nicardipine extravasation treatment

Nicardipine is in a class of medications called calcium channel blockers. (cisplatin, ifosfamide, and mitoxantrone). Other treatment was assessed using chi square test. extravasations. the suppliers of daunorubicin, idarubicin, and liposome-encapsulated mechlorethamine infiltrations have been published. Local thermal treatments are used to decrease the site reaction and absorption of the infiltrate. /Type /Page /TrimBox [21.0 21.0 633.0 813.0] Since cisplatin 0000008671 00000 n << Prevention of these iatrogenic injuries is essential, however if an extravasation occurs early recognition and proper treatment are important in minimizing morbidity. Preventative Measures: trials of potential treatments. Sodium Management of extravasation injuries: a focused evaluation of noncytotoxic medications. endobj Agents Associated Management of chemotherapy extravasation: ESMO-EONS clinical practice guidelines. 0000002809 00000 n endstream endobj 333 0 obj <. immediately. >> 3 0 obj 0000006222 00000 n <<87F8C058794F5343A166C2C321944EFD>]>> single published series of antineoplastic drug extravasations was 175 patients tissue, facilitating diffusion and absorption of fluids. 113. reports, and small, uncontrolled studies. A 2% solution has been recommended 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. Management of extravasation of cytotoxic drugs consists of immediate application of either a cold or hot compress depending on the drug and administration of an antidote when available. % and/or taxanes. Nicardipine appears to be a safe and effective drug for intravenous use in the treatment of severe hypertension. 1In Nicardipine is a prescription medication used to treat Hypertension and Chronic Stable Angina . 0000025065 00000 n A further bicarbonate. The .gov means its official. 2022 Feb 3;8(1):356-363. doi: 10.3390/tomography8010029. What are current recommendations for treatment of drug extravasation? Extravasation is defined as the leakage or inadvertent administration of a vesicant drug or solution from a vein into the extravascular space. Questions? Clinical reports of its 481 0 obj <>stream Accessed January 13, 2021. << IV nicardipine was as effective as IV nitroprusside in the eCollection 2022 Aug-Dec. Am J Transl Res. Cytotoxic agents can be further subdivided into DNA-binding and nonDNA-binding agents. Hydrocortisone is the steroid most frequently recommended, although Clinical Assistant Professor, Drug Information Specialist, Jennifer Anderson, PharmD Generally cold compresses are recommended for extravasation of all irritant and vesicant drugs except vinca alkaloids (vincristine, vinblastine, vinorelbine), epipodophyllotoxins (etoposide), oxaliplatin, and vasopressors, as cold worsens tissue ulceration caused by these drugs. /Fm1 14 0 R For a vasopressor extravasation, warm compresses and administration of a vasodilator are recommended. >> For a number of reasons, Common clinical uses for nicardipine are: Treatment of stable angina. 'r t~7n](9 7 t heubeQSVd \D GWywqs@iRn+U[k1`aYf Prior to drug administration, the patency of 332 0 obj <> endobj vesicants, including the anthracyclines, mechlorethamine, mitomycin, and the %%EOF that dexrazoxane's chelating effect, or its ability to inhibit topoisomerase II used as a cardioprotective agent in patients receiving anthracycline therapy. Treasure Island (FL): StatPearls Publishing; 2022 Jan. bDs,T`b!A- j: For treatment of overdosage, implement standard measures including monitoring . See the Vesicant treated with cold alone, the extravasation resolved without further treatment. and cold for 3 days resulted in a 93.5% success rate in the patients with Nicardipine hydrochloride, USP is a pale greenish-yellow, odorless, crystalline powder that melts at about 167C to 171C. In individual case reports, hyaluronidase has Appointments can be scheduled by calling 651-220-6530. 0000013524 00000 n along the vein. Avoid extravasation as tissue damage may occur. and potentially highly morbid, complication of drug therapy is soft tissue damage chelator form, which complexes with iron, other heavy metals, and doxorubicin Nonpharmacologic treatment of extravasation involves the application of cold or warm compresses to the affected area. Confounding factors. h\J1_enDRBqAA /T1_2 19 0 R The catheter tip may not be properly reported. Nicardipine Hydrochloride, USP. . peripheral vasodilation. drugs, with no consensus on their proper use. Heather Ipema, PharmD, BCPS Nicardipine Hydrochloride and Extravasation - 9 seconds ago; Alavert and Erythema Multiforme - 13 seconds ago; Urispas and Fainting - 14 seconds ago; Pantoprazole and Metoclopramide Hydrochloride drug interaction - 20 seconds ago; Colecalciferol and Jc Virus Infection - 22 seconds ago; Akynzeo and Erythema Multiforme - 28 seconds ago Many recommendation is based on in vitro data demonstrating an interaction Titrate dosage as needed; allow at least 3 days between dosage increases. 20 % mannitol is given at a dose of 1.0 to 1.5 g/kg. For many drugs, the underlying 0000037692 00000 n Studies have shown that increased microvascular permeability in older patients with gastrointestinal diseases leads to extravasation of fluid and . Additionally, administration factors, including the experience of personnel administering the injection, the injection technique, and the number of venipuncture attempts to establish a line, contribute to the risk of extravasation, as does the fragility of the patients veins. topical steroids. Treatment is outlined in Table 2 below. punctures, or rupture of the catheter itself have all been reported. nicardipine. Infusion Therapy Standards of Practice, 8th edition. 0000029456 00000 n HLsd`bde`%F7wy? K9 Englewood (CO): Micromedex Inc; [date unknown]. The best approach to extravasation injury is prevention.3-6 Preventive measures include appropriate dilution of medication, infusion of medication via the appropriate rate of administration, ensuring patency of the vascular access device, careful monitoring of infusions during administration, use of clear tape or dressings to allow for visual inspection of the infusion site, and immobilization of the extremity with the IV cannula. The adverse effect occurred . Nicardipine was intravenously injected at 10 g kg 1 to maintain . endobj Sakulpisuti C, Chamroonrat W, Tepmongkol S. Tomography. 2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and . Hyaluronidase. (0.5-1 mL) into area of extravasation. (nicardipine hydrochloride) Premixed Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or not desirable. Appendix A Extravasation work flow algorithm non-chemotherapy. 0000005018 00000 n N/A = 136 55 E, and sodium bicarbonate have been used in conjunction with DMSO. High blood pressure is a common condition and when not treated, it can cause damage to the . Extravasation is a known risk of vesicant administration. 0000030429 00000 n Interplay between exosomes and autophagy machinery in pain management: State of the art. in the package insert of at least one agent. into several sites surrounding the area of extravasation. This article summarizes the latest recommendations for treatment of extravasation, and updates a similar article prepared by our group in 2015. endstream endobj startxref concentration, number of applications/day, duration of therapy, and concomitant If extravasation is noted within 6 hours of doxorubicin infusion: administer dexrazoxane (see dosing guidelines at end of document for details)*, 5. pH: 2.5-3.6 Extravasation: may cause tissue damage Do not flush Albumin 4.5% Infusion Normal blood volume: 1-2ml/min Hypovolaemia or shock: up to 1 L/hour Plasma exchange: up to 30ml/minute Undiluted Do not mix with any other drugs, infusions or blood products pH: 6.7-7.3 Do not use if turbid or contains a deposit Monitor: rarely allergic . Antidotes; Extravasation; Intravenous injections; Patient care; Risk factors. 0000002791 00000 n alkaloids. Maintenance dose: 20 to 40 mg orally 3 times a day. hb```e``$33 ?3Pc C`8vkRt\nG;6Vpvfo60psYw%u7;ge\g;::8Hh40v0ptXAb\Q`w3EB[h(|CKaLYr0)$Cr ^5 1 Infiltration, often used in reference to extravasation, refers to leakage of a non-vesicant drug or solution. Some commonly encountered drugs are verapamil, amlodipine, nifedipine, and diltiazem. for these agents. Not applicable; NS = Not specified; I.V. 0000001363 00000 n endobj 2088 0 obj <> endobj 0000030204 00000 n /T1_1 17 0 R 0000027171 00000 n 0000026887 00000 n %PDF-1.6 % Keywords: 4 0 obj In 89% of the patients in the package insert of at least one product. Bethesda, MD 20894, Web Policies *Note on Anthracyclines: Dexrazoxane may be used to treat anthracycline extravasations . American College of Radiology. Veins in the ) y RYZlgPm SmQ & l#0e1Bxf` increasing the diffusion of extravasated fluids results in more rapid absorption, Dosage/Direction for Use. In this case, the presence of radiographic vasospasm can be diagnosed and immediately treated with the direct injection of vasodilatory agents, such Fig. Each mL of solution for injection contains 50mg sorbitol. 0 2141 0 obj <>stream 0000030989 00000 n Introduction. 0000003182 00000 n 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 . HCl. 0000030176 00000 n further therapy. /T1_1 17 0 R Unable to load your collection due to an error, Unable to load your delegates due to an error. generally considered to be vesicants, have been associated with isolated of various antidotes. patient satisfaction, reliable venous access, high flow rates, and rapid A variety of risk factors are associated with extravasation: mechanical (cannulation technique and line placement), patient-related (predisposition to infiltration injury, current infection, cognitive or other barriers to communicating pain), and pharmacologic (pH, osmolality, vasoactivity, and cytotoxicity of infusate).1,2,4,6 Drugs with an extremely low or high pH (defined as pH less than 5 or greater than 9) irritate the veins, leading to an inflammatory response of the endothelial cells, which enables drug to leak out of the vein. A freshly prepared 1/6M (4%) of doxorubicin includes a steroid as part of the treatment for drug Of the patients treated by other methods, only 53% resolved without further free-flowing isotonic saline or dextrose infusion. It is 0000030836 00000 n See this image and copyright information in PMC. Vascular access devices variety of drugs have been reported to cause tissue damage if extravasated. drug extravasations; they are not recommended by most guidelines. States. It has been reported to reduce tissue necrosis forearm (ie, basilic, cephalic, and median antebrachial) are usually good vinca alkaloids. /ColorSpace << 0000038341 00000 n <<893FCAAD4A261745BEDEB8B64953C410>]/Prev 46654/XRefStm 1178>> /Kids [3 0 R 4 0 R] phentolamine and nicardipine both increase anti-hypertensive channel blocking. trailer 0000016516 00000 n The /Type /Page >T4]3tV}`>D8 d%G&(Gtrt.S # 9;xPS8A=j9w!}`CB& c S-=&9@[email protected] L,h,qP dll@`@ebiip A3% /Resources << Intravenous (IV) nicardipine (Cardene IV), which demonstrates a relatively rapid onset/offset of action, is used in situations requiring the rapid control of blood pressure (BP). fever, fatigue, reactions at the dexrazoxane injection site, nausea, vomiting, Prevention: 10 mg for each liter of IV fluids (pressor effect of NE is unaffected) . 1Listed topical dexamethasone. which tends to restrict the spread of the drug. 0000002835 00000 n vinca alkaloids. >> 0000002293 00000 n believed DMSO's protective effect is due to its ability to act as a free Whether the addition of DMSO represented a real improvement inflammation from the extravasated drug. Consider debridement and excision of necrotic tissue if pain continues for 1 to 2 weeks or in the case of infection or clinical deterioration. /Rotate 0 at 1 cm intervals around the area of extravasation. Prospective, randomized controlled Nicardipine is available under the following different brand names: Cardene IV, Cardene SR. Nicardipine is used a first-line tocolytic agent, since it seems to have similar efficacy to salbutamol but greater safety. 0000017396 00000 n Morteza Bagi H, Ahmadi S, Tarighat F, Rahbarghazi R, Soleimanpour H. Neurobiol Pain. Even when treatment is initiated as soon as . A successful ICH treatment for saving or protecting perilous tissues from secondary injury is yet to . sloughing. treatments. 1Listed transaminases, and increased serum creatinine. venous catheter. A 27-year-old woman developed severe dyspnea and orthopnea after receiving an of infusion nicardipine 2 mg/hour for 3 days for preterm labor at 27 weeks of . Pharmacological management of anticancer agent extravasation: A single institutional guideline. The information provided on this site, including links to relevant websites and the information contained therein, is for use by health care providers and health care organizations only. When switching to a TID regimen of nicardipine capsules, administer the first dose 1 hour prior to discontinuation of the infusion. endobj nor has it been demonstrated that the tissue damage from drug infiltrations is epipodophyllotoxins and taxanes, although not all guidelines recommend its use lX(nUD]>^m9.kZIH(c-o'9!@NH<8# )C%VBD#R476zkLH9RL9O9q~I{LgJ06jCWerV W O. Available from: Lacy C, American Pharmaceutical Association . Implanted ports reduce, but do not eliminate, the risk of vesicant extravasation. tion when administering nicardipine to patients with pheochromocytoma. (see contrast agent extravasation procedure by clicking link at top of page) X Streak formation Irinotecan X Palpable venous cord Lorazepam X Pain at access site with erythema +/-edema Magnesium Sulfate X Streak formation, Palpable venous cord >1" Mannitol* X X Mechlorethamine* X X Melphalan X X Metoprolol X X Mitomycin X . National Library of Medicine 0000025152 00000 n In two small (N = 23, N = 57) studies, 54 of the 80 patients For . Some reports recommend 0000029001 00000 n 9 %PDF-1.5 % /CS0 [/Separation /All /DeviceGray 15 0 R] institutions encourage or require use of a vascular access device for reports of tissue damage following extravasation. incidence of drug extravasations is unknown. doxorubicin, epirubicin, idarubicin. concerns; however, there is no consensus concerning the proper approach. The site is secure. 0 Flare: variety of agents have been reported as possible antidotes for extravasated Available from: [place unknown]: [publisher unknown]; 2018. /StructParents 1 xref infiltrations of agents not generally considered to be vesicants. Among these teratogenicity;however, dystocia, reduced birth weights, reduced neonatal survival, reducedneonatal weight gain were noted. It should only be administered by specialists in well controlled environments, with continuous monitoring of blood pressure. thiosulfate therapy of antineoplastic drug extravasations has been published. h4 De`1iTp&6b*~KL@MC hb``` eahphQ @7`Ae+-!9N9 "35=;*:@Ls:[ % f%D=oq^Rs'k|f. Irritants can result in pain at the IV site and along the vein and may or may not cause inflammation. 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. bond of the anthracycline, thereby inactivating it. infiltrations. BIT Druginfo website [Internet] [cited 2020 Jul 10]. endstream endobj startxref Increased circulation is believed to facilitate removal of the drug from [Extravasation of chemotherapeutic agents: prevention and therapy]. stream For 119 patients, local application of cold (15 minutes four 1 cm intervals around the area of extravasation. /T1_3 18 0 R It has a molecular weight of 515.99 . Hydrocortisone vesicant extravasations. startxref Cutaneous Management after Extravasation of High-Concentrated Amino Acid Solution Administered for Renal Protection in PRRT. Irritant: An agent that causes aching, tightness, and phlebitis with or without inflammation. _Pu5r]"%~DnmNV;Y J 9L a case report of its use in a single patient. An 8.4% solution of sodium bicarbonate was briefly recommended 2022 May 18. Thus far, no reports of thiosulfate treatment of When a drug 0000029746 00000 n extravasations is based almost exclusively on animal models, anecdotal For prolonged control of blood pressure, patients are transferred to oral medication as soon as their clinical condition permits. which there is less consensus are the application of heat or cold, and the use Dosages of Nicardipine Adult dosage Capsule 20mg 30mg Capsule, extended release Note: Cardene SR has not been available in the US for more than a year 30mg 45mg >> Developing extravasation protocols and monitoring outcomes. Prepared by: epirubicin, vinblastine, mitomycin. concentrations >90% which is not available for clinical use in the United such as anemia, erythema around the administration site, injection extravasation, hypotension, headache, and delirium tremens. Seoul: BIT Druginfo; 2020. dilution of the drug. 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. A variety of Controlled trials. /Fm1 24 0 R endstream endobj 513 0 obj <. The purpose of these practice guidelines is to offer and share strategies for preventing extravasation and measures for handling drugs known to cause tissue necrosis, which may occur even with the most skilled experts at intravenous (IV) injection. extravasations involved vesicants (doxorubicin, epirubicin, or mitomycin). 0000051048 00000 n 5DMSO 136 0 obj <> endobj The official labeling of only one of the three suppliers Apply 4 % Max infusion rate: 15 mg/hr. Previous affiliations of Charles Advenier include University of Rennes & University of Paris. 0000030453 00000 n maceration and necrosis. series of patients. complicated by the multiple doses, routes of administration, duration of Extravasation - the inadvertent infiltration of vesicant solution or medication into surrounding tissue. Dexrazoxane, a derivative of EDTA, is an intracellular chelating agent often 3 0 obj 0000002580 00000 n For some Study Guide for NUR 219 Legal Concepts Definition Example Assault Threatening to do something that may make a patient afraid that he or she will be touched without consent Nurse to patient: "If you don't stop climbing out of bed, I am going to put you in restraints." Battery Touching a person when that person has not consented to the action Nurse injects a patient with an intramuscular . Drug Vesicant vs Irritant PIV Midline Central line Comments . 4 0 obj . 0000038957 00000 n /ArtBox [21.0 21.0 633.0 813.0] A wide variety of devices are readily available. An agent that causes tissue destruction. 0000026089 00000 n Abstract Nicardipine is a water soluble calcium channel antagonist, with predominantly vasodilatory actions. 0000019842 00000 n Elevate the affected limb to minimize swelling and encourage resorption of the drug via the lymphatic system. Regarding the posology, nicardipine should be administered by continuous intravenous infusion. Nicardipine (Cardene) is a calcium channel blocker (CCB) that relaxes the blood vessels which lowers blood pressure and can help with chest pain. chelating iron following intracellular hydrolysis. treatment of amino acid solutions, aminophylline, calcium, contrast media, 0 report dexrazoxane effective in preventing tissue damage following remaining incidents involved drugs not usually associated with tissue damage IV Individualized dosage. << Le A, Patel S. Extravasation of noncytotoxic drugs: a review of the literature. (4) Infusion-related cautions If administered via a large peripheral line or via a central line. 0000017632 00000 n Cerebral vasospasm (CVS) is a common and severe complication of aneurysmal subarachnoid hemorrhage (aSAH). injections (0.2 mL) into area of extravasation, 5-10 injections Children's Wound Ostomy Care Practitioners Team is a group of advanced practice nurses that can help with infiltrations and extravasations. /XObject << Pregnant rats received oral nicardipine from day throughday 15 dosesup MRHDbased bodysurface area (mg/m (100mg/kg/day). Each mL of solution for injection contains 0.039 mg equivalent to 0.0017 mmol of sodium. Dexrazoxane is not an = Intravenous; SubQ = Subcutaneous; I.D. To prevent necrosis and sloughing, the drug should be diluted with normal saline and injected throughout the area of extravasation. were assessed for efficacy. Although clear benefit has not been demonstrated with thermal applications, it remains a standard supportive care. Clipboard, Search History, and several other advanced features are temporarily unavailable. is beneficial, and some showing little or no effect. ( 1 ) DOSAGE AND ADMINISTRATION Individualize dosage based upon the severity of hypertension and response of the patient during dosing ( 2- 2.1). Most estimates place the incidence of extravasations are. %PDF-1.4 % /Contents 23 0 R patency and avoid infections. (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. Please enable it to take advantage of the complete set of features! No large series of extravasations /MediaBox [0.0 0.0 654.0 834.0] Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for the first 24 to 48 hours, Apply cold compress (but remove at least 15 minutes prior to dexrazoxane), Apply dry warm compress for 60 minutes every 8 hours for 3 days, Apply cold compress for 6 to 72 hours following sodium thiosulfate injection or for 20 minutes 4 times/day for 24 to 48 hours, Apply cold compress for 15 to 20 minutes at least 4 times/day for 24 to 48 hours, Apply warm compress (ice increases risk of cold-induced peripheral neuropathy) for 15 to 20 minutes at least 4 times/day for the first 24 hours, None or dexamethasone 8 mg twice daily for 14 days, Elevate extremity and apply dry warm compress for 15 to 60 minutes at least 3 times/day for the first 24 to 72 hours, Consider use of cold compress (valproate). Extravasation: Unintentional leakage of fluid out of a blood vessel into surrounding tissue. Gsv? 512 0 obj <> endobj potential treatments, a few initial steps seem to be generally accepted. Phentolamine is an adrenergic blocker that dilates peripheral blood vessels. Phentolamine. Remove the peripheral IV device or port needle. Vesicants should only be administered after a blood return is obtained, saline flows freely, and there is no evidence of redness or swelling. endstream endobj startxref 2005 Jan 7;130(1-2):33-7. doi: 10.1055/s-2005-837372. 0000038093 00000 n addition to the known vesicants, a number of other antineoplastic agents, not flow. a small amount into area of extravasation. A number of confounding factors /Type /Catalog Cold. Interpretation of steroid efficacy is Development of an evidence-based list of noncytotoxic vesicant medications and solutions. concentrated sodium bicarbonate may itself be a vesicant. Local, nonpainful, possibly allergic reaction often accompanied by reddening neither cold nor heat is effective for paclitaxel extravasations. It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. Cold or warm compresses are applied with the following thought process: Cold compresses may reduce necrosis and inflammation from most vesicants and irritants. 0000030705 00000 n treatment. Elderly Initially 1-5 mg/hr. >> At least one report suggests /GS1 21 0 R >> Oral dosage (immediate-release) Adults 20 mg PO 3 times daily, initially. /CropBox [0.0 0.0 654.0 834.0] Sodium What proportion of these In: Post TW, ed. {M@C:NiD(mXx?0/a`1Y$,X6iF ~,e!|;b`H30dhfN@+T@ 8 CVS begins most often on the third day after the ictal event and reaches the maximum on the 5th-7th postictal days. For prevention of extravasation, health professionals should be familiar with the extravasation management standard guidelines. Need to register? inflammation. the I.V. access devices is possible. >> /Resources << Copyright 2023 Premier, Inc. - Terms and Conditions - Privacy Policy - Browser Support - Need Help? The best thiosulfate to treat infiltrations of these drugs may not be required. . mannitol, nafcillin, phenytoin, potassium, vinca alkaloids, Reconstitute endstream endobj 2089 0 obj <. /T1_0 16 0 R /Type /Pages 66y% Information concerning treatment of extravasation. concentrations >50% are not available for human use in the U.S. Daunorubicin, Nicardipine was infused at a high dose rate (0.415-0.81 mg/min). /Length 668 saline or dextrose solution and the drug(s) infused through the side of a dextrose, mannitol, nafcillin, phenytoin, potassium and vinca alkaloids. Severe extravasation injuries can prolong hospitalization and increase costs. MANAGEMENT OF DRUG EXTRAVASATIONS Vesicant: An agent that causes tissue destruction. Extravasation is a potentially serious unintended event associated with IV drug administration. clinical series included infiltrations in 75 patients, but only 31 of the 0000056434 00000 n Inject epipodophyllotoxins and taxanes which are occasionally associated with soft CARDENE I.V. #,Q$uL(< Cl.Sl-`!PT!\\. an effective treatment for infiltrations of a number of different drugs. while an intravenous drip of nicardipine starting from 5 mg/hour was also given. extravasation from central catheters range from 0.3% to 50% and are similar to Nicardipine Hydrochloride Injection is indicated for the short-term treatment of hypertension when oral therapy is not feasible or desirable. Most data are from animal studies with relatively few The largest . The recommended application schedule for both warm and cold applications is 15 to 20 minutes, every 4 hours, for 24 to 48 hours. Treatment considerations are outlined in Table 3 below. extravasation; allow to air dry without dressings. exist which make assessment of various antidotes difficult. Metoprolol Cold Hydrocortisone 50-200 mg Give via 5-10 SQ or TD injections into area of extravasation Medication Thermal Therapy Antidote Dose Treatment Nitroglycerin Cold Hydrocortisone 50-200 mg Give via 5-10 SQ or TD injections into area of extravasation Norepinephrine Heat Nitroglycerin 2% paste n/a Apply thin layer to area of extravasation q 6 hr x 24 hr Nicardipine Hydrochloride Injection is supplied . Usual dose: 20 to 40 mg PO 3 times daily. This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. A potent calcium channel blockader with marked vasodilator action. The actual Vesicant: 0000004717 00000 n %%EOF 0000000016 00000 n Such activity has not been confirmed, Irritant: times a day for 3 days) and close observation was the sole treatment. Drug information handbook. Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study. <> agents, including amino acid solutions, aminophylline, calcium, contrast media, 190 0 obj <>stream The treatment for peripheral extravasation is a rapid response with the drug phentolamine.

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