Phenytoin extravasation management

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Dexrazoxane is not an effective chelator itself, but is hydrolyzed intracellularly to an open-ring chelator form, which complexes with iron, other heavy metals, and doxorubicin complexes to inhibit the generation of free radicals. The data supporting use of heat are less convincing than for cold. To continue reading this article, you must log in with your personal, hospital, or group practice subscription.

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Place cannula in forearm when possible. The use of hyaluronidase for treatment of extravasations in a premature infant. For many drugs, the underlying mechanism responsible for the tissue damage is not certain.

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Usually appears within minutes after injection. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.

Refer to the medicines administration policy in the GOSH document library. Leakage of a drug that causes pain, necrosis, or tissue sloughing. Clinical staging and conservative management of peripheral lymphedema Cutaneous side effects of conventional chemotherapy agents.

Journal List Saudi J Anaesth v. For some proposed antidotes, a wide variety of different doses, concentrations, methods of application, and duration of therapy have been reported, making determination of the optimal treatment regimen difficult. Sudden swelling about port pocket or chest area; no or loss of blood return; palpable subcutaneous tissue; fluid leaking around needle.

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Follow-up studies in a variety of animal models failed to confirm the original report. Risk factors for infiltration and extravasation Risk factors include device-related, drug-related, patient-related and clinician-related factors Sauerland et al Learn how UpToDate can help you. Days 1 and 2 Day 3. Flooding the infiltration site with saline or dextrose in an attempt to dilute the drug solution generally is not recommended.

The proposed mechanism of action was that the high pH of the bicarbonate solution would break the glycosidic bond of the anthracycline, thereby inactivating it. Although there is considerable uncertainty regarding the value of some potential treatments, a few initial steps seem to be generally accepted. The infiltrated catheter should not be removed immediately. The pressure reading should not be the sole indicator for an extravasation Sauerland et al As such, this rate probably underestimates the true incidence of chemotherapy extravasation injury.

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