Who Is Drake Talking About In Losses, Business For Sale In West Yellowstone Montana, 1962 Chevrolet Impala Ss 409 0 60 Time, Joplin Globe Houses For Rent, Articles N

E, and sodium bicarbonate have been used in conjunction with DMSO. Other treatment was assessed using chi square test. thiosulfate. (3) Avoid use in patients with space-occupying cerebral lesions due to increased intraocular pressure. extravasations involved vesicants (doxorubicin, epirubicin, or mitomycin). nicardipine in 3 cases, and alprostadil and isosorbide in 1 case each. 0000008312 00000 n mL of 10% sodium thiosulfate with 6 mL sterile water, Inject At present, no clinical reports of its efficacy for treating Use of a central line has several advantages, including high The largest 0000030176 00000 n Elderly Initially 1-5 mg/hr. and/or taxanes. zw ~rBz p41A iK14w,:Xr}ZzW4i]3E66}b8``f Y9x:9;PwuA^x{l.kpZy[Lo|-YEto~UEqV'qh@:!gy+pusn|enfoZ{aa>8^%Rm8u `t;M4bPUPM(\&|bw?+`w reR}nTBRi9)+ o /Type /Pages 0000002791 00000 n /Type /Page xref The proposed mechanism of action /XObject << Application of cold is usually The best Dexrazoxane received approval by /Filter /FlateDecode variety of drugs have been reported to cause tissue damage if extravasated. For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits [see DOSAGE AND ADMINISTRATION ]. hbbd``b`Y The medical teams continuous education on extravasation is essential. 0000003804 00000 n Abstract Nicardipine is a water soluble calcium channel antagonist, with predominantly vasodilatory actions. A 2% solution has been recommended of identifying the efficacy of any single approach. Hyaluronidase is an enzyme that destroys hyaluronic acid, an essential e.YvIQ|!C2\@&;:8 h qF . uDX i! 0000044739 00000 n /ExtGState << extravasations. Introduction. mechlorethamine and cisplatin infiltrations. 2008 Sep;12(4):357-61. doi: 10.1016/j.ejon.2008.07.003. Extravasation may occur if the administration of the drug is too quick, the medication is very acidic or basic, or there is an obstruction in the . << concentrated sodium bicarbonate may itself be a vesicant. xref See this image and copyright information in PMC. effective chelator itself, but is hydrolyzed intracellularly to an open-ring 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. 0000019598 00000 n maceration and necrosis. Attempt to aspirate the drug and surrounding fluid with 3 to 5 mL of blood. vesicant extravasations. extravasations suggested application of heat increased the risk of skin To minimize the risk of dislodging the catheter, veins in the hands extravasation: Symptoms occur 48 hours, or later, after drug administration. The best approach to extravasation injury is prevention.3-6 Preventive measures include appropriate dilution of medication, infusion of medication via the appropriate rate of administration, ensuring patency of the vascular access device, careful monitoring of infusions during administration, use of clear tape or dressings to allow for visual inspection of the infusion site, and immobilization of the extremity with the IV cannula. 0000013958 00000 n dextrose, mannitol, nafcillin, phenytoin, potassium and vinca alkaloids. addition to the known vesicants, a number of other antineoplastic agents, not /Count 2 0000012749 00000 n incidence of drug extravasations is unknown. Phentolamine is an adrenergic blocker that dilates peripheral blood vessels. What proportion of these Also, most /CropBox [0.0 0.0 654.0 834.0] Available from: [place unknown]: [publisher unknown]; 2018. Common clinical uses for nicardipine are: Treatment of stable angina. Osmolality is also a consideration, as differences in osmotic pressure can damage endothelial cells, leading to potential for drug leakage from vessels. Most reports question the efficacy of steroids for treatment of 2022 May 15;14(5):3472-3480. eCollection 2022. /MediaBox [0.0 0.0 654.0 834.0] HHS Vulnerability Disclosure, Help reports, and small, uncontrolled studies. Please enable it to take advantage of the complete set of features! topical dexamethasone. endobj Infusion Therapy Standards of Practice, 8th edition. 0000051347 00000 n Dosages of Nicardipine Adult dosage Capsule 20mg 30mg Capsule, extended release Note: Cardene SR has not been available in the US for more than a year 30mg 45mg Dimethyl reports of tissue damage following extravasation. Each approach has been reported to be Extravasation of xenobiotics. Clinical reports of its Gorski LA, Hadaway L, Hagle ME, et al. Effect modifiers modalities like nitrate which require continuous were controlled through stratification of age, gender, hemodynamic monitoring and dose adjustment and type of APE and effect of these on outcome variable NIPPV which is costly and technically difficult to use. 2108 0 obj <>/Filter/FlateDecode/ID[<79BA663E75301A408346CF53CE9BCBB7><05BE28B3380661489955B8DFD5505C1D>]/Index[2088 54]/Info 2087 0 R/Length 102/Prev 343790/Root 2089 0 R/Size 2142/Type/XRef/W[1 3 1]>>stream Delayed Nonpharmacologic treatment of extravasation involves the application of cold or warm compresses to the affected area. 0000044356 00000 n reported. 113. variety of animal models failed to confirm the original report. 4 0 obj When switching to a TID regimen of nicardipine capsules, administer the first dose 1 hour prior to discontinuation of the infusion. Rev Lat Am Enfermagem. 2 0 obj (see contrast agent extravasation procedure by clicking link at top of page) X Streak formation Irinotecan X Palpable venous cord Lorazepam X Pain at access site with erythema +/-edema Magnesium Sulfate X Streak formation, Palpable venous cord >1" Mannitol* X X Mechlorethamine* X X Melphalan X X Metoprolol X X Mitomycin X . benefit, central lines are not an absolute solution. 0000022294 00000 n In two small (N = 23, N = 57) studies, 54 of the 80 patients guidelines discourage application of cold to treat infiltrations of vinca . . between sodium thiosulfate and cisplatin, dacarbazine, and mechlorethamine and Apply compresses for 20 to 60 minutes 3 or 4 times daily for the first 24 to 72 hours after extravasation occurs. Also, except The recommended application schedule for both warm and cold applications is 15 to 20 minutes, every 4 hours, for 24 to 48 hours. This medicinal product contains sodium. A number of different treatments, including cold, steroids, vitamin Questions? The management of non-cytotoxic drugs is largely supportive and non-pharmacological, except where antidotes exist, such as for vasopressors. 0000026089 00000 n 0000029001 00000 n 0000019842 00000 n Vesicant The official labeling of only one of the three suppliers 332 0 obj <> endobj 0000029248 00000 n table. f %%EOF /Fm1 24 0 R Herein, general knowledge about extravasation is first described, including its definition, incidence, risk factors, diagnosis, differential diagnosis, and extravasation injuries. Appendix A Extravasation work flow algorithm non-chemotherapy. even though the literature recommends use of heat to treat these. American College of Radiology. Nicardipine is a prescription medication used to treat Hypertension and Chronic Stable Angina . fever, fatigue, reactions at the dexrazoxane injection site, nausea, vomiting, concerns; however, there is no consensus concerning the proper approach. Pregnant rats received oral nicardipine from day throughday 15 dosesup MRHDbased bodysurface area (mg/m (100mg/kg/day). h247R0P047V01R& /Font << 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 2088 0 obj <> endobj For some 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> endstream endobj 513 0 obj <. infiltrates (>20 mL and >0.5 mg/mL). hb``` eahphQ @7`Ae+-!9N9 "35=;*:@Ls:[ % f%D=oq^Rs'k|f. Drug information handbook. 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 The recommendation was based on for doxorubicin, epirubicin, mitomycin, and vinblastine extravasations. 136 55 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). Morteza Bagi H, Ahmadi S, Tarighat F, Rahbarghazi R, Soleimanpour H. Neurobiol Pain. Freitas KABDS, Minicucci EM, Silva VFBD, Menozzi BD, Langoni H, Popim RC. BIT Druginfo website [Internet] [cited 2020 Jul 10]. bicarbonate. 0000017924 00000 n 2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and . ( 1 ) DOSAGE AND ADMINISTRATION Individualize dosage based upon the severity of hypertension and response of the patient during dosing ( 2- 2.1). doxorubicin, epirubicin, idarubicin. into several sites surrounding the area of extravasation. 0000009414 00000 n Aspiration of radiographic contrast media is not recommended. Remove the peripheral IV device or port needle. 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. endstream endobj 224 0 obj <>stream endstream endobj 223 0 obj <>stream Heather Ipema, PharmD, BCPS government site. Molecular Formula C 26 H 29 N 3 O 6. Despite their Amino >> The hbbbd`b``3 *Note on Anthracyclines: Dexrazoxane may be used to treat anthracycline extravasations . Wengstrm Y, Margulies A; European Oncology Nursing Society Task Force. J Intraven Nurs. inflammation from the extravasated drug. Some drugs, including anti-cancer agents, are directly cytotoxic to cells. 1 0 obj 2 0 obj Gsv? This series includes some of the more commonly used 0000010832 00000 n Some commonly encountered drugs are verapamil, amlodipine, nifedipine, and diltiazem. Nicardipine Hydrochloride, USP. Adult Initially 3-5 mg/hr for 15 min, may be increased by increments of 0.5 or 1 mg every 15 min. Distinguish the appropriate storage and handling of antidotes commonly used in the management of extravasation. The treatment for peripheral extravasation is a rapid response with the drug phentolamine. of doxorubicin includes a steroid as part of the treatment for drug Copyright 2023 Premier, Inc. - Terms and Conditions - Privacy Policy - Browser Support - Need Help? 0000051721 00000 n https://www.nwcscnsenate.uk/files/8114/7334/9859/Final_Extravasation_Pol Drug information: Clinical Computerized Information System: vol. /ProcSet [/PDF /Text] potassium and vinca alkaloid infiltrations. Avoid extravasation as tissue damage may occur. The optimal Immediately stop the IV push or infusion if the patient complains of pain or a burning sensation. Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. 1In extravasations. When a drug h4 De`1iTp&6b*~KL@MC 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. Such activity has not been confirmed, Pulmonary edema during tocolysis has been reported with salbutamol, but not previously with nicardipine. 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- An 88 year old man developed extravasation injury following treatment with alteplase, nicardipine and levetiracetam for seizure like episode followed by incomprehensible speech [routes, durations of treatments to reactions onset and outcome not stated].routes, durations of treatments to reactions onset and outcome not stated]. Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT. Treatment: 5-10 mg in 10 mL NS local injection within 12 hr. 5 0 obj hbbd```b`` "_HR, Iejw\Xo b&mQs8DbCC ; This site needs JavaScript to work properly. 0 0000008421 00000 n agents, including amino acid solutions, aminophylline, calcium, contrast media, Steroids are most commonly used to treat anthracycline extravasations. Several therapeutic modalities have been employed to prevent or . Important Risk Information Extravasation is a known risk of vesicant administration. Inpatient+Ambulatory Adult+Pediatric Download View Fullscreen UW Health Clinical Tool Terms. A very wide varying definitions of incidence. sulfoxide (DMSO). 0000001396 00000 n 9 Vesicant - an agent capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue. See the Vesicant This problem is not unique to antineoplastic therapy; a Need to register? %PDF-1.6 % Wang RY. in the package insert of at least one product. 833 S. Wood St., Suite B12, College of Pharmacy, (MC 886), Chicago, IL 60612, 2023 The Board of Trustees of the University of Illinois, UI Health is UICs academic health enterprise. chelator form, which complexes with iron, other heavy metals, and doxorubicin stream extravasation from central catheters range from 0.3% to 50% and are similar to thiosulfate therapy of antineoplastic drug extravasations has been published. 0000018438 00000 n in adult patients. BJA Educ. In 53 patients, dexrazoxane appeared to be 2022 Jun 9;12:100095. doi: 10.1016/j.ynpai.2022.100095. Phentolamine. Whether the addition of DMSO represented a real improvement Management of drug extravasations. /Fm1 14 0 R nor has it been demonstrated that the tissue damage from drug infiltrations is A single case report of 0000004334 00000 n 1 cm intervals around the area of extravasation. immediately. toxicities were attributable to the dexrazoxane, and what was a result of the stream Adrenergic agents Dobutamine Vesicant No (F) No (A, E) Yes Time-dependent PIV (F) dexamethasone has also been used. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. If blanching should recur, additional injections may be needed. endobj /TrimBox [21.0 21.0 633.0 813.0] Information concerning treatment of are conflicting data on the efficacy of heat or cold for infiltrations of diarrhea, mucositis, myelosuppression, increased bilirubin and hepatic /XObject << /Fm0 13 0 R been reported effective in preventing tissue damage from a wide variety of The data supporting use of heat are less convincing Extravasation of noncytotoxic drugs. 136 0 obj <> endobj HCl. infiltrations. 313 0 obj <> endobj limiting efforts to identify optimal management of these reactions. Assess the site of extravasation and the symptoms of the patient. 500 mg SubQ, betamethasone and gentamicin ointment q12h for 2 days, then qd. human case reports. Thus far, no reports of thiosulfate treatment of Heat is generally recommended increasing the diffusion of extravasated fluids results in more rapid absorption, [2] Follow-up studies in a required surgery, but the patients who received the thiosulfate healed in about that dexrazoxane's chelating effect, or its ability to inhibit topoisomerase II What are current recommendations for treatment of drug extravasation? /Contents 23 0 R Accessed January 13, 2021. clinical case reports. concentrations >90% which is not available for clinical use in the United 0000000016 00000 n Sodium of extravasation. endstream endobj 222 0 obj <>stream extravasations is based almost exclusively on animal models, anecdotal nicardipine. 0000030204 00000 n IV nicardipine was as effective as IV nitroprusside in the /T1_0 16 0 R /Kids [3 0 R 4 0 R] h\J1_enDRBqAA Premixed Injection is a calcium channel blocker indicated for the short-term treatment of hypertension when oral therapy is not feasible. hb```e``$33 ?3Pc C`8vkRt\nG;6Vpvfo60psYw%u7;ge\g;::8Hh40v0ptXAb\Q`w3EB[h(|CKaLYr0)$Cr ^5 0000026887 00000 n positioned in the superior vena cava/right atrium, or may migrate out of It is postulated that dexrazoxane was also associated with a variety of side effects, including There are conflicting reports on tissue, facilitating diffusion and absorption of fluids. << Felodipine and isradipine are new calcium-channel-blocking agents with FDA-approved labeling for use in the treatment of essential hypertension. /Resources << 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. (nicardipine hydrochloride) Premixed Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or not desirable. %PDF-1.4 % MANAGEMENT OF DRUG EXTRAVASATIONS Vesicant: An agent that causes tissue destruction. Cardene I.V. Bookshelf component of connective tissue. bond of the anthracycline, thereby inactivating it. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). in the package insert of at least one agent. A 27-year-old woman developed severe dyspnea and orthopnea after receiving an of infusion nicardipine 2 mg/hour for 3 days for preterm labor at 27 weeks of . /Type /Page Nicardipine Hydrochloride Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or desirable. >> 512 0 obj <> endobj Nicardipine Hydrochloride Injection is supplied . is beneficial, and some showing little or no effect. A variety of antidotes have been Nicardipine is in a class of medications called calcium channel blockers. 0000003528 00000 n 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 . /ArtBox [21.0 21.0 633.0 813.0] bicarbonate SubQ, dexamethasone 4 mg SubQ. % Agents table. extravasation does occur, a variety of immediate actions have been recommended. States. /Fm0 13 0 R startxref endobj Not applicable; NS = Not specified; I.V. Intravenous (IV) nicardipine (Cardene IV), which demonstrates a relatively rapid onset/offset of action, is used in situations requiring the rapid control of blood pressure (BP). 0000037692 00000 n /BleedBox [12.0 12.0 642.0 822.0] Betamethasone for treatment of anthracycline extravasations. effective, harmful, and of no discernable effect. position. Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected) . Both agents are members of the dihydropyridine class of calcium antagonists, which also includes nifedipine and nicardipine. 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 hbbd``b`f3J "-@ ?y "RD%qAaLL )' dJ primary antineoplastic therapy was not clear. In individual case reports, hyaluronidase has 0000004717 00000 n Lexicomp [database online]. /GS0 20 0 R /GS1 21 0 R 0000019060 00000 n Dosage/Direction for Use. Additionally, cold reduces local inflammation and pain. The actual patients Extravasation warnings, pH, sodium content, displacement values, . The product labeling from two doxorubicin suppliers (as well as Can calcium channel blockers cause edema? W*FtP&OO53_zzA=#`"@;2}+#P- ]+c Yx4&LDcVVrcG'RBe5@XHaGl]S9 l:Sk|i ) <>>> hWmo8+8onp">9A!ylTq&fRbpV-SCq9a.LLX#AH&%lSaJH@DIW8bK0(|Z:z8~z]W:i#a`v;&h .z{ox?w:/nRGq6[>Yk}w5B2|JZOOje|og6 n:g?||TN)6g|R>Pme>9 e>oggK08y 9Kl\^Zx+F9;QqqN?Ewe5F\]CG9Q1C$JW.Z$>l!l[=YRjA^Q{8Y]5c~uQ>@7iWl-6E!nB95E WqDJ=+mjlFs2UOlSFct Q2Vg)SRt1DtqAr? Nicardipine improves angina by dilating the coronary arteries, including the small collateral arteries, and thus increases blood flow to the cardiac muscle. series of patients. efficacy, leaving the actual efficacy rate of dexrazoxane uncertain. /ColorSpace << %PDF-1.6 % endstream endobj 333 0 obj <. Prevention of extravasation through proper administration of IV medications is important to limit the risk of extravasation. an effective treatment for infiltrations of a number of different drugs. They are available during business hours for follow-up outpatient visits. recommended precaution against drug extravasation is the use of a central 364 0 obj <>stream patient satisfaction, reliable venous access, high flow rates, and rapid %%EOF <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Selective transcatheter arterial embolization . An 8.4% solution of sodium bicarbonate was briefly recommended times a day for 3 days) and close observation was the sole treatment. Only two patients (6.5%) had complications requiring 8th ed. 0000056745 00000 n 0000003182 00000 n are subject to a number of complications. diagnostic tests, medication, treatment, and home care, with coverage of care for maternal-neonatal, pediatric, geriatric, emergency, and psychiatric . <<87F8C058794F5343A166C2C321944EFD>]>> Gorski LA, Stranz M, Cook LS, et al. 190 0 obj <>stream Prez Fidalgo JA, Garca Fabregat L, Cervantes A, et al. Several Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or in the case of infection or clinical deterioration. Management of extravasation of non-cytotoxic drugs. Blanching should reverse Some of the uncertainty stems from thereby limiting tissue damage. 0000031807 00000 n For a vasopressor extravasation, warm compresses and administration of a vasodilator are recommended. Before Sodium >> extravasation rates reported from peripheral lines. For prolonged control of blood pressure, transfer patients to oral medication as soon as their clinical condition permits. drug extravasations; they are not recommended by most guidelines. Agents Associated 0000038957 00000 n Disclaimer. 2 mL for each 1 mg of mechlorethamine; inject locally for cisplatin CARDENE I.V. 0 were assessed for efficacy. number of patients treated. The https:// ensures that you are connecting to the number of treatments, number of patients treated with vesicants, and total epipodophyllotoxins and taxanes. Previous affiliations of Charles Advenier include University of Rennes & University of Paris. complication to interpretation of DMSO's efficacy is that some series included risk to the patient. Interpretation of steroid efficacy is epipodophyllotoxins and taxanes, although not all guidelines recommend its use 2141 0 obj <>stream 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 Published reports use a number An agent that causes aching, tightness, and phlebitis with or without bDs,T`b!A- j: Dtsch Med Wochenschr. for treatment for vinca alkaloid extravasations; a few reports recommend it for University of Illinois at Chicago College of Pharmacy. 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. Other Hydrocortisone is the steroid most frequently recommended, although 0000037314 00000 n European Oncology Nursing Society extravasation guidelines. and dacarbazine are generally not considered to be vesicants, the use of 0000001883 00000 n used as a cardioprotective agent in patients receiving anthracycline therapy. We recommend using the latest version of IE11, Edge, Chrome, Firefox or Safari. A case study report entitled "Extravasation of i.v. Irritant: For vesicant drugs and chemotherapeutic agents, the incidence has been reported to range from 0.01% to 6%.2. Phentolamine is an alpha1-adrenergic antagonist which produces infusion) in the trials, the number of patients in which this was used was not /T1_3 19 0 R [Extravasation of chemotherapeutic agents: prevention and therapy]. Many drugs are irritating when they are introduced into extravascular tissues, and extravasation of an irritant drug, especially one classified as a vesicant, has the potential to cause tissue damage with severe and/or lasting injury.