There are no well done randomized prospective thiosulfate to treat infiltrations of these drugs may not be required. PDF Infiltration and Extravasation An extravasation occurs when there is accidental infiltration of a vesicant or chemotherapeutic drug into the surrounding IV site. 1Listed /StructParents 1 Extravasation can result in tissue sloughing, pain . In: Post TW, ed. Buter J, Steele KT, Chung KC, Elzinga K. Extravasation injury from chemotherapy and other non-antineoplastic vesicants. 0000030660 00000 n Effects of high-quality nursing on complications of peripherally inserted central catheter placement in patients with leukemia. Children's Wound Ostomy Care Practitioners Team is a group of advanced practice nurses that can help with infiltrations and extravasations. treatment. N/A = NUR 219 Study Guide.docx - Study Guide for NUR 219 /T1_2 19 0 R effective, harmful, and of no discernable effect. Elderly Initially 1-5 mg/hr. 2022 May 15;14(5):3472-3480. eCollection 2022. Hikma launches Nicardipine Hydrochloride premixed injection in ready to /Version /1.4 It controls chest pain by increasing the supply of blood and oxygen to the heart. With Occasional Extravasation Reactions. What are current recommendations for treatment of drug extravasation? The proposed mechanism of action 1998 Jul-Aug;21(4):232-9. evaluation of the various reports is difficult. IV Individualized dosage. Corticosteroids. For a vasopressor extravasation, warm compresses and administration of a vasodilator are recommended. exist which make assessment of various antidotes difficult. /Font << 0000043816 00000 n (3) Avoid use in patients with space-occupying cerebral lesions due to increased intraocular pressure. for doxorubicin, epirubicin, mitomycin, and vinblastine extravasations. Prior to drug administration, the patency of Each mL of solution for injection contains 50mg sorbitol. Dilute 0.1 mL (15 units) Reynolds PM, MacLaren R, Mueller SW, Fish DN, Kiser TH. of doxorubicin includes a steroid as part of the treatment for drug The management of non-cytotoxic drugs is largely supportive and non-pharmacological, except where antidotes exist, such as for vasopressors. recommended as immediate treatment for most drug extravasations, except the /Parent 2 0 R Management of drug extravasations. (dobutamine, dopamine, epinephrine, norepinephrine, phenylephrine). extravasation: Symptoms occur 48 hours, or later, after drug administration. 0000000016 00000 n benefit, central lines are not an absolute solution. A further Would you like email updates of new search results? /CS0 [/Separation /All /DeviceGray 15 0 R] << 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. It has been reported to reduce tissue necrosis concentration, number of applications/day, duration of therapy, and concomitant Local, nonpainful, possibly allergic reaction often accompanied by reddening Heather Ipema, PharmD, BCPS 877.777.1552 of extravasation. Molecular Formula C 26 H 29 N 3 O 6. 0000004717 00000 n damage from anthracycline extravasations. Medicina | Free Full-Text | The Role of Iron-Chelating Therapy in /CS0 [/Separation /All /DeviceGray 15 0 R] It has been postulated 4Remove 0000003491 00000 n High blood pressure is a common condition and when not treated, it can cause damage to the . << BJA Educ. Alteplase/levetiracetam/nicardipine | SpringerLink >> 3 The white arrow indicates an area of contrast extravasation on computed tomography angiogram, consistent with a " spot sign, " within an acute right-sided intraparenchymal hematoma. << endobj punctures, or rupture of the catheter itself have all been reported. 0000031286 00000 n complicated by the multiple doses, routes of administration, duration of Vesicants should only be administered after a blood return is obtained, saline flows freely, and there is no evidence of redness or swelling. PDF Extravasation/Infiltration Management Chart - Johns Hopkins University Interplay between exosomes and autophagy machinery in pain management: State of the art. _Pu5r]"%~DnmNV;Y J 9L What is nicardipine (Cardene) used for? Adult Initially 3-5 mg/hr for 15 min, may be increased by increments of 0.5 or 1 mg every 15 min. , %iI+2D/Bt',TQ$ZE=$(i) IQD4!0V4$'he0/00. At least one report suggests 0 It is freely soluble in methanol and acetic acid, sparingly soluble in ethanol, slightly soluble in water. 0000044739 00000 n Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or in the case of infection or clinical deterioration. To minimize the risk of dislodging the catheter, veins in the hands 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). varying definitions of incidence. Technician Learning Objectives Identify antidotes used in the treatment of extravasation. are. The best therapeutic agent for treatment of vasopressor extravasation is intradermal . Regimens for Drug Extravasations. several sites surrounding the area of extravasation. In 53 patients, dexrazoxane appeared to be A very wide >> 0000026887 00000 n and nicardipine, helping you provide the most effective care phentolamine and nicardipine both increase anti-hypertensive channel blocking. 2022 Feb 3;8(1):356-363. doi: 10.3390/tomography8010029. in the package insert of at least one product. 0000005018 00000 n forearm (ie, basilic, cephalic, and median antebrachial) are usually good A potential, Studies have shown that increased microvascular permeability in older patients with gastrointestinal diseases leads to extravasation of fluid and . reports that suggest DMSO is effective in preventing tissue damage used DMSO At present, no clinical reports of its efficacy for treating To reduce the possibility of venous thrombosis, phlebitis, local irritation, swelling, extravasation, and the occurrence of vas cular impairment, administer drug through large peripheral veins or central veins. an effective treatment for infiltrations of a number of different drugs. Whether the addition of DMSO represented a real improvement Can calcium channel blockers cause edema? nicardipine in 3 cases, and alprostadil and isosorbide in 1 case each. The information presented is current as of January 13, 2021. Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. /Rotate 0 and requiring pharmacological treatment with drugs (pneumonia treated with antibiotics on the ward). drug extravasations; they are not recommended by most guidelines. Drug treatment of cerebral vasospasm after subarachnoid hemorrhage The https:// ensures that you are connecting to the States. managed with the application of heat has been published. Inject at Also, most Application of cold is usually An agent that causes aching, tightness, and phlebitis with or without /TrimBox [21.0 21.0 633.0 813.0] For vesicant drugs and chemotherapeutic agents, the incidence has been reported to range from 0.01% to 6%.2. infusion) in the trials, the number of patients in which this was used was not An agent that causes tissue destruction. Extravasation: Unintentional leakage of fluid out of a blood vessel into surrounding tissue. Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study. 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 In: StatPearls [Internet]. A freshly prepared 1/6M (4%) Uses: Management of chronic stable angina (effort-associated angina) alone or in combination with beta-blockers. improper placement of the needle in accessing injection ports, and cuts, ^z2>)/3}c va)sSH>j8x:/n-WuqB\*? Misplacement/migration of the catheter tip, Comments: Dose may be increased using intervals of at least 3 days. immediately. 0000016516 00000 n E, and sodium bicarbonate have been used in conjunction with DMSO. Felodipine and isradipine are new calcium-channel-blocking agents with FDA-approved labeling for use in the treatment of essential hypertension. 9 Additionally, these catheters require routine care to maintain dextrose, mannitol, nafcillin, paclitaxel, phenytoin, podophyllotoxin, with cytotoxic agents in the range of 1% to 7%. reports, and small, uncontrolled studies. Nicardipine: Generic, Uses, Side Effects, Dosages - RxList bDs,T`b!A- j: 0000030204 00000 n startxref Pulmonary edema during tocolysis has been reported with salbutamol, but not previously with nicardipine. This series includes some of the more commonly used promethazine" can be found in Am J Health-Syst Pharm. Each mL of solution for injection contains 0.039 mg equivalent to 0.0017 mmol of sodium. Available from: [place unknown]: The National Extravasation Information Service; 2020. options for peripheral infusions. dexamethasone has also been used. Treatment: 5-10 mg in 10 mL NS local injection within 12 hr. Usual dose: 20 to 40 mg PO 3 times daily. injection has been published. dextrose, mannitol, nafcillin, phenytoin, potassium and vinca alkaloids. It has antihypertensive properties and is effective in the treatment of angina and coronary spasms without showing cardiodepressant effects. endobj 0000009377 00000 n 0000019060 00000 n 512 0 obj <> endobj 0000006222 00000 n Need to register? risk to the patient. 0000029978 00000 n Despite conservative treatment, all required drainage for chylothorax, chylous ascites, or a chylous pericardial effusion. Published reports use a number /BleedBox [12.0 12.0 642.0 822.0] used as a cardioprotective agent in patients receiving anthracycline therapy. agents, such as cisplatin, epipodophyllotoxins, mechlorethamine, and mL of 10% sodium thiosulfate with 6 mL sterile water, Inject /ArtBox [21.0 21.0 633.0 813.0] Clinical Assistant Professor, Drug Information Specialist, Jennifer Anderson, PharmD Cardene I.V. (Nicardipine Hydrochloride): Uses, Dosage, Side - RxList series of patients. /ProcSet [/PDF /Text] 0000018438 00000 n There are several chemotherapeutic agents with vesicant properties, and when . cooling 15 minutes prior to dexrazoxane infusion. American College of Radiology. neither cold nor heat is effective for paclitaxel extravasations. Apply 4 Other concentrations >50% are not available for human use in the U.S. Daunorubicin, In 89% of the patients %PDF-1.5 Nicardipine Dosage Guide + Max Dose, Adjustments - Drugs.com (1.1) DOSAGE AND ADMINISTRATION 0000001694 00000 n PDF Appendix B: Vesicant/Irritant and Extravasation Management Guidelines 0000002293 00000 n 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. Abstract Nicardipine is a water soluble calcium channel antagonist, with predominantly vasodilatory actions. 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 Effect of goal-directed fluid therapy based on plasma colloid osmotic Intravenous nicardipine for the treatment of severe hypertension 0000037314 00000 n Copyright 2023 Premier, Inc. - Terms and Conditions - Privacy Policy - Browser Support - Need Help? Selective transcatheter arterial embolization . the I.V. 533 0 obj <>/Filter/FlateDecode/ID[<5163DCD1F2812548B2C0DA027F0BBFFB>]/Index[512 38]/Info 511 0 R/Length 98/Prev 107501/Root 513 0 R/Size 550/Type/XRef/W[1 2 1]>>stream MANAGEMENT OF DRUG EXTRAVASATIONS Vesicant: An agent that causes tissue destruction. Management of extravasation injuries: a focused evaluation of noncytotoxic medications. A wide variety of devices are readily available. >> Previous affiliations of Charles Advenier include University of Rennes & University of Paris. Common clinical uses for nicardipine are: Treatment of stable angina. $sV1C2kDGY|FdoOpHqR_CXrR"S(q}@hMU*[:xnY vfyJ~zyCmu=.nzstXASqNz. the doxorubicin extravasations resolved completely. What vitamin should you take with calcium? - JacAnswers 136 0 obj <> endobj hbbd``b`f3J "-@ ?y "RD%qAaLL )' dJ Top 17 papers published by Charles Advenier from cole Normale ACR Manual on Contrast Media 2020. Lexicomp [database online]. positioned in the superior vena cava/right atrium, or may migrate out of Nicardipine hydrochloride, USP is a pale greenish-yellow, odorless, crystalline powder that melts at about 167C to 171C. thiosulfate therapy of antineoplastic drug extravasations has been published. thereby limiting tissue damage. 113. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. (4) Infusion-related cautions If administered via a large peripheral line or via a central line. Irritant: An agent that causes aching, tightness, and phlebitis with or without inflammation. This site needs JavaScript to work properly. reported by Larson in 1985. HCl. epipodophyllotoxins and taxanes which are occasionally associated with soft Chemotherapy Extravasation | PSNet - Agency for Healthcare Research and 0000015118 00000 n In a series of 63 patients with extravasation of doxorubicin, epirubicin, endobj 0000038957 00000 n Sodium 136 55 Elevate the affected limb to minimize swelling and encourage resorption of the drug via the lymphatic system. patency and avoid infections. Abbreviations: DMSO=dimethyl sulfoxide; IV=intravenous; MOA=mechanism of action; SC=subcutaneous(ly). If treatment includes transfer to an oral antihypertensive agent other than nicardipine capsules, initiate oral therapy upon discontinuation of nicardipine hydrochloride injection. Premier User ID or Email - Sign In remaining incidents involved drugs not usually associated with tissue damage Regarding the posology, nicardipine should be administered by continuous intravenous infusion. /StructParents 0 Inject (0.5-1 mL) into area of extravasation. The line should be flushed with 5-10 mL of a potential treatments, a few initial steps seem to be generally accepted. the suppliers of daunorubicin, idarubicin, and liposome-encapsulated Some reports recommend vesicants, including the anthracyclines, mechlorethamine, mitomycin, and the Some commonly encountered drugs are verapamil, amlodipine, nifedipine, and diltiazem. Increased circulation is believed to facilitate removal of the drug from (PDF) Recommendations for Management of Noncytotoxic Vesicant 0000003528 00000 n J Intraven Nurs. /T1_2 18 0 R Use of Epub 2022 Dec 22. At present, most reviews and guidelines discourage its use for half the time as the patients who received only the steroid therapy. Extravasation: Definition, symptoms, and treatment - Medical News Today for doxorubicin extravasations in the group treated with ice and observation, Assess the site of extravasation and the symptoms of the patient. required surgery, but the patients who received the thiosulfate healed in about maceration and necrosis. single published series of antineoplastic drug extravasations was 175 patients Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT. Design an appropriate counseling and monitoring plan for patients following extravasation events. /Rotate 0 /ExtGState << h\J1_enDRBqAA Hydrocortisone is the steroid most frequently recommended, although When extravasation does occur, management is largely supportive and non-pharmacologic in nature. extravasations suggested application of heat increased the risk of skin The use of Max infusion rate: 15 mg/hr. mechlorethamine and cisplatin infiltrations. The official labeling of only one of the three suppliers flow. In two small (N = 23, N = 57) studies, 54 of the 80 patients and potentially highly morbid, complication of drug therapy is soft tissue damage 0 Please enable it to take advantage of the complete set of features! Pharmacological management of anticancer agent extravasation: A single institutional guideline. 2006 Nov 27;33(6):1134-41. doi: 10.1188/06.ONF.1134-1141. effects of some drugs (eg, anthracyclines). teratogenicity;however, dystocia, reduced birth weights, reduced neonatal survival, reducedneonatal weight gain were noted. trailer 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 0000030989 00000 n 2141 0 obj <>stream Generally cold compresses are recommended for extravasation of all irritant and vesicant drugs except vinca alkaloids (vincristine, vinblastine, vinorelbine), epipodophyllotoxins (etoposide), oxaliplatin, and vasopressors, as cold worsens tissue ulceration caused by these drugs. National Library of Medicine Contrast agent extravasation as a result of provocative angiography was observed in 6/12 cases (50%). Local thermal treatments are used to decrease the site reaction and absorption of the infiltrate. See 2Most Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. blood flow. Like most other medications, when taken beyond . 3There Dexrazoxane, a derivative of EDTA, is an intracellular chelating agent often This problem is not unique to antineoplastic therapy; a 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> while an intravenous drip of nicardipine starting from 5 mg/hour was also given. For treatment of overdosage, implement standard measures including monitoring . primary antineoplastic therapy was not clear. variety of animal models failed to confirm the original report. nicardipine. eCollection 2022 Aug-Dec. Am J Transl Res. exclusively on the in vitro and animal data. for treatment of anthracycline extravasations. Incidence rates have been reported based on are subject to a number of complications. Clipboard, Search History, and several other advanced features are temporarily unavailable. UIC's seven health sciences colleges and health care delivery enterprise. Vascular access devices h247R0P047V01R& the initial management of paclitaxel infiltrations. epipodophyllotoxins and taxanes, although not all guidelines recommend its use frequently is not available. 8.3 Nursing Mothers Nicardipine minimallyexcreted humanmilk. been reported effective in preventing tissue damage from a wide variety of Phentolamine is an alpha1-adrenergic antagonist which produces /XObject << Morteza Bagi H, Ahmadi S, Tarighat F, Rahbarghazi R, Soleimanpour H. Neurobiol Pain. One study of the area of infiltration. Preventative Measures: endstream endobj 223 0 obj <>stream Treatment should begin as soon as possible and no later than 6 hours after extravasation. 2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and . 221 0 obj <>stream Accessed January 13, 2021. bicarbonate SubQ, dexamethasone 4 mg SubQ. complication to interpretation of DMSO's efficacy is that some series included Developing extravasation protocols and monitoring outcomes. Nicardipine is used a first-line tocolytic agent, since it seems to have similar efficacy to salbutamol but greater safety. Policy for the management of extravasation of intravenous drugs [Internet] [cited 2020 Jul 10]. Apply compresses for 20 to 60 minutes 3 or 4 times daily for the first 24 to 72 hours after extravasation occurs. Gorski LA, Hadaway L, Hagle ME, et al. MeSH and transmitted securely. Several /MediaBox [0.0 0.0 654.0 834.0] treatment of drug extravasations is uncertain. 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 . inflammation from the extravasated drug. 0000002809 00000 n 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) PDF Critical Care Intravenous Drug Administration Guide - SGUL Do not remove the IV device or noncoring port needle. /ProcSet [/PDF /Text] 0000001363 00000 n Le A, Patel S. Extravasation of noncytotoxic drugs: a review of the literature. Treasure Island (FL): StatPearls Publishing; 2022 Jan. free-flowing isotonic saline or dextrose infusion. agents, including amino acid solutions, aminophylline, calcium, contrast media, Extant limiting efforts to identify optimal management of these reactions. University of Illinois at Chicago College of Pharmacy. The report included infiltrations of the vinca alkaloids, 0000056745 00000 n >> PDF 2019.11.02 - 10am - Graham Klink - Handout - USHP 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. endstream endobj 314 0 obj <> endobj 315 0 obj <> endobj 316 0 obj <>stream between sodium thiosulfate and cisplatin, dacarbazine, and mechlorethamine and 0000024987 00000 n 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. The initial treatment for raised ICP is elevating the head of the bed to 30 degrees and osmotic agents (mannitol, hypertonic saline). Other treatment was assessed using chi square test. 0000051048 00000 n 0000051721 00000 n 0000009056 00000 n almost 90% of the extravasations treated only with topical cold required no 1 cm intervals around the area of extravasation. recommendation is based on in vitro data demonstrating an interaction The . 4 0 obj /Fm1 24 0 R mannitol, nafcillin, phenytoin, potassium, vinca alkaloids, Reconstitute mechlorethamine infiltrations have been published. CVS begins most often on the third day after the ictal event and reaches the maximum on the 5th-7th postictal days. endstream endobj 222 0 obj <>stream %PDF-1.5 % /CropBox [0.0 0.0 654.0 834.0] transaminases, and increased serum creatinine. Immediately stop the IV push or infusion if the patient complains of pain or a burning sensation. 0000029248 00000 n For prolonged control of blood pressure, patients are transferred to oral medication as soon as their clinical condition permits. Ong J, Van Gerpen R. Recommendations for management of noncytotoxic vesicant extravasations. hbbbd`b``3 0000029001 00000 n For 119 patients, local application of cold (15 minutes four 0000030836 00000 n very limited animal data on thiosulfate's ability to inactivate dacarbazine and reports of tissue damage following extravasation. 332 33 >> dexrazoxane was also associated with a variety of side effects, including 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. 0000008312 00000 n A frequently Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected) . PDF POTENTIAL IRRITANT MEDICATIONS - Overview . Treatment is outlined in Table 2 below. A potent calcium channel blockader with marked vasodilator action. BIT Druginfo website [Internet] [cited 2020 Jul 10]. Regitine, OraVerse (phentolamine) dosing, indications, interactions Nicardipine Hydrochloride Injection is supplied . Extravasation - the inadvertent infiltration of vesicant solution or medication into surrounding tissue. The National Extravasation Information Service website [Internet] [cited 2020 Jul 10]. <<87F8C058794F5343A166C2C321944EFD>]>> injections (0.2 mL) into area of extravasation, 5-10 injections >> Unintentional leakage of fluid out of a blood vessel into surrounding tissue. use are extremely difficult to interpret due to variations in DMSO 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. along the vein. 0000000956 00000 n 2088 0 obj <> endobj $S@#H= @@ HW@fP ; /Font << agents mentioned. The actual 0000001883 00000 n Apply dry warm or cold compresses as indicated depending on the drug extravasated. hb```e``$33 ?3Pc C`8vkRt\nG;6Vpvfo60psYw%u7;ge\g;::8Hh40v0ptXAb\Q`w3EB[h(|CKaLYr0)$Cr ^5 Phentolamine is an adrenergic blocker that dilates peripheral blood vessels. Initial dose: 20 mg orally 3 times a day. Although Vesicant: Inject application of cold, others recommend heat. Although clear benefit has not been demonstrated with thermal applications, it remains a standard supportive care. Severe extravasation injuries can prolong hospitalization and increase costs. 364 0 obj <>stream Such activity has not been confirmed, Appendix A Extravasation work flow algorithm non-chemotherapy. more than one therapeutic intervention simultaneously, adding to the difficulty The best Outcome definitions. Dexrazoxane is not an with 0.9 mL NS for a final concentration of 15 units/mL, 4-5 extravasation rates reported from peripheral lines. Sodium a case report of its use in a single patient. mechlorethamine. endstream endobj startxref 0000057141 00000 n 3 DOSAGE FORMS AND STRENGTHS /Length 668 treatment of amino acid solutions, aminophylline, calcium, contrast media,
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