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What is nicardipine (Cardene) used for? HCl. /Type /Page /TrimBox [21.0 21.0 633.0 813.0] [2] /XObject << Animal models indicate application of heat exacerbates the
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(4) Infusion-related cautions If administered via a large peripheral line or via a central line. Nicardipine hydrochloride, USP is a pale greenish-yellow, odorless, crystalline powder that melts at about 167C to 171C. Although clear benefit has not been demonstrated with thermal applications, it remains a standard supportive care. 0000030429 00000 n
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Keywords: A 27-year-old woman developed severe dyspnea and orthopnea after receiving an of infusion nicardipine 2 mg/hour for 3 days for preterm labor at 27 weeks of . UIC's seven health sciences colleges and health care delivery enterprise. 8.3 Nursing Mothers Nicardipine minimallyexcreted humanmilk. 0000000016 00000 n
If extravasation is noted within 6 hours of doxorubicin infusion: administer dexrazoxane (see dosing guidelines at end of document for details)*, 5. patient satisfaction, reliable venous access, high flow rates, and rapid
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In adults, treatment should start with a continuous administration of nicardipine at a rate of 3-5 mg/h. guidelines discourage application of cold to treat infiltrations of vinca
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Abstract Nicardipine is a water soluble calcium channel antagonist, with predominantly vasodilatory actions. were assessed for efficacy. vial with NS to a concentration of 150 units/mL. Severe extravasation injuries can prolong hospitalization and increase costs. One-third of the patients in the two studies were not assessed for
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The best approach to extravasation injury is prevention.3-6 Preventive measures include appropriate dilution of medication, infusion of medication via the appropriate rate of administration, ensuring patency of the vascular access device, careful monitoring of infusions during administration, use of clear tape or dressings to allow for visual inspection of the infusion site, and immobilization of the extremity with the IV cannula. It is suggested that steroids reduce local
0000009414 00000 n
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2023 Feb;23(2):42-45. doi: 10.1016/j.bjae.2022.11.002. 221 0 obj
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A variety of recommendations exist for each of these
An 88 year old man developed extravasation injury following treatment with alteplase, nicardipine and levetiracetam for seizure like episode followed by incomprehensible speech [routes, durations of treatments to reactions onset and outcome not stated].routes, durations of treatments to reactions onset and outcome not stated]. free-flowing isotonic saline or dextrose infusion. line should be verified. A 2% solution has been recommended
It lowers blood pressure by relaxing the blood vessels so the heart does not have to pump as hard. Hyaluronidase is an enzyme that destroys hyaluronic acid, an essential
0000025065 00000 n
total number of drug doses administered, number of vesicant doses administered,
0000003340 00000 n
IV nicardipine was as effective as IV nitroprusside in the 331 0 obj
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Sakulpisuti C, Chamroonrat W, Tepmongkol S. Tomography. epipodophyllotoxins and taxanes. In one report of antineoplastic drug extravasation treatment,
In a series of 63 patients with extravasation of doxorubicin, epirubicin,
0000013958 00000 n
Vesicant:
In: StatPearls [Internet]. 0000037314 00000 n
Important Risk Information Careers. Prompt interdisciplinary action is often necessary for the treatment of extravasation injuries. Vesicants can cause tissue destruction and / or blistering. Use Caution/Monitor . successful thiosulfate treatment of an accidental intramuscular mechlorethamine
reported by Larson in 1985. variety of animal models failed to confirm the original report. managed with the application of heat has been published. flow. pH: 2.5-3.6 Extravasation: may cause tissue damage Do not flush Albumin 4.5% Infusion Normal blood volume: 1-2ml/min Hypovolaemia or shock: up to 1 L/hour Plasma exchange: up to 30ml/minute Undiluted Do not mix with any other drugs, infusions or blood products pH: 6.7-7.3 Do not use if turbid or contains a deposit Monitor: rarely allergic . /T1_0 16 0 R endstream
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Apply compresses for 20 to 60 minutes 3 or 4 times daily for the first 24 to 72 hours after extravasation occurs. unclear. %PDF-1.5
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Misplacement/migration of the catheter tip,
0000043816 00000 n
The author has an hindex of 41, co-authored 241 publication(s) receiving 6283 citation(s). complicated by the multiple doses, routes of administration, duration of
/T1_0 16 0 R Drug information handbook. Corticosteroids. topical dexamethasone. extravasations. Cold. reports of tissue damage following extravasation. Bookshelf Irritant:
government site. Mix 4
the area of infiltration. 4 0 obj
A case study report entitled "Extravasation of i.v. punctures, or rupture of the catheter itself have all been reported. vinca alkaloids. concentrated sodium bicarbonate may itself be a vesicant. times a day for 3 days) and close observation was the sole treatment. Inject into
h4 De`1iTp&6b*~KL@MC % /Annots [22 0 R] 3 DOSAGE FORMS AND STRENGTHS with 0.9 mL NS for a final concentration of 15 units/mL, 4-5
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treatment. Kimmel J, Fleming P, Cuellar S, Anderson J, Haaf CM. transaminases, and increased serum creatinine. hWmo8+8onp">9A!ylTq&fRbpV-SCq9a.LLX#AH&%lSaJH@DIW8bK0(|Z:z8~z]W:i#a`v;&h
.z{ox?w:/nRGq6[>Yk}w5B2|JZOOje|og6 n:g?||TN)6g|R>Pme>9 e>oggK08y 9Kl\^Zx+F9;QqqN?Ewe5F\]CG9Q1C$JW.Z$>l!l[=YRjA^Q{8Y]5c~uQ>@7iWl-6E!nB95E WqDJ=+mjlFs2UOlSFct Q2Vg)SRt1DtqAr? Drug Vesicant vs Irritant PIV Midline Central line Comments . Molecular Formula C 26 H 29 N 3 O 6. It has been postulated
2005 Jan 7;130(1-2):33-7. doi: 10.1055/s-2005-837372. Many of the existing reports, both animal and human, used
for treatment for vinca alkaloid extravasations; a few reports recommend it for
/ExtGState << stream
thereby limiting tissue damage. /ArtBox [21.0 21.0 633.0 813.0] peripheral vasodilation. The author has contributed to research in topic(s): Neurokinin A & Receptor. Oral dosage (immediate-release) Adults 20 mg PO 3 times daily, initially. 0000003804 00000 n
Seoul: BIT Druginfo; 2020. /Kids [3 0 R 4 0 R] 0000051721 00000 n
0000008421 00000 n
Remove the peripheral IV device or port needle. /Parent 2 0 R The management of non-cytotoxic drugs is largely supportive and non-pharmacological, except where antidotes exist, such as for vasopressors. Reports of animal trials offer little
0000003182 00000 n
Copyright 2023 Premier, Inc. - Terms and Conditions - Privacy Policy - Browser Support - Need Help? Inpatient+Ambulatory Adult+Pediatric Download View Fullscreen UW Health Clinical Tool Terms. Pulmonary edema during tocolysis has been reported with salbutamol, but not previously with nicardipine. xref
0000037692 00000 n
0000030836 00000 n
It may also inhibit the local
Usual dose: 20 to 40 mg PO 3 times daily. mechanism responsible for the tissue damage is not certain. Despite the improvement in treatment of aSAH, CVS complicating aSAH has remained the main cause of death. injection of a 2% thiosulfate solution in addition to the subcutaneous and
/Resources << Interpretation of steroid efficacy is
/StructParents 0 Inject at
which tends to restrict the spread of the drug. %%EOF
remaining 56 patients received a variety of antidotes. Sodium
Extravasation of xenobiotics. 0000001396 00000 n
20 % mannitol is given at a dose of 1.0 to 1.5 g/kg. Intravenous (IV) nicardipine (Cardene IV), which demonstrates a relatively rapid onset/offset of action, is used in situations requiring the rapid control of blood pressure (BP). For some of
The stage of injury and vesicant's mechanism of tissue injury dictate treatment. f 0000009377 00000 n
Nicardipine appears to be a safe and effective drug for intravenous use in the treatment of severe hypertension. In individual case reports, hyaluronidase has
of various antidotes. bond of the anthracycline, thereby inactivating it. In: Post TW, ed. Lexicomp [database online]. 2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and . (dobutamine, dopamine, epinephrine, norepinephrine, phenylephrine). One study of
CARDENE I.V. %PDF-1.4 States. variety of drugs have been reported to cause tissue damage if extravasated. very limited animal data on thiosulfate's ability to inactivate dacarbazine and
chelator form, which complexes with iron, other heavy metals, and doxorubicin
9 <<87F8C058794F5343A166C2C321944EFD>]>>
This information is intended as an educational piece and should not be used as the sole source for clinical decision-making. Buter J, Steele KT, Chung KC, Elzinga K. Extravasation injury from chemotherapy and other non-antineoplastic vesicants. /CropBox [0.0 0.0 654.0 834.0] 0000017924 00000 n
Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study. ^z2>)/3}c va)sSH>j8x:/n-WuqB\*? saline or dextrose solution and the drug(s) infused through the side of a
efficacy, leaving the actual efficacy rate of dexrazoxane uncertain. One report of the application of heat for nonantineoplastic drug
/Length 668 500 mg SubQ, betamethasone and gentamicin ointment q12h for 2 days, then qd. Increased circulation is believed to facilitate removal of the drug from
/ProcSet [/PDF /Text] 4 0 obj 0000038093 00000 n
Hudson, OH: Wolters Kluwer Health; 2021. http://onlinelexi.com. Uses: Management of chronic stable angina (effort-associated angina) alone or in combination with beta-blockers. endstream
endobj
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in the package insert of at least one product. . An 8.4% solution of sodium bicarbonate was briefly recommended
An extravasation occurs when there is accidental infiltration of a vesicant or chemotherapeutic drug into the surrounding IV site. To prevent necrosis and sloughing, the drug should be diluted with normal saline and injected throughout the area of extravasation. %PDF-1.4
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use are extremely difficult to interpret due to variations in DMSO
The remaining 32 patients received subcutaneous
%%EOF
necrosis are possible. radical scavenger (one theory suggests tissue damage from vesicants,
for treatment of anthracycline extravasations. %PDF-1.6
%
When switching to a TID regimen of nicardipine capsules, administer the first dose 1 hour prior to discontinuation of the infusion. recommended precaution against drug extravasation is the use of a central
Wang RY. Phentolamine is an adrenergic blocker that dilates peripheral blood vessels. fever, fatigue, reactions at the dexrazoxane injection site, nausea, vomiting,
An agent that causes tissue destruction. 0000031286 00000 n
particularly anthracyclines, is due to formation of hydroxyl free radicals). It has antihypertensive properties and is effective in the treatment of angina and coronary spasms without showing cardiodepressant effects. number of patients treated. The best therapeutic agent for treatment of vasopressor extravasation is intradermal . complexes to inhibit the generation of free radicals. $S@#H= @@ HW@fP
; If treatment includes transfer to an oral antihypertensive agent other than nicardipine capsules, initiate oral therapy upon discontinuation of nicardipine hydrochloride injection. This medicinal product contains sodium. almost 90% of the extravasations treated only with topical cold required no
h247R0P047V01R& Knowledge of the mechanism of extravasation-induced tissue injury, agents for reversal, and appropriate nonpharmacologic treatment methods is essential. neither cold nor heat is effective for paclitaxel extravasations. Treatment options Clevidipine 1-2 mg/h IV, titrate by doubling the dose every 2-5 min until desired BP reached; maximum 21 mg/h; or Labetalol 10-20 mg IV over 1-2 min, may repeat 1 time; or Nicardipine 5 mg/h IV, titrate up by 2.5 mg/h every 5-15 min, maximum 15 mg/h; when desired BP reached, adjust to maintain proper BP limit increasing the diffusion of extravasated fluids results in more rapid absorption,
extravasation treatment.26 Consequently, current man-agement recommendations are based for the most part on anecdotal experience.2,27-29 However, all current guidelines recommend the following steps at the first sign of infiltration or extravasation: (1) stop administra-tion of IV fluids immediately; (2) disconnect the IV tub- the antidotes, the purported mechanism of action of the antidote is also
treatment for extravasation reactions is prevention. J Intraven Nurs. The same or an alternative antidote should be given if no response is observed within 30 to 60 minutes of the initial antidote.6, Management of extravasation of cytotoxic drugs. immediately. Management of drug extravasations. << /Pages 2 0 R extravasations suggested application of heat increased the risk of skin
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At present, no clinical reports of its efficacy for treating