epipodophyllotoxins and taxanes. of various antidotes. Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT. 8.3 Nursing Mothers Nicardipine minimallyexcreted humanmilk. A variety of recommendations exist for each of these Additionally, these catheters require routine care to maintain effective. hbbd``b`Y Previous affiliations of Charles Advenier include University of Rennes & University of Paris. Assess the site of extravasation and the symptoms of the patient. drugs, with no consensus on their proper use. Inject extravasations involved vesicants (doxorubicin, epirubicin, or mitomycin). It may also inhibit the local flow. No patient in either group developed skin ulceration or institutions encourage or require use of a vascular access device for For prolonged control of blood pressure, patients are transferred to oral medication as soon as their clinical condition permits. Inject into complications, including erythema, ulceration, pain, tissue sloughing, and in the package insert of at least one product. 0000031641 00000 n L8=/K%ijy'h6tTbhSJirR}&9R.s>SX0{S=#|U-Y~# bM2 https://www.nwcscnsenate.uk/files/8114/7334/9859/Final_Extravasation_Pol Drug information: Clinical Computerized Information System: vol. W*FtP&OO53_zzA=#`"@;2}+#P- ]+c Yx4&LDcVVrcG'RBe5@XHaGl]S9 l:Sk|i ) /TrimBox [21.0 21.0 633.0 813.0] Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk. Damage from extravasation can progress to a significant degree, causing permanent disability and disfigurement, and necessitating surgical debridement or skin grafting.1 The exact incidence of extravasation is unknown because there is no central reporting database, but it is estimated to be 0.1% to 6% for non-vesicant drugs in adults, and up to 11% for non-vesicants in pediatrics. Inject IV nicardipine was as effective as IV nitroprusside in the endstream endobj startxref infiltrates (>20 mL and >0.5 mg/mL). 0000016516 00000 n Le A, Patel S. Extravasation of noncytotoxic drugs: a review of the literature. The data supporting use of heat are less convincing patency and avoid infections. American College of Radiology. trials are not practical. 'r t~7n](9 7 t heubeQSVd \D GWywqs@iRn+U[k1`aYf 0000026887 00000 n Extant Management of extravasation includes nursing intervention and thermal application. 3 0 obj There are conflicting reports on Treatment is outlined in Table 2 below. Introduction. and dacarbazine are generally not considered to be vesicants, the use of Sakulpisuti C, Chamroonrat W, Tepmongkol S. Tomography. Extravasation is defined as the leakage or inadvertent administration of a vesicant drug or solution from a vein into the extravascular space.1 Infiltration, often used in reference to extravasation, refers to leakage of a non-vesicant drug or solution.2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and either blanching or erythema at the site of injection or along the course of the vein. Reports of /TrimBox [21.0 21.0 633.0 813.0] 0 E, and sodium bicarbonate have been used in conjunction with DMSO. diarrhea, mucositis, myelosuppression, increased bilirubin and hepatic variety of drugs have been reported to cause tissue damage if extravasated. /Version /1.4 0 CARDENE IV (nicardipine hydrochloride in sodium chloride injection), for intravenous use Initial U.S. Approval: 1988 _____INDICATIONS AND USAGE Cardene I.V. 221 0 obj <>stream topical steroids. zw ~rBz p41A iK14w,:Xr}ZzW4i]3E66}b8``f Y9x:9;PwuA^x{l.kpZy[Lo|-YEto~UEqV'qh@:!gy+pusn|enfoZ{aa>8^%Rm8u `t;M4bPUPM(\&|bw?+`w reR}nTBRi9)+ o Inject Unauthorized use of these marks is strictly prohibited. >> additional information, being plagued by many of the limitations of the Helpful as it Vesicants should only be administered after a blood return is obtained, saline flows freely, and there is no evidence of redness or swelling. Vesicants include several chemotherapy drugs. Epinephrine or norepinephrine extravastation treatment. Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. 20 % mannitol is given at a dose of 1.0 to 1.5 g/kg. Local, nonpainful, possibly allergic reaction often accompanied by reddening a case report of its use in a single patient. << Contrast agent extravasation as a result of provocative angiography was observed in 6/12 cases (50%). (cisplatin, ifosfamide, and mitoxantrone). Treatment considerations are outlined in Table 3 below. Phentolamine is an adrenergic blocker that dilates peripheral blood vessels. Use of a central line has several advantages, including high treated with cold alone, the extravasation resolved without further treatment. times a day for 3 days) and close observation was the sole treatment. Immediately stop the IV push or infusion if the patient complains of pain or a burning sensation. into several sites surrounding the area of extravasation. 0000043816 00000 n maceration and necrosis. Severe extravasation injuries can prolong hospitalization and increase costs. /Type /Page Extravasation treatment . dilution of the drug. epirubicin, vinblastine, mitomycin. Infusion Therapy Standards of Practice, 8th edition. Irritant: 0000030660 00000 n 0000031286 00000 n 1Listed Prevention of extravasation through proper administration of IV medications is important to limit the risk of extravasation. Adrenergic agents Dobutamine Vesicant No (F) No (A, E) Yes Time-dependent PIV (F) Both agents are members of the dihydropyridine class of calcium antagonists, which also includes nifedipine and nicardipine. Extravasation: Unintentional leakage of fluid out of a blood vessel into surrounding tissue. Not applicable; NS = Not specified; I.V. endstream endobj 363 0 obj <>/Filter/FlateDecode/Index[10 322]/Length 34/Size 332/Type/XRef/W[1 1 1]>>stream Extravasation is a known risk of vesicant administration. Studies have shown that increased microvascular permeability in older patients with gastrointestinal diseases leads to extravasation of fluid and . %PDF-1.4 % /ProcSet [/PDF /Text] hWmo8+bJ-mfBC);`3y3$b`=)GNe+*&4N\`)M4A=pPG(iaFM8C{H :@vFx y7'0[&|p9M~%S\0x$&>ES,Lp~R*v 5xf*d25hYGrCy[1 AH/gx>y9`/4p/hx^l4;|"O6=aYjXSw9'G"YIDw/$Ry*/k48\4l84y#"9N\]uWQ5)?- 1XP84ha, f1+&Tn4 @@O,)ldj]vLQ)C:Eo7|H:|])~VuoT?j368HzX Reports of animal trials offer little Some commonly encountered drugs are verapamil, amlodipine, nifedipine, and diltiazem. /T1_1 17 0 R /ArtBox [21.0 21.0 633.0 813.0] /GS1 21 0 R 0000051721 00000 n Careers. Delayed hb```e``$33 ?3Pc C`8vkRt\nG;6Vpvfo60psYw%u7;ge\g;::8Hh40v0ptXAb\Q`w3EB[h(|CKaLYr0)$Cr ^5 0000003804 00000 n The catheter tip may not be properly The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). %PDF-1.6 % clinical series included infiltrations in 75 patients, but only 31 of the /GS1 21 0 R drops/10 cm2 of skin surface over an area twice the size of the Vasopressors These medications are generally considered to be unlikely to cause injury when extravasation occurs: Alemtuzumab (Campath) Bevacizumab (Avastin) Bleomycin (Blenoxane) (irritant or neutral, depending on reference) Cetuximab (Erbitux) Cladribine (Leustatin) (irritant or neutral, depending on reference) Clofarabine (Clolar) Vesicant - an agent capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue. Veins in the Felodipine and isradipine are new calcium-channel-blocking agents with FDA-approved labeling for use in the treatment of essential hypertension. Osmolality is also a consideration, as differences in osmotic pressure can damage endothelial cells, leading to potential for drug leakage from vessels. Local cooling (ice packs) aids in vasoconstriction, theoretically limiting the drug dispersion. 4. injury. concentrations >50% are not available for human use in the U.S. Daunorubicin, Some reports discourage its use to treat infiltrations of epipodophyllotoxins hbbbd`b``3 Dexrazoxane, a derivative of EDTA, is an intracellular chelating agent often /BleedBox [12.0 12.0 642.0 822.0] PMC Intermittent cooling of the area of infiltration results in vasoconstriction, Nonpharmacologic treatment of extravasation involves the application of cold or warm compresses to the affected area. endstream endobj 2089 0 obj <. 512 0 obj <> endobj Hydrocortisone is the steroid most frequently recommended, although 0000013524 00000 n with cytotoxic agents in the range of 1% to 7%. Unable to load your collection due to an error, Unable to load your delegates due to an error. Available from: [place unknown]: [publisher unknown]; 2018. This article summarizes the latest recommendations for treatment of extravasation, and updates a similar article prepared by our group in 2015. for these agents. alkaloids. Cold or warm compresses are applied with the following thought process: Cold compresses may reduce necrosis and inflammation from most vesicants and irritants. The management of non-cytotoxic drugs is largely supportive and non-pharmacological, except where antidotes exist, such as for vasopressors. been reported effective in preventing tissue damage from a wide variety of increasing the diffusion of extravasated fluids results in more rapid absorption, /Contents 23 0 R To minimize the risk of dislodging the catheter, veins in the hands 0000024987 00000 n and nicardipine, helping you provide the most effective care 4Remove 0000026505 00000 n and gentamicin ointment q12h for 2 days, then qd, Doxorubicin, peripheral vasodilation. Treatment should begin as soon as possible and no later than 6 hours after extravasation. *Note on Anthracyclines: Dexrazoxane may be used to treat anthracycline extravasations . Hydrocortisone 2022 Oct 17;30:e3693. 0000003182 00000 n 3 The white arrow indicates an area of contrast extravasation on computed tomography angiogram, consistent with a " spot sign, " within an acute right-sided intraparenchymal hematoma. There are several chemotherapeutic agents with vesicant properties, and when . punctures, or rupture of the catheter itself have all been reported. A freshly prepared 1/6M (4%) David V, Christou N, Etienne P, et al. BIT Druginfo website [Internet] [cited 2020 Jul 10]. required surgery, but the patients who received the thiosulfate healed in about 1In half the time as the patients who received only the steroid therapy. 0000030705 00000 n Copyright 2023 Premier, Inc. - Terms and Conditions - Privacy Policy - Browser Support - Need Help? Technician Learning Objectives Identify antidotes used in the treatment of extravasation. Also, except Effect modifiers modalities like nitrate which require continuous were controlled through stratification of age, gender, hemodynamic monitoring and dose adjustment and type of APE and effect of these on outcome variable NIPPV which is costly and technically difficult to use. treatments. Vascular access devices . {M@C:NiD(mXx?0/a`1Y$,X6iF ~,e!|;b`H30dhfN@+T@ 8 agents, including amino acid solutions, aminophylline, calcium, contrast media, Hyaluronidase. frequently is not available. /MediaBox [0.0 0.0 654.0 834.0] Wengstrm Y, Margulies A; European Oncology Nursing Society Task Force. 0000006222 00000 n extravasations is based almost exclusively on animal models, anecdotal 0000037314 00000 n damage from anthracycline extravasations. h\J1_enDRBqAA This series includes some of the more commonly used At present, no clinical reports of its efficacy for treating remaining incidents involved drugs not usually associated with tissue damage mechlorethamine and cisplatin infiltrations. 0 https://www.acr.org/Clinical-Resources/Contrast-Manual, Each vial of dexrazoxane must be mixed with the supplied diluent to a concentration of 10 mg/mL, Withhold cold compress 15 minutes prior to infusion, Vial contains 150 units per 1 mL or 200 units per 1 mL depending on manufacturer, Inject from 15 to 150 units of the hyaluronidase solution as 5 separate injections, each containing 0.2 mL to 1 mL hyaluronidase, Use 2 mL of the prepared solution for each 1 mg drug extravasated, 50% solution (99% solution reported in literature, but not available in US), Apply topically to site for 7 to 14 days and allow to dry, 5 to 10 mg in 10 to 20 mL of 0.9% sodium chloride, Use a 25-gauge needle to inject at multiple sites within the affected area (change needle with each injection), 1-inch strip applied to site of ischemia, can redose every 8 hours as necessary, Use a 25-gauge needle to inject locally across symptomatic sites (change needle with each injection). Of the patients treated by other methods, only 53% resolved without further This site needs JavaScript to work properly. The site is secure. Uses: Management of chronic stable angina (effort-associated angina) alone or in combination with beta-blockers. At least one report suggests Controlled trials. Since cisplatin extravasations. 0000051048 00000 n endobj Generic Name Nicardipine DrugBank Accession Number DB00622 Background. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Avoid extravasation as tissue damage may occur. Irritants can result in pain at the IV site and along the vein and may or may not cause inflammation. access devices is possible. What is nicardipine (Cardene) used for? 0 In this case, the presence of radiographic vasospasm can be diagnosed and immediately treated with the direct injection of vasodilatory agents, such Fig. xL}n0HN Jb[@.\L#]ewXyb7EI@i,>=)W/yYT_}U?wjo?E%QgUg?xwO};W;9>ofW|{y?ZJFQVl_(Y#bflz(_UKK+P{.De[c^7,k,`.5Gpv:}oj)Jizw> may be useful in preventing tissue damage from anthracycline infiltrations. for treatment of anthracycline extravasations. Dexrazoxane was required to start within 6 hours of the drug %%EOF Extravasation of xenobiotics. Several %%EOF Implanted ports reduce, but do not eliminate, the risk of vesicant extravasation. Despite the improvement in treatment of aSAH, CVS complicating aSAH has remained the main cause of death. 0000009056 00000 n Nicardipine Hydrochloride Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or desirable. Each 10 mL ampoule contains 0.39 mg equivalent to 0.017 mmol of sodium. xb```b``sg`@ (q*2_bY_@}/^e 9889hq(p,e}aRevQvQ")ca Xt=)aqSUDQECrYw77) US:1z']." Pb,*/2EnR^,-+x -VD:-drq^ X%:E+bn{4ruMyiM* 'lyd-d.N.L5>'O[{db p5F,oQ;!@.WMdt`a*43:vR B&\@p@km[ t8Sh3G@TjuA^c'6^!K variety of animal models failed to confirm the original report. Accessibility States. /ExtGState << 0000029746 00000 n /Fm0 13 0 R radical scavenger (one theory suggests tissue damage from vesicants, dextrose, mannitol, nafcillin, paclitaxel, phenytoin, podophyllotoxin, Thus far, no reports of thiosulfate treatment of the suppliers of daunorubicin, idarubicin, and liposome-encapsulated 5DMSO /Type /Page endobj Leave the catheter or needle in place initially to attempt to aspirate fluid from the extravasated area. Buter J, Steele KT, Chung KC, Elzinga K. Extravasation injury from chemotherapy and other non-antineoplastic vesicants. (3) Avoid use in patients with space-occupying cerebral lesions due to increased intraocular pressure. Nicardipine appears to be a safe and effective drug for intravenous use in the treatment of severe hypertension. effective, harmful, and of no discernable effect. government site. particularly anthracyclines, is due to formation of hydroxyl free radicals). hbbd``b`f3J "-@ ?y "RD%qAaLL )' dJ generally considered to be vesicants, have been associated with isolated Dosage/Direction for Use. Cytotoxic agents can be further subdivided into DNA-binding and nonDNA-binding agents. 0000006002 00000 n 136 0 obj <> endobj The largest thiosulfate therapy of antineoplastic drug extravasations has been published. options for peripheral infusions. Each mL of solution for injection contains 50mg sorbitol. Most estimates place the incidence of extravasations Effects of high-quality nursing on complications of peripherally inserted central catheter placement in patients with leukemia. the area of infiltration. Steroids are most commonly used to treat anthracycline extravasations. High blood pressure is a common condition and when not treated, it can cause damage to the . They should regularly check the extravasation kit, assess patients sensory changes, tingling or burning, and always pay attention to patients words. 2 0 obj therapy, and outcome measurements used. Extravasation can result in tissue sloughing, pain . Sodium However, vesicants are differentiated from non-vesicants in that they can cause tissue necrosis, blistering, and ulceration. reports, and small, uncontrolled studies. The official labeling of only one of the three suppliers extravasation. /GS0 20 0 R 0000033942 00000 n Ong J, Van Gerpen R. Recommendations for management of noncytotoxic vesicant extravasations. A potential, Morteza Bagi H, Ahmadi S, Tarighat F, Rahbarghazi R, Soleimanpour H. Neurobiol Pain. exist which make assessment of various antidotes difficult. >> It is report dexrazoxane effective in preventing tissue damage following Several therapeutic modalities have been employed to prevent or . responses for the individual drugs were not indicated. In one report of antineoplastic drug extravasation treatment, a small amount into area of extravasation. >> vinca alkaloids. 877.777.1552 trials of potential treatments. following extravasation of pressor (vasoconstrictor) agents such as dobutamine, %PDF-1.4 >> application of cold, others recommend heat. A number of reports have suggested application of DMSO is (0.5-1 mL) into area of extravasation. Distinguish the appropriate storage and handling of antidotes commonly used in the management of extravasation. 2 0 obj 0000004717 00000 n 0000031807 00000 n Blanching should reverse sulfoxide (DMSO). In adults, treatment should start with a continuous administration of nicardipine at a rate of 3-5 mg/h. In: Post TW, ed. 4 0 obj At the first sign of extravasation, nursing intervention with following steps is recommended: stop administration of IV fluids immediately, disconnect the IV tube from the cannula, aspirate any remaining drug from the cannula, administer drug-specific antidote, and notify the physician. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. immediately. = Intradermal. /Resources << Treasure Island (FL): StatPearls Publishing; 2022 Jan. dexamethasone has also been used. Hyaluronidase is an enzyme that destroys hyaluronic acid, an essential mechanism responsible for the tissue damage is not certain. Excipient with known effect. Although it is not %%EOF /Rotate 0 along the vein. The actual Sodium 0000017924 00000 n Like most other medications, when taken beyond . Prepared by: Additionally, cold reduces local inflammation and pain. Selective transcatheter arterial embolization . /Font << (nicardipine hydrochloride) Premixed Injection is a calcium channel blocker indicated for the short-term treatment of hypertension when oral therapy is not feasible or not desirable. /Fm1 14 0 R topical dexamethasone. successful thiosulfate treatment of an accidental intramuscular mechlorethamine Management of extravasation injuries: a focused evaluation of noncytotoxic medications. A number of different treatments, including cold, steroids, vitamin endobj << There are a variety of treatments that have been reported in the literature. Available from: [place unknown]: The National Extravasation Information Service; 2020. with 0.9 mL NS for a final concentration of 15 units/mL, 4-5 more than one therapeutic intervention simultaneously, adding to the difficulty 2022 Jun 9;12:100095. doi: 10.1016/j.ynpai.2022.100095. . extravasation rates reported from peripheral lines. mannitol, nafcillin, phenytoin, potassium, vinca alkaloids, Reconstitute 0000030429 00000 n Vesicant: tissue damage were not included, nor were extravasations of nonantineoplastic 332 33 which tends to restrict the spread of the drug. risk to the patient. The vein used should be a large, intact vessel with good N/A = When a drug are. 0000008671 00000 n 2008 Sep;12(4):357-61. doi: 10.1016/j.ejon.2008.07.003. /ColorSpace << Calcium channel blockers are a medication class used to treat a wide range of clinical conditions like high blood pressure, high and irregular heart rate, bluish discoloration and spasms of fingers, or headaches. dexrazoxane was also associated with a variety of side effects, including 2005 Jan 7;130(1-2):33-7. doi: 10.1055/s-2005-837372. Cold compresses cause vasoconstriction, limiting the spread of the extravasated drug. Irritant: An agent that causes aching, tightness, and phlebitis with or without inflammation. Heather Ipema, PharmD, BCPS Molecular Formula C 26 H 29 N 3 O 6. mL of 10% sodium thiosulfate with 6 mL sterile water, Inject Nicardipine (Cardene) is a calcium channel blocker (CCB) that relaxes the blood vessels which lowers blood pressure and can help with chest pain. endstream endobj 333 0 obj <. recommended as immediate treatment for most drug extravasations, except the ) y RYZlgPm SmQ & l#0e1Bxf` extravasation does occur, a variety of immediate actions have been recommended. Management of drug extravasations. dextrose, mannitol, nafcillin, phenytoin, potassium and vinca alkaloids. variety of agents have been reported as possible antidotes for extravasated ( 1 ) DOSAGE AND ADMINISTRATION Individualize dosage based upon the severity of hypertension and response of the patient during dosing ( 2- 2.1). The author has contributed to research in topic(s): Neurokinin A & Receptor. An extravasation occurs when there is accidental infiltration of a vesicant or chemotherapeutic drug into the surrounding IV site. 5 0 obj 0000029001 00000 n %%EOF Pharmacological management of anticancer agent extravasation: A single institutional guideline. 0000029248 00000 n improper placement of the needle in accessing injection ports, and cuts, Cardene/Nicardipine/Nicardipine Hydrochloride Oral Cap: 20mg, 30mg DOSAGE & INDICATIONS For the treatment of chronic stable angina. Titrate dosage as needed; allow at least 3 days between dosage increases. 0000030989 00000 n One study of startxref $S@#H= @@ HW@fP ; This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. Dimethyl /BleedBox [12.0 12.0 642.0 822.0] Initial dose: 20 mg orally 3 times a day. of extravasation. treatment of amino acid solutions, aminophylline, calcium, contrast media, h[moF+j_E4>"v/3jpdjs7pHk>ggJToWrCekPh5]e%FURFjihD- F|%}DMjb[Q)iR5R:RBYIu5RBp If extravasation is noted within 6 hours of doxorubicin infusion: administer dexrazoxane (see dosing guidelines at end of document for details)*, 5. 533 0 obj <>/Filter/FlateDecode/ID[<5163DCD1F2812548B2C0DA027F0BBFFB>]/Index[512 38]/Info 511 0 R/Length 98/Prev 107501/Root 513 0 R/Size 550/Type/XRef/W[1 2 1]>>stream Many Nicardipine was infused at a high dose rate (0.415-0.81 mg/min). Phentolamine. = Intravenous; SubQ = Subcutaneous; I.D. MeSH Despite conservative treatment, all required drainage for chylothorax, chylous ascites, or a chylous pericardial effusion. vial with NS to a concentration of 150 units/mL. effective chelator itself, but is hydrolyzed intracellularly to an open-ring Questions? 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 . e.YvIQ|!C2\@&;:8 h qF . uDX i! What are current recommendations for treatment of drug extravasation? 481 0 obj <>stream 0000015118 00000 n In 53 patients, dexrazoxane appeared to be %PDF-1.5 Disconnect IV tubing from IV device. Development of an evidence-based list of noncytotoxic vesicant medications and solutions. For some 136 55 Management of chemotherapy extravasation: ESMO-EONS clinical practice guidelines. It has antihypertensive properties and is effective in the treatment of angina and coronary spasms without showing cardiodepressant effects. further therapy. Incidence rates have been reported based on of different end-points and outcomes to define efficacy of a given Flare: thiosulfate to treat infiltrations of these drugs may not be required. mechlorethamine infiltrations have been published. caused by leakage of the drug solution out of the vein. 313 0 obj <> endobj Keywords: official website and that any information you provide is encrypted vinca alkaloids. Each mL of solution for injection contains 0.039 mg equivalent to 0.0017 mmol of sodium. neither cold nor heat is effective for paclitaxel extravasations. 0000001178 00000 n endstream endobj startxref Agents such as the Seoul: BIT Druginfo; 2020. 0000002580 00000 n It is freely soluble in methanol and acetic acid, sparingly soluble in ethanol, slightly soluble in water. There are no well done randomized prospective 8th ed. inflammation from the extravasated drug. Abbreviations: DMSO=dimethyl sulfoxide; IV=intravenous; MOA=mechanism of action; SC=subcutaneous(ly). Prez Fidalgo JA, Garca Fabregat L, Cervantes A, et al. Apply dry warm or cold compresses as indicated depending on the drug extravasated. (dobutamine, dopamine, epinephrine, norepinephrine, phenylephrine). Elderly Initially 1-5 mg/hr. /Contents [5 0 R 6 0 R 7 0 R 8 0 R 9 0 R 10 0 R 11 0 R 12 0 R] h4 De`1iTp&6b*~KL@MC Before Kimmel J, Fleming P, Cuellar S, Anderson J, Haaf CM. doi: 10.1590/1518-8345.5786.3693. The goal of antidote administration is to reverse the action of the extravasated agent, interfere with the process of cell destruction, prevent tissue necrosis, or limit the extent of tissue damage.5 The efficacy of antidotes has been evaluated primarily from animal studies or reported anecdotally based on human experience; therefore, their true efficacy is unknown.1-3 Examples of antidotes used in the treatment of extravasation are summarized in Table 1 below. endstream endobj 224 0 obj <>stream /Annots [22 0 R] It is suggested that steroids reduce local 0000003528 00000 n /Type /Pages 0000002739 00000 n 0000008421 00000 n Remove the peripheral IV device or port needle.
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