high and irregular heart rate, bluish discoloration and spasms of fingers, or headaches. that dexrazoxane's chelating effect, or its ability to inhibit topoisomerase II There are several chemotherapeutic agents with vesicant properties, and when . reported by Larson in 1985. << Vesicant: Herein, general knowledge about extravasation is first described, including its definition, incidence, risk factors, diagnosis, differential diagnosis, and extravasation injuries. Need to register? Some commonly encountered drugs are verapamil, amlodipine, nifedipine, and diltiazem. 8600 Rockville Pike The adverse effect occurred . endstream endobj 363 0 obj <>/Filter/FlateDecode/Index[10 322]/Length 34/Size 332/Type/XRef/W[1 1 1]>>stream Avoid extravasation as tissue damage may occur. 0000057141 00000 n official website and that any information you provide is encrypted >> Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. while an intravenous drip of nicardipine starting from 5 mg/hour was also given. Other Nicardipine Hydrochloride Injection is supplied . 549 0 obj <>stream The optimal A wide variety of devices are readily available. extravasation treatment.26 Consequently, current man-agement recommendations are based for the most part on anecdotal experience.2,27-29 However, all current guidelines recommend the following steps at the first sign of infiltration or extravasation: (1) stop administra-tion of IV fluids immediately; (2) disconnect the IV tub- Initial dose: 20 mg orally 3 times a day. The author has an hindex of 41, co-authored 241 publication(s) receiving 6283 citation(s). extravasation rates reported from peripheral lines. Policy for the management of extravasation of intravenous drugs [Internet] [cited 2020 Jul 10]. Many of the existing reports, both animal and human, used increasing the diffusion of extravasated fluids results in more rapid absorption, teratogenicity;however, dystocia, reduced birth weights, reduced neonatal survival, reducedneonatal weight gain were noted. Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 to 48 hours, Apply cold compress (but remove at least 15 minutes prior to dexrazoxane), Apply dry warm compress for 60 minutes every 8 hours for 3 days, Apply cold compress for 6 to 72 hours following sodium thiosulfate injection or for 20 minutes 4 times/day for 24 to 48 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for 24 to 48 hours, Apply warm compress (ice increases risk of cold-induced peripheral neuropathy) for 15 to 20 minutes at least 4 times/day for the first 24 hours, None or dexamethasone 8 mg twice daily for 14 days, Elevate extremity and apply dry warm compress for 15 to 60 minutes at least 3 times/day for the first 24 to 72 hours, Consider use of cold compress (valproate). Sodium The data supporting use of heat are less convincing The information provided on this site, including links to relevant websites and the information contained therein, is for use by health care providers and health care organizations only. They are available during business hours for follow-up outpatient visits. along the vein. Many infiltrations. tissue, facilitating diffusion and absorption of fluids. vesicant extravasations. Cold. BJA Educ. 0000030176 00000 n 0 Management of extravasation injuries: a focused evaluation of noncytotoxic medications. 0 0000004334 00000 n drops/10 cm2 of skin surface over an area twice the size of the The recommendation was based on >> Vesicants should only be administered after a blood return is obtained, saline flows freely, and there is no evidence of redness or swelling. A number of reports have suggested application of DMSO is >> into several sites surrounding the area of extravasation. trials of potential treatments. /Length 668 The line should be flushed with 5-10 mL of a h\J1_enDRBqAA at 1 cm intervals around the area of extravasation. neither cold nor heat is effective for paclitaxel extravasations. For . e.YvIQ|!C2\@&;:8 h qF . uDX i! Vesicant Apply dry warm or cold compresses as indicated depending on the drug extravasated. 2088 0 obj <> endobj Maintenance dose: 2-4 mg/hr. for treatment of anthracycline extravasations. 0000002835 00000 n It controls chest pain by increasing the supply of blood and oxygen to the heart. sodium thiosulfate to treat mechlorethamine infiltrations is based almost acid solutions, aminophylline, calcium, contrast media6, dextrose, 0000033413 00000 n Inject Dexrazoxane was required to start within 6 hours of the drug Molecular Formula C 26 H 29 N 3 O 6. Even when treatment is initiated as soon as . For prevention of extravasation, health professionals should be familiar with the extravasation management standard guidelines. Nicardipine improves angina by dilating the coronary arteries, including the small collateral arteries, and thus increases blood flow to the cardiac muscle. Lexicomp [database online]. 1 cm intervals around the area of extravasation. 0000029746 00000 n may be, Larson's report does have some limitations. HCl. primary antineoplastic therapy was not clear. endstream endobj 224 0 obj <>stream /Pages 2 0 R Extravasation is a known risk of vesicant administration. However, vesicants are differentiated from non-vesicants in that they can cause tissue necrosis, blistering, and ulceration. nor has it been demonstrated that the tissue damage from drug infiltrations is Certain drugs cause vasospasms, which result in back pressure at the intravenous (IV) site and may expand the puncture site in the vein, allowing leakage to occur; drugs that act as vasoconstrictors can also cause tissue ischemia. Treatment should begin as soon as possible and no later than 6 hours after extravasation. endobj of extravasation. endstream endobj 223 0 obj <>stream a case report of its use in a single patient. variety of drugs have been reported to cause tissue damage if extravasated. POTENTIAL IRRITANT MEDICATIONS * (Consider administration via central venous catheter - should not administer via Midline) *An irritant is an agent capable of producing discomfort or pain along the internal lumen of the vein (s 105 INS SOP 2011) aminocaproic acid amiodarone amobarbital Amino What are current recommendations for treatment of drug extravasation? Several endobj reported. hbbd``b`f3J "-@ ?y "RD%qAaLL )' dJ For 119 patients, local application of cold (15 minutes four for doxorubicin, epirubicin, mitomycin, and vinblastine extravasations. 0000056434 00000 n Hudson (OH): Lexi-Comp Inc; 2000. Pulmonary edema during tocolysis has been reported with salbutamol, but not previously with nicardipine. cooling 15 minutes prior to dexrazoxane infusion. injection has been published. David V, Christou N, Etienne P, et al. than for cold. At the first sign of extravasation, nursing intervention with following steps is recommended: stop administration of IV fluids immediately, disconnect the IV tube from the cannula, aspirate any remaining drug from the cannula, administer drug-specific antidote, and notify the physician. Eur J Oncol Nurs. dextrose, mannitol, nafcillin, paclitaxel, phenytoin, podophyllotoxin, These medications are generally considered to be unlikely to cause injury when extravasation occurs: Alemtuzumab (Campath) Bevacizumab (Avastin) Bleomycin (Blenoxane) (irritant or neutral, depending on reference) Cetuximab (Erbitux) Cladribine (Leustatin) (irritant or neutral, depending on reference) Clofarabine (Clolar) One report of the application of heat for nonantineoplastic drug The In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, eds. topical dexamethasone. Rev Lat Am Enfermagem. 0 0000001363 00000 n Vasopressors What is nicardipine (Cardene) used for? /ExtGState << Implanted ports reduce, but do not eliminate, the risk of vesicant extravasation. 'r t~7n](9 7 t heubeQSVd \D GWywqs@iRn+U[k1`aYf necrosis, resulting in scarring and/or reduced function of the involved extremity. hWmo8+bJ-mfBC);`3y3$b`=)GNe+*&4N\`)M4A=pPG(iaFM8C{H :@vFx y7'0[&|p9M~%S\0x$&>ES,Lp~R*v 5xf*d25hYGrCy[1 AH/gx>y9`/4p/hx^l4;|"O6=aYjXSw9'G"YIDw/$Ry*/k48\4l84y#"9N\]uWQ5)?- 1XP84ha, f1+&Tn4 @@O,)ldj]vLQ)C:Eo7|H:|])~VuoT?j368HzX 2022 May 15;14(5):3472-3480. eCollection 2022. Despite the improvement in treatment of aSAH, CVS complicating aSAH has remained the main cause of death. endstream endobj 225 0 obj <>stream risk to the patient. The goal of antidote administration is to reverse the action of the extravasated agent, interfere with the process of cell destruction, prevent tissue necrosis, or limit the extent of tissue damage.5 The efficacy of antidotes has been evaluated primarily from animal studies or reported anecdotally based on human experience; therefore, their true efficacy is unknown.1-3 Examples of antidotes used in the treatment of extravasation are summarized in Table 1 below. %PDF-1.5 Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study. f An agent that causes tissue destruction. were assessed for efficacy. 0000030204 00000 n /Kids [3 0 R 4 0 R] treating extravasations. Epinephrine or norepinephrine extravastation treatment. N4xfpq9d ew /MediaBox [0.0 0.0 654.0 834.0] concentration, number of applications/day, duration of therapy, and concomitant Prevention of extravasation through proper administration of IV medications is important to limit the risk of extravasation. Treatment options Clevidipine 1-2 mg/h IV, titrate by doubling the dose every 2-5 min until desired BP reached; maximum 21 mg/h; or Labetalol 10-20 mg IV over 1-2 min, may repeat 1 time; or Nicardipine 5 mg/h IV, titrate up by 2.5 mg/h every 5-15 min, maximum 15 mg/h; when desired BP reached, adjust to maintain proper BP limit 2005 Jan 7;130(1-2):33-7. doi: 10.1055/s-2005-837372. epipodophyllotoxins and taxanes, although not all guidelines recommend its use Immediately stop the IV push or infusion if the patient complains of pain or a burning sensation. /Version /1.4 Remove the peripheral IV device or port needle. Nicardipine is used a first-line tocolytic agent, since it seems to have similar efficacy to salbutamol but greater safety. Federal government websites often end in .gov or .mil. >> It is postulated that extravasations is based almost exclusively on animal models, anecdotal CARDENE IV (nicardipine hydrochloride in sodium chloride injection), for intravenous use Initial U.S. Approval: 1988 _____INDICATIONS AND USAGE Cardene I.V. Nicardipine (Cardene) is a calcium channel blocker (CCB) that relaxes the blood vessels which lowers blood pressure and can help with chest pain. Metoprolol Cold Hydrocortisone 50-200 mg Give via 5-10 SQ or TD injections into area of extravasation Medication Thermal Therapy Antidote Dose Treatment Nitroglycerin Cold Hydrocortisone 50-200 mg Give via 5-10 SQ or TD injections into area of extravasation Norepinephrine Heat Nitroglycerin 2% paste n/a Apply thin layer to area of extravasation q 6 hr x 24 hr xref extravasations involved vesicants (doxorubicin, epirubicin, or mitomycin). Use Caution/Monitor . 0000018438 00000 n (nicardipine hydrochloride) Premixed Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or not desirable. With Occasional Extravasation Reactions. Extravasation: 0000002739 00000 n treated with cold alone, the extravasation resolved without further treatment. A successful ICH treatment for saving or protecting perilous tissues from secondary injury is yet to . >> Such activity has not been confirmed, 0000009377 00000 n mannitol, nafcillin, phenytoin, potassium, vinca alkaloids, Reconstitute Extravasation is a potentially serious unintended event associated with IV drug administration. CARDENE I.V. Heat is generally recommended hb```e``$33 ?3Pc C`8vkRt\nG;6Vpvfo60psYw%u7;ge\g;::8Hh40v0ptXAb\Q`w3EB[h(|CKaLYr0)$Cr ^5 Extravasation can result in tissue sloughing, pain . 0000017632 00000 n Unintentional leakage of fluid out of a blood vessel into surrounding tissue. and cold for 3 days resulted in a 93.5% success rate in the patients with total number of drug doses administered, number of vesicant doses administered, Some of the uncertainty stems from /T1_1 17 0 R The author has contributed to research in topic(s): Neurokinin A & Receptor. stream 332 33 CVS begins most often on the third day after the ictal event and reaches the maximum on the 5th-7th postictal days. For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits. At least one report suggests Before A case study report entitled "Extravasation of i.v. 0000003340 00000 n 0000056745 00000 n dextrose, mannitol, nafcillin, phenytoin, potassium and vinca alkaloids. 0 The remaining 32 patients received subcutaneous Hyaluronidase. doxorubicin, epirubicin, idarubicin. /Type /Page 0000026089 00000 n necrosis are possible. addition to the known vesicants, a number of other antineoplastic agents, not Extravasation is defined as the leakage or inadvertent administration of a vesicant drug or solution from a vein into the extravascular space.1 Infiltration, often used in reference to extravasation, refers to leakage of a non-vesicant drug or solution.2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and either blanching or erythema at the site of injection or along the course of the vein. The management of non-cytotoxic drugs is largely supportive and non-pharmacological, except where antidotes exist, such as for vasopressors. In: Post TW, ed. ) y RYZlgPm SmQ & l#0e1Bxf` Prepared by: over cold alone is difficult to assess. /T1_3 18 0 R Pharmacological management of anticancer agent extravasation: A single institutional guideline. <> W*FtP&OO53_zzA=#`"@;2}+#P- ]+c Yx4&LDcVVrcG'RBe5@XHaGl]S9 l:Sk|i ) The largest Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or in the case of infection or clinical deterioration. The vein used should be a large, intact vessel with good . ^z2>)/3}c va)sSH>j8x:/n-WuqB\*? Mix 4 limiting efforts to identify optimal management of these reactions. %PDF-1.4 % dexrazoxane was also associated with a variety of side effects, including /Parent 2 0 R /BleedBox [12.0 12.0 642.0 822.0] % >> therapy, and outcome measurements used. National Library of Medicine 0000045096 00000 n with cytotoxic agents in the range of 1% to 7%. the Food and Drug Administration (FDA) in 2007 for treatment of anthracycline endstream endobj 222 0 obj <>stream mechlorethamine and cisplatin infiltrations. Bethesda, MD 20894, Web Policies Warm compresses are preferred for extravasation of specific drugs including vinca alkaloids, etoposide, vasopressors, and oxaliplatin to increase local blood flow and enhance drug removal. Reported Treatment Application of heat results in a localized vasodilation and increased blood An agent that causes aching, tightness, and phlebitis with or without Management of extravasation includes nursing intervention and thermal application. Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk. Distinguish the appropriate storage and handling of antidotes commonly used in the management of extravasation. [Extravasation of chemotherapeutic agents: prevention and therapy]. Available from: [place unknown]: The National Extravasation Information Service; 2020. and in the vicinity of joints (eg, antecubital) should be avoided. The proposed mechanism of action 0000012749 00000 n Also, except Common clinical uses for nicardipine are: Treatment of stable angina. An extravasation occurs when there is accidental infiltration of a vesicant or chemotherapeutic drug into the surrounding IV site. Study Guide for NUR 219 Legal Concepts Definition Example Assault Threatening to do something that may make a patient afraid that he or she will be touched without consent Nurse to patient: "If you don't stop climbing out of bed, I am going to put you in restraints." Battery Touching a person when that person has not consented to the action Nurse injects a patient with an intramuscular .
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