Can doxorubicin cause extravasation injury?
Doxorubicin is one of the most widely used drugs and hence has the highest potential and risk for extravasation, and, therefore, dexrazoxane should be made available at all centers that administer anthracyclines chemotherapy.
Is doxorubicin a vesicant or irritant?
Chemotherapy vesicant & irritant properties and suggested management for extravasation
| Drug | Vesicant or Irritant |
|---|---|
| Daunorubicin liposomal (DaunoXome) | Irritant |
| Docetaxel (Taxotere) | Irritant (usually) Vesicant (rare) |
| Doxorubicin (Adriamycin) | Vesicant |
| Pegylated liposomal doxorubicin (Doxil) | Irritant |
When there is extravasation of chemotherapy that is a vesicant the nurse should initially?
Once vesicant extravasation occurs, the clinician should immediately stop the infusion; however, the cannula or noncoring port needle should be kept in place and an attempt to aspirate the vesicant with a 10-mL syringe should be made.
What is the difference between Vesicants and irritants?
Vesicant drugs can induce the formation of blisters and/or destroy tissue. Irritant drugs can cause pain at the injection site or along the vein, with or without an inflammatory reaction. Some of these agents can potentially cause soft tissue ulcers.
What are the treatment options for extravasation with doxorubicin?
Doxorubicin Antidotes
- Dexrazoxane. Dexrazoxane is an iron chelator that prevents anthracycline-iron complexes and free radical formation causing oxidative damage.
- Dimethyl sulfoxide (DMSO)
- Hyaluronidase.
- DMSO.
- As L-asparaginase is a non-irritant, it is fairly benign.
Can extravasation cause tissue damage?
Extravasation occurs when a vesicant drug leaks out of the vein and into the surrounding tissue. When this happens, a person will likely experience serious tissue damage, including ulceration and tissue death, if they do not receive treatment in time.
Is doxorubicin liposomal a vesicant?
Although the package insert states that Doxil® is an irritant, we took all necessary precautions and administered all the treatments currently available in Japan because the extravasation was massive, and doxorubicin per se is classified as a vesicant.
What are the side effects of doxorubicin?
Side Effects
- Cough or hoarseness accompanied by fever or chills.
- darkening or redness of the skin (if you recently had radiation treatment)
- fast or irregular heartbeat.
- fever or chills.
- joint pain.
- lower back or side pain accompanied by fever or chills.
- pain at the injection site.
What are the symptoms of extravasation?
What are signs of an infiltration/extravasation?
- Redness around the site.
- Swelling, puffy or hard skin around the site.
- Blanching (lighter skin around the IV site)
- Pain or tenderness around the site.
- IV not working.
- Cool skin temperature around the IV site or of the scalp, hand, arm, leg or foot near the site.
What is the difference between vesicants and irritants?
What are the possible complications of extravasation of doxorubicin hydrochloride?
Extravasation of DOXOrubicin hydrochloride can result in severe local tissue injury and necrosis requiring wide excision and skin grafting. Immediately terminate the drug, and apply ice to the affected area. Severe myelosuppression resulting in serious infection, septic shock, requirement for transfusions, hospitalization, and death may occur.
What is vesicant extravasation and why is it dangerous?
Vesicant chemotherapy agents are known to cause tissue necrosis if they leak from the vein or are inadvertently administered into the tissue. Extravasation is a known risk of vesicant administration. Implanted ports reduce, but do not eliminate, the risk of vesicant extravasation.
What are the signs and symptoms of liposomal doxorubicin extravasation?
In a few case reports of liposomal doxorubicin extravasation, patients had reported pain, erythema, and edema but no necrosis or ulceration of extravasation area nor there were need to undergo surgical debridement[31].
What is the effect of vesicants on vasoconstriction?
Vesicants with high vasoconstrictive potential can result in tissue necrosis by severe vasoconstriction of capillary smooth muscles and reducing blood flow. Vesicants that are retained in extravasation tissue area for a long duration lead to a vicious cycle of direct cell injury.