186 0 obj <>stream Treatment of anthracycline extravasation with dexrazoxane.

described four case reports in dogs with doxorubicin extravasation; three dogs received varying doses of dexrazoxane within 2 hr of extravasation and 1 after 48 hr. Chemotherapeutic agents are at highest risk for complications due to the nature of the agents and the potential to cause high cellular damage when extravasated. up to 9 hours, should be treated with DMSO. About AAHA ��b���*����ڬ����T�f���ی��8'ϷE�N���t�b�XJ��H���ms��9f�=#]ѓ*���q�\"6P�"�ءf��|V���En3An�t+�~Z��l�%��� ����#k��S�����U ‡Recommended antidote: DMSO. Dexrazoxane treatment of doxorubicin extravasation injury in four dogs. �L|FF�����ۄ��|�. Among veterinary patients, careful monitoring of the patient and injection site for manifestations of erythema and drug leakage during an injection/ infusion would be prudent practice.Unfortunately at this time, there is not a consensus concerning the management of chemotherapy extravasation in human medicine. Venable RO, Saba CF, Endicott MM, et al. 12 Although Savene® is the only licensed antidote supported by clinical research … A chemotherapeutic extravasation is considered an oncologic emergency.When assessing a chemotherapy extravasation, it is important to understand the classification of the chemotherapeutic agent in terms of its potential to cause cellular damage if extravasated.
24–48 hr following extravasation. Cold compress will help to constrict local blood vessels and localize tissue damage. The volume, contact time, and drug properties are all factors that have to be considered when assessing an extravasation event. The second goal of treatment is to neutralize the chemotherapeutic once localized or dilute the agent to allow it to be absorbed and consequently metabolized.For the purposes of this document, we will focus upon five commonly used chemotherapeutics and their antidotes: doxorubicin, vincristine, vinblastine, carboplatin, and L-asparaginase.In veterinary medicine, Venable et al. Chemotherapeutics can be classified into three categories: vesicants, irritants, and non-irritants.Vesicants can cause pain, edema, and erythema, and potentially lead to blisters and tissue necrosis when extravasated. The dogs that received dexrazoxane within 2 hr made full recoveries with no surgical debridement, whereas the dog that received dexrazoxane 48 hr after the event required surgical debridement. �2A��{��X:��~����"%�R)��| =�OӬ'�ͣ�K_V�� Adapted from [1]. 12575 W. Bayaud Ave., Lakewood, *No recommended antidote. 5,6 As Savene® is a chemotherapy drug, precautions will be needed when reconstituting and administering the treatments. The lack of strength and large variability in management practices in case reports make it difficult to standardize and rank management practice in terms of efficacy. T����oҿ�g2M ������GmS��탍k��e�|Kv�t�UK��7���R�7��,� y}Vw&��;�B$+@�Z{��4%��c+,Xk��W ��f�PZ9�v3�����/X �T����f{ �����#�7���z�%5A"۞qX�s'd��b�}u�7�(/R�h�R߱�FE���� AAHA publications Accreditation and membership 1.

The choice of localization or dispersion depends on the chemotherapeutic agents. Neutralize Use the antidote specific to the agent. Education Dilute Use the antidote specific to the agent. 2. §Recommended antidote: hyaluronidase. 2Firmly apply a cold pack to the extravasated area for 30 minutes every 4 hours for the first 24 hours. Resources All Rights Reserved. †Recommended antidote: dexrazoxane or dimethyl sulfoxide (DMSO). Despite a large amount of published literature on this topic, most recommendations are based upon empirical, or anecdotal, evidence.

AAHA Guidelines Non-irritants do not usually produce local reactions to surrounding tissue; however, mild inflammation has been reported. Extravasation is a term that describes a drug inadvertently or accidentally leaking into surrounding tissue or the subcutaneous space during IV infusions. Disperse Apply dry warm compresses for 20–30 min at a time, 4 times a day for the first 24–48 hr following extravasation. =�c�۠OC�7�g�rXa��xI���1SC���[�1������Ǟ']�b�9�%ne�J�r���v��s�g �C��ͮ All orders are currently shipping as normal.

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