A number of immediate effects may occur within 30 minutes of the start of treatment. These include:1
- pain at insertion site
- venous pain
- cold sensation along vein
- red flush along the vein
- facial and bodily flushing
- abnormal tastes or smells
- hypersensitivity reaction
Some antineoplastic agents are associated with hypersensitivity reactions mediated by an immune mechanism (IgE), and involve the release of vasoactive agents. It occurs when an individual is exposed to a drug a second time, after prior exposure and when the immune cells are sensitised. Systemic responses include urticarial, rash, hypotension and more severe bronchospasm or anaphylaxis with profound vasomotor collapse.13
It is also important to consider that individuals may be allergic to other substances in the medical environment such as latex, other supportive drugs, blood transfusions, or food.
Extravasation occurs when a drug inadvertently leaks into the surrounding subcutaneous or subdermal tissues rather than into the intravenous compartment during administration. The degree of tissue destruction is directly related to the properties of the drug extravasated, duration of tissue exposure, and amount of infiltrate.1
Extravasation of vesicant drugs can have devastating consequences for individuals. Effects include pain, tissue necrosis and possible limb dysfunction. Some agents have antidotes that will minimize or prevent local tissue damage.13
Resource Document – Extravasation Management 32 (free resource, but you must register and click 'Remember me' to bypass the login page in future).
Identify agents associated with hypersensitivity reactions and outline strategies to minimise their occurrence and manage any adverse events.
Access Resource Document – Extravasation Management 32 (free resource, but you must register and click 'Remember me' to bypass the login page in future) website, and:
- Identify common vesicant, irritant and non-irritant agents.
- Appraise the current policy and procedure in your health care facility for managing extravasation of antineoplastic agents in light of the published guidelines
- Discuss immediate actions to manage a vesicant extravasation.
Identify agents associated with pain at administration and discuss strategies to prevent and manage discomfort during and after their administration.