Treatment Of Vincristine Extravasation

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2019.11.02 - 10am - Graham Klink - Handout

Recognize riskfactors for extravasation including iatrogenic causes, patientfactors, andhigh‐ agents. Recall the pharmacology of agents used in the treatment of extravasation reversal. Construct an appropriate treatment regimen including both pharmacologic and non‐pharmacologic

Data Sheet Template - Medsafe

Vincristine is a vesicant and may cause a severe local reaction on extravasation. If leakage into the surrounding tissue should occur during intravenous administration of vincristine, the infusion should be discontinued immediately and any remaining porti on of the dose should be introduced into another vein.

Guidelines for the Management of Extravasation of a Systemic

Mgt of Extravasation of a Systemic Anti-Cancer Therapy including Cytotoxic Agents v1.docx Document Purpose The purpose of this guideline is to provide clear guidance on the causes, prevention, recognition and management of an extravasation of a Systemic Anti-Cancer Therapy used in the treatment of malignant disease in the patient

Guidelines on treatment of extravasation

Management of Extravasation If extravasation does occur, prevention of serious injury and tissue damage becomes the main focus of those involved in the patient management. Swift action is important to limit the damage (treatment should be administered within 1 hour), however extravasations may only become apparent 1-4 weeks after drug

Pediatric IV Infiltration/Extravasation 2010 Update

IV Extravasation Assess Stage 3 or 4, any blood or vesicant Stop infusion Attempt to aspirate back any residual fluid from existing catheter Remove PIV if not needed for antidote treatment Elevate Stage 0 Stage 2 Stop infusion Attempt to aspirate back any residual fluid from existing catheter Remove PIV if not needed for antidote treatment

Managing Vesicant Extravasations

Vesicant extravasation Vesicant extravasation treatment Tissue necrosis Disclosure: L.S. has acted as a consultant to TopoTarget USA (manufacturer of Totect™, which is mentioned in this article), and has received an honorarium from Baxter (manufacturer of Hylenex , which is mentioned in this article) for participation in a focus group.

S P E C I A L P A P E R Extravasations of Vesicant / Non

Types of Extravasation National Extravasation Information Service (NEIS) examined the types of extravasation by separating into three types (Jones, Coe, 2004). Pre-extravasation syndrome: It leads to flexibility and local hyper-sensibility in various degrees. Type I: stiffness and swelling that around buller and infusion area;

Chemotherapy Vesicant Extravasation Management [3289]

Dexrazoxane must be given ASAP and within 6 hours of extravasation. Infuse in large vein in an area other than the extravasation. [ ] DEXRAZOXANE ORDERABLE (FOR EXTRAVASATION) 500 mg/m2, intravenous, for 1 Hours, every 24 hours, Starting S+2, For 1 Doses Infuse in large vein in an area other than the extravasation. Treatment/Monitoring

Irritants and Vesicants Guide to Intravenous Administration

Sep 18, 2016 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 Drug Vesicant vs Irritant PIV Midline Central line Comments Adrenergic agents Dobutamine Vesicant No (F) No (A, E) Yes Time-dependent PIV (F)

Chemotherapy extravasation guideline

9 Detection of extravasation 10 General principles for the treatment of extravasation Peripheral lines Central lines Application of heat or cold to the area Flush-out technique 12 Pharmacological management of extravasation Corticosteroids Antidotes 14 Summary of management of peripheral extravasation General treatment instructions Neutrals

BC Cancer Protocol Summary for Adjuvant Therapy for

Extravasation: DACTINomycin and vinCRIStine cause pain and tissue necrosis if extravasated. Refer to BC Cancer Extravasation Guidelines. 2. Neutropenia: Fever or other evidence of infection must be assessed promptly and treated aggressively. Call Dr. Christine Simmons or tumour group delegate @ (604) 877-6000 or 1-800-663-

Treatment of Doxorubicin Extravasation with Intravenous

Nov 01, 2006 treatment of a breast cancer patient who experienced extravasation of doxorubicin.9 This patient was treated with dexrazoxane IV within 1 hour after extravasation, which immediately relieved pain at the site. The dose of dexrazoxane was repeated 5 hours after extravasation, and a final dose was given 24 hours later. No tissue

Treatment of tissue extravasation by antitumor agents

A review of the treatment given to patients with an- titumor drug extravasation who were observed at M. D. Anderson Hospital and Tumor Institute at Hous- ton, Texas, from January 1979 to September 1980 showed an incidence of extravasation in one case per 1,000 vena punctures when Adriamycin (doxorubicin) and vincristine were given.

VINCRISTINE SULFATE- vincristine sulfate injection, solution

intravenous administration of Vincristine Sulfate Injection, USP may cause considerable irritation. If extravasation occurs, the injection should be discontinued immediately, and any remaining portion of the dose should then be introduced into another vein. Local injection of hyaluronidase and the application of


A case study report entitled Extravasation of i.v. promethazine can be found in Am J Health-Syst Pharm. 1999; 56:1742-3. *Note on Anthracyclines: Dexrazoxane may be used to treat anthracycline extravasations in adult patients. Treatment should begin as soon as possible and no later than 6 hours after extravasation. 9

Guidelines on treatment of extravasation with cytotoxic drugs

Patients receiving cancer treatment may have multiple risk factors that make IV administration very difficult. In addition, there may be factors relating to equipment / material used, concomitant medications and the treatment themselves. Some of the most common factors known to increase the risk of extravasation are listed below: Patient factors

Chemotherapy Vesicant Extravasation Management (Outpatient

Printed on 8/31/2020 at 11:06 AM from SUP Page 1 of 4 Chemotherapy Vesicant Extravasation Management (Outpatient) [3452] 1. If you suspect or recognize an extravasation, please stop the chemotherapy immediately.

Preventing Vincristine Administration Errors: Does Evidence

eral IV devices, and vincristine infusion greatly increases the risk of extravasation injuries. In the United Kingdom, syringes are used for vincristine administration. How-ever, larger syringes (e.g., 10 ml or larger instead of 3 5 ml syringes) are used. For adults and children 10 years of age and older, vincristine is diluted to a con-


Extravasation: The unintentional leakage of vesicant intravenous fluids or medication into the perivascular, subcutaneous tissue or interstitial space which is capable of causing pain, necrosis and/or sloughing of tissue. Immediate emergency management of suspected vesicant extravasation must be performed to minimize tissue damage. Infiltration

Peripheral I.V. Infiltrations

vincristine, calcium chloride, higher concentrations of glucose and potassium, vasopressors Common irritants: nafcillin, clindamycin, cefotaxime, amphotericin B Always refer to your local institution formulary to determine if the infusion is a vesicant or an irritant


Guidelne No: 1/C/16:9057-01:00 Guideline: IV Extravasation Management Date of Publishing: 26 September 2016 2:19 PM Date of Printing: Page 4 of 34


the extravasation site should be dabbed with Dimethylsulfoxid (DMSO) 99% B Recommendation grade For extravasation due to anthracyclines, for which Dexrazoxan was not applied, the application of DMSO should be performed Procedure: Application every 8 hours for at least 7-14 days Dabbing, no rubbing and no use of pressure

Standard Operating Procedures for the Management of Phlebitis

Dec 12, 2019 5 Extravasation: Identification and procedure for treatment For the management of extravasation of the vesicant chemotherapy agents listed below, refer to the PHNT Oncology and Blood Services Clinical Chemotherapy Service Operations Policy Group A Group B Docetaxel Paclitaxel Vinblastine Vincristine Vindesine Amsacrine Carmustine Dacarbazine

3474 Extravasation Chemotherapy - Lee Health

A. Obtain Extravasation Kit B. Apply DRY heat for vinBLAStine, vinCRIStine, Vinorelbine, Etoposide, Dacarbazine, Oxaliplatin and Teniposide for 15-20 minutes at least 4 times a day for 24-72 hours. Apply DRY cold for all other chemotherapy agents not listed above for 15-20 minutes at least 4 times a day for 24-72 hours.


acid in this treatment is not certain and may not be essential. Extravasation Vincristine is a vesicant and may cause a severe local reaction on extravasation. If leakage into the surrounding tissue occurs, the injection should be discontinued immediately and any remaining portion of the dose should be introduced into another vein.


Chemotherapy extravasation guideline, WOSCAN 2009. 7. Assessment, Prevention & Management of Extravasation of Cytotoxic Medications GONG Cancer Care Guidelines 2009. 8. Extravasation policy for all drugs, chemotherapy & non chemotherapy, NHS Tayside, 2008. 9. Policy for the Treatment of extravasation Injury, NHS, Avon, Somerset and Wiltshire 2012.


Perform local examination for extravasation on a regular basis after treatment and until resolution. If vesicant compounds other than anthracyclines are being used through the same intravenous access, (e.g. vincristine, mitomycin, and vinorelbine), consider treatments for these other vesicant compounds. Totect is


(*) Note that inadvertent intrathecal administration of vincristine has occurred despite dilution to 10ml and 20ml in syringes. (11,12) CAUTION - Despite dilution vincristine remains a vesicant and extravasation should be avoided. Policies ensuring safe administration techniques and stringent monitoring must be followed to avoid

Drug Information Sheet Vincristine

Vincristine * Use this sheet to review specific information on this chemotherapy drug* Route: 1 mg/ml Intravenously with an over-the-needle catheter CAUTION for extravasation (see below). Given as an IV bolus injection. Storage: Store in refrigerator and protect from light; a 1989 study suggested to discard after 30 days.

Chemotherapy Extravasation C

motherapy extravasation ranges from 0.1% 6.5% (Ener et al., 2004), with re - ports of extravasation occurrence via central venous catheters ranging from 0.3% 4.7% (Cassagnol & McBride, 2009) and, in one early report, an inci - dence of 6.4% (Brothers et al., 1988). No benchmark existed for the incidence of chemotherapy extravasations.


Extravasation is a severe complication in the administration of cytotoxic chemotherapy. It causes pain, erythema, inflammation, discomfort and if left undiagnosed or inappropriately treated can lead to necrosis, secondary infection and functional loss of the tissue and/or limb concerned

Infiltration and Extravasation - HADAWAY ASSOCIATES

Extravasation injury from cancer chemotherapy is reported to be 11% in children and 22% in adults.3 Jacobs reported a rate of 0.6% (41 events out of 6,600 injections) for extravasation of contrast agents given with high-pressure injector pumps.4 Although pumps do not cause infiltration or extravasation, their use forces fluid into the subcuta-

Y36-511-411 CONTRAINDICATIONS WARNINGS Vincristine Sulfate

Vincristine sulfate is a white to off-white powder. It is soluble in methanol, freely soluble in water, but only slightly soluble in 95% ethanol. In 98% ethanol, vincristine sulfate has an ultraviolet spectrum with maxima at 221 nm ( +47,000). Each mL contains vincristine sulfate, 1 mg (1.08 µmol); mannitol, 100 mg; and water for injection, qs.

Immediate management of an extravasation

of an extravasation Vesicant non-DNA binding Vinblastine Vincristine Vindesine Vinflunine Vinorelbine STOP: the injection or intravenous infusion immediately. LEAVE: the venous access device (VAD) in place. ASPIRATE: any residual drug from VAD.

label - Food and Drug Administration

treatment measures (5.2) Marqibo ® (vinCRIStine sulfate LIPOSOME injection), for intravenous use Neurologic Toxicity: Monitor patients for peripheral motor and sensory, Initial U.S. Approval: 2012 central and autonomic neuropathy. Patients with preexisting severe neuropathy should be treated with Marqibo only after careful risk-

Extravasation/Infiltration Management Chart

(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

Chemotherapy Extravasation Management

Chemotherapy Extravasation Management Extravasation is a term that describes a drug inadvertently or accidentally leaking into surrounding tissue or the subcutaneous space during IV infusions. The volume, contact time, and drug properties are all factors that have to be considered when assessing an extravasation event.

Management of Extravasation Policy

Apr 19, 2016 If an extravasation is suspected treatment must begin as soon as possible. Early detection and starting treatment within 24 hours can significantly reduce tissue damage. However, in some cases extravasation may only become apparent 1-4 weeks after administration. If extravasation has occurred from a mix of more than one vesicant with both