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Question for Oncology Infusion RNs re Dexrazoxane,Zinecard

Out institution is writing a policy in regards to chemo extravasation and administration of Dexrazoxane infusion for extravasation of Anthracycline and prophylactically for cardiac protection pre transfusion of Anthracycline. The recommendations from ONS is to : 'Dexrazoxane should be infused over 1-2 hrs in a large vein in an area other than the extravasation if possible or distal to the extravasation site'. Can anyone tell me why this infusion needs to be 'in a large vein' and what defines a large vein. They are not saying centrally and yet do say to give distal to extravasation site in some cases and use opposite side in another statement. Is it pH - although it dilutes to a pH of ~ 7.0.

Any information would be appreciated,

Thank you

 Totect and not Zinecard has

 Totect and not Zinecard has a labeled indication for treating anthracycline Extravasation. Pain on infusion and phlebitis is a problem so a vein with the largest diameter provides more hemodilution of infusing Med. So choose the largest vein possible in the forearm for that patient. There is no definition for "large vein" when talking about peripheral infusion. Vein choice is relative to vein size for each patient. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

 Thank you Lynn

 Thank you Lynn


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