Individual Management of Drug extravasation~4
DRUG |
GROUP |
ASPIRATE And instill steroids001 |
'SPREAD’ AND DILUTE
|
LOCALISE AND NEUTRALISE |
SPECIFIC MANAGEMENT |
ADDITIONAL INFORMATION |
Methotrexate |
2 |
Y |
|
Y |
Apply topical hydrocortisone and cover the area with an ice pack h for the next 4 hours. If the local reaction has then settled apply heat g for a further 24 to 48 hours. 2 |
Possibility of local inflammation. S/C hyaluronidase may facilitate dispersion of large volume extravasations in addition to the warm compressions |
Mitomycin |
5 |
Y |
|
Y |
Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress. 1 h |
Avoid contact with good skin. If blistering occurs, stop the DMSO and seek further advice. Surgical excision e is sometimes required to prevent serious damage |
Mitozantrone |
4 |
Y |
|
Y |
Apply topical DMSO, every 2 hours at the extravasation site followed by topical hydrocortisone cream and a cold compress. 1 h |
Possibility of local inflammation or necrosis and/or pain |
Mustine |
5 |
Y |
|
Y |
Infiltrate the area with sodium thiosulphate.b Introduce a further 100 mg of hydrocortisone to the infiltrated area. Apply cold compression for 12 hours.h |
Surgical excision e is sometimes required to prevent serious damage |
Oxaliplatin |
4 |
Y |
Y |
|
Infiltrate with hyaluronidase a and a 500 ml bag of 5% dextrose plus further hyaluronidase a should be placed in the centre of the extravasation area in a ‘hypodermoclysis’ f fashion, the area warmed to aid dispersion. The fluid should be left up to 8 hours or until the 500ml is dissipated. |
Caution in diabetic patients |
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