Difference between revisions of "Vesicant & irritant chemotherapy"
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− | '' | + | ''Adapted from the Beth Israel Deaconess Medical Center: Administration and Extravasation Management of Vesicant Chemotherapy Agents, revised 11/2010.'' Authors: Holly Dowling, RN, BSN, OCN; unit based educator Ambulatory Hematology/Oncology; Zaven Norigian, Pharm.D., BCOP; Clinical Pharmacy Coordinator - Oncology; Meggie Galligan, RN, BSN; unit based educator Inpatient Hematology/BMT; Erin Tardanico, RN, BSN; OCN, unit based educator Inpatient Oncology |
==Vesicant chemotherapy== | ==Vesicant chemotherapy== | ||
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*Thiotepa | *Thiotepa | ||
*Topotecan (Hycamtin) | *Topotecan (Hycamtin) | ||
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+ | | row2a | row 2b |- | ||
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Revision as of 06:24, 12 November 2011
Adapted from the Beth Israel Deaconess Medical Center: Administration and Extravasation Management of Vesicant Chemotherapy Agents, revised 11/2010. Authors: Holly Dowling, RN, BSN, OCN; unit based educator Ambulatory Hematology/Oncology; Zaven Norigian, Pharm.D., BCOP; Clinical Pharmacy Coordinator - Oncology; Meggie Galligan, RN, BSN; unit based educator Inpatient Hematology/BMT; Erin Tardanico, RN, BSN; OCN, unit based educator Inpatient Oncology
Vesicant chemotherapy
- Cisplatin (Platinol) [in concentrations =0.5 mg/mL)
- DACTINomycin (Actinomycin-D, Cosmegen)
- DAUNOrubcin (daunomycin, Cerubidine)
- DOXOrubicin (Adriamycin)
- Epirubicin (Ellence)
- IDArubicin (Idamycin)
- Mechlorethamine (Mustargen)
- Mitomycin C (Mutamycin)
- Oxaliplatin (Eloxatin)
- VinBLAStine (Velban)
- VinCRIStine (Oncovin)
- Vinorelbine (Navelbine)
Vascular irritant chemotherapy
- Arsenic Trioxide (Trisenox)
- Bleomycin (Blenoxane)
- Bortezomib (Velcade)
- Busulfan (Busulfex)
- CARBOplatin (Paraplatin)
- Carmustine (BiCNU)
- CISplatin (Platinol) [concentration <0.5mg/mL)
- Cladribine (Leustatin)
- Dacarbazine (DTIC-Dome)
- DOCEtaxel (Taxotere)
- Etoposide (VePsid)
- Etoposide Phosphate (Etopophos)
- Fluorouracil
- Gemcitabine (Gemzar)
- Ifosfamide (Ifex)
- Irinotecan (Camptosar)
- Liposomal Cytarabine (DepoCYT)
- Liposomal DAUNOrubicin (Daunoome)
- Liposomal DOXOrubicin (Doxil)
- Liposomal VinCRIStine (Marqibo)
- Melphalan (Alkeran)
- Mitoxantrone (Novantrone)
- PACLItaxel (Taxol)
- PACLItaxel, nanoparticle albumin-bound (Abraxane)
- Plicamycin (Mithracin)
- Teniposide (Vumon)
- Thiotepa
- Topotecan (Hycamtin)
item 2 |- | row 2b |- |
- | Irritant | Cold | None | None
Bleomycin Irritant Cold None None Bortezomib Irritant Cold None None Busulfan Irritant Cold None None CARBOplatin Irritant Cold – every 8 hours for 3 days Sodium Thiosulfate OR Mix 4 mL of 10% sodium thiosulfate with 6 mL sterile water (yields 10mL of 1/6 molar sodium thiosulfate). Inject 5 mL subcutaneously using a 25 gauge needle, changing needles between each injection, into afftected area in a pinwheel fashion. DMSO** 99% 4 drops per 10 square centimeters of skin surface applied topically over area twice the size affected every 8 hours for 7 days. Allow to air dry. Carmustine Irritant Cold Manage conservatively Manage conservatively as first line option with supportive non-pharmacologic care measures. Hyaluronidase maybe used in extreme cases such as large volume extravasation, severe irritation, etc. Hyaluronidase Inject a total of 1 mL (200 units) divided into 5-10 subcutaneous injections of 0.1-0.2 mL in a pinwheel fashion using a 25 guage needle, changing needles between each injection, into affected area up to 250 units or until symptoms resolve. CISplatin Irritant* Cold – 60 minutes every 8 hours for 3 days Sodium Thiosulfate OR Mix 4 mL of 10% sodium thiosulfate with 6 mL sterile water (yields 10mL of 1/6 molar sodium thiosulfate). Inject 5 mL subcutaneously using a 25 gauge needle, changing needles between each injection, into afftected area in a pinwheel fashion. DMSO 99% 4 drops per 10 square centimeters of skin surface applied topically over area twice the size affected every 8 hours for 7 days. Allow to air dry. Cladribine Irritant Cold None None
Mechlorethamine Vesicant Cold Sodium Thiosulfate Mix 4 mL of 10% sodium thiosulfate with 6 mL sterile water (yields 10mL of 1/6 molar sodium thiosulfate). Inject 5 mL subcutaneously using a 25 gauge needle, changing needles between each injection, into afftected area in a pinwheel fashion. Melphalan Irritant Cold None None Mitomycin C Vesicant Cold Sodium Thiosulfate Mix 4 mL of 10% sodium thiosulfate with 6 mL sterile water (yields 10mL of 1/6 molar sodium thiosulfate). Inject 5 mL subcutaneously using a 25 gauge needle, changing needles between each injection, into afftected area in a pinwheel fashion. Mitoxantrone Irritant Cold - Apply cold packs for 15-20 minutes 4 times per day for 1-2 days. None None Oxaliplatin Vesicant Heat - Apply warm compresses to extravasation site for 1 hour. Caution- excessive heat can cause tissue damage. Sodium Thiosulfate Mix 4 mL of 10% sodium thiosulfate with 6 mL sterile water (yields 10mL of 1/6 molar sodium thiosulfate). Inject 5 mL subcutaneously using a 25 gauge needle, changing needles between each injection, into afftected area in a pinwheel fashion. PACLItaxel Irritant Cold - Apply ice to the area for 15-20 minutes each hour for 4 hours. Caution- excessive cold can cause tissue damage. Hyaluronidase Inject a total of 1 mL (200 units) divided into 5-10 subcutaneous injections of 0.1-0.2 mL in a pinwheel fashion using a 25 guage needle, changing needles between each injection, into affected area up to 250 units or until symptoms resolve. PACLItaxel, nanoparticle albumin-bound Irritant Cold None None Plicamycin Irritant Cold None None Teniposide Irritant Cold Hyaluronidase Inject a total of 1 mL (200 units) divided into 5-10 subcutaneous injections of 0.1-0.2 mL in a pinwheel fashion using a 25 guage needle, changing needles between each injection, into affected area up to 250 units or until symptoms resolve. Thiotepa Irritant Cold None None Topotecan Irritant Cold None None VinBLAStine Vesicant Heat Hyaluronidase Inject a total of 1 mL (200 units) divided into 5-10 subcutaneous injections of 0.1-0.2 mL in a pinwheel fashion using a 25 guage needle, changing needles between each injection, into affected area up to 250 units or until symptoms resolve. VinCRIStine Vesicant Heat Hyaluronidase Inject a total of 1 mL (200 units) divided into 5-10 subcutaneous injections of 0.1-0.2 mL in a pinwheel fashion using a 25 guage needle, changing needles between each injection, into affected area up to 250 units or until symptoms resolve. Vinorelbine Vesicant Heat Hyaluronidase Inject a total of 1 mL (200 units) divided into 5-10 subcutaneous injections of 0.1-0.2 mL in a pinwheel fashion using a 25 guage needle, changing needles between each injection, into affected area up to 250 units or until symptoms resolve.|}
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