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Chemotherapy

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Chemotherapy, Chemotherapy Extravasation

  • General
  1. Exercise encouraged following high dose Chemotherapy
    1. Safe
    2. Prevents deconditioning
    3. Decreases toxic side effects of Chemotherapy
  2. Reference
    1. Dimeo (1997) Blood 90:3390-4 [PubMed]
  • Agents
  1. Alkylating Agent
  2. Antimetabolite Chemotherapy
  3. Hormonally Active Chemotherapy
  4. Plant Alkaloid Chemotherapy
  5. Antibiotic Chemotherapy
  6. Miscellaneous Medication
    1. Amsacrine
    2. Asparaginase
    3. Hydoxyurea
    4. Mitoxantrone
    5. Mitotane (Lysodren)
    6. Quinacrine
  • Management
  • Extravasation of agents from IV
  1. Practice vigilent prevention
  2. Findings: Onset with hours of Chemotherapy
    1. Early: Pain, local erythema and swelling
    2. Later: Blanching, Blistering, discoloration and tissue necrosis
  3. Management: Early recognition and treatment is critical
    1. Immediately stop any infusion
    2. Leave cannula in place until management plan is established
    3. Apply ice to area
    4. Do not compress area
    5. Use antidotes if available
    6. Urgent Consultations with Oncology and Surgery
      1. Debridement with skin grafting may be needed
  4. Complications
    1. Scarring
    2. Contractures
    3. Amputation
  5. References
    1. Higdon (2006) Am Fam Physician 74:1873-80 [PubMed]
    2. Higdon (2018) Am Fam Physician 97(11):741-8 [PubMed]