Pharmacology
Anti-Neoplastics
Extravasation with Anti-neoplastics
Vesicants are agents that, if deposited into the subcutaneous tissue (extravasation), cause
tissue necrosis and damage to underlying tendons, nerves, and blood vessels. The full
extent of tissue damage may take several weeks to become apparent.
Indications of extravasation include:
Absence of blood return from IV catheter
Resistance to flow of IV fluid
Swelling, pain, and/or redness to IV site
Some medications classified as vesicants:
Vinca Alkaloids and Antitumor Antibiotics
Daunorubicin, Doxorubicin (Adriamycin), Vincristine, Vinblastine, Nitrogen Mustard
If extravasation is suspected, stop drug administration immediately and administer
protocol according to institution’s policy. (Ex- aspiration of infiltrated drug and inject
neutralizing solution such as Hyaluronidase.)
Ways to minimize extravasation:
Check for blood return prior to drug administration
Good IV access or Implanted vascular access device
Slow administration of chemotherapeutic agent
Monitor IV access closely during administration
Have client report any s/s of swelling, pain, redness or burning to IV site
If you have to administer a combination of chemotherapeutic agents that consist of
vesicants and non-vesicants (such as irritants), you need to administer the non-vesicants
first. These are less likely to cause tissue destruction.
