Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
Extravasation
|
Leakage of vesicant material into subcutaneous tissue during administration
|
|
|
Infiltration
|
Inadvertent administration of a non-vesicant or irritant or medication into surrounding tissue
|
|
|
Vesicant
|
Drugs which are capable of causing pain, inflammation, and blistering of the local skin, underlying flesh and structures, leading to tissue death and necrosis.
|
|
|
Irritant
|
Drugs capable of causing inflammation, irritation or pain at site of extravasation, but rarely cause tissue breakdown
|
|
|
Compare and contrast DNA-binding agents with non-DNA-binding agents.
|
DNA-binding agents cause lethal DNA crosslinking or strand breaks, leading to cell apoptosis.
Non-DNA binding agents interfere with mitosis. These agents are easier to remove and cause less tissue damage. |
|
|
What are the signs and symptoms of extravasation?
|
Burning, stinging, discomfort/pain at injection site
Swelling, redness, blistering at injection site. No blood return Resistance on the plunger of the syringe of a bolus drug. Absence of free flow of the infusion. |
|
|
What is the initial treatment in the management of extravasation?
|
Stop the injection/infusion. Disconnect the IV tubing.
Withdraw as much of the drug as possible Mark area of skin |
|
|
What are some ways to prevent extravasation?
|
Careful and continual assessment of cannulation site
Give vesicant drugs before other cytotoxic chemo drugs Flush IV lines before and after administration. Peripheral bolus doses of vesicants must be given via a fast running infusion of a compatible fluid Consider central venous route to minimize risk |
|
|
Which vesicant cytotoxics may be given by peripheral infusion (in bags)?
|
Paclitaxel
Vinca alkaloids Dacarbazine |
|
|
Name the 4 agents that can be used to treat extravasation
|
DMSO
Hyaluronidase Sodium thiosulfate Dexrazoxane |
|
|
What drug can be used to treat extravasations caused by vinca alkaloids or taxanes?
|
Hyaluronidase
|
|
|
What drug can be used to treat anthracyclin induced extravasations?
|
Dexrazoxane
|
|
|
What is the mechanism of action of DMSO?
|
Free radical scavenging/ antioxidant properties
May speed up the removal of extravasated drug |
|
|
What is the mechanism of action of Hyaluronidase?
|
Breaks down extracellular matrix to increase fluid to the site and dilute the actual concentration in the skin
|
|
|
What is the mechanism of action of Sodium thiosulfate?
|
Prevents alkylation and tissue destruction by providing a substrate for alkylation in the subcutaneous tissue
|
|
|
What is the mechanism of action of Dexrazoxane?
|
1) an iron chelator, preventing formation of iron-anthracycline complexes and iron-mediated hydroxyl radicals that cause oxidative damage
2) stabilizes topoisomerase II and makes it inaccessible to anthracycline chemotherapy |
|
|
What is the non-pharmacological and pharmacological treatments for anthracycline extravasations?
|
NP: cold compress
P: Dexrazoxane Topical DMSO |
|
|
What is the non-pharmacological and pharmacological treatments for Mitomycin C extravasations?
|
NP: cold compress
P: Topical DMSO |
|
|
What is the non-pharmacological and pharmacological treatments for vinca alkaloid extravasations?
|
Hyaluronidase
|
|
|
What is the non-pharmacological and pharmacological treatments for Taxane extravasations?
|
Hyaluronidase
|
|
|
What isthe pharmacological treatment for Mechlorethamine (nitrogen mustard) extravasation?
|
Sodium thiosulfate
|
|
|
What are the problems associated with catheter occlusions?
|
Interupt delivery of chemotherapy, intravenous medication, nutritional support, blood products and acquisition of venous blood samples for testing
|
|
|
What are the treatment options for catheter occlusions?
|
Thrombolytics
Catheter replacement |
|
|
What is the risk of using streptokinase for catheter occlusions?
|
Risk of life-threatening anaphylaxis
|
|
|
What is the dose of Alteplase
|
<30kg: NTE 2mg/ml retain for 0.5-2hrs; may instill second dose if remains occluded
>30kg: 2mg retain for 0.5-2hours, may instill second dose if remains occluded |
