Additionally, administration factors, including the experience of personnel administering the injection, the injection technique, and the number of venipuncture attempts to establish a line, contribute to the risk of extravasation, as does the fragility of the patient’s veins. Cytotoxic agents can be further subdivided into DNA-binding and non–DNA-binding agents. Some drugs, including anti-cancer agents, are directly cytotoxic to cells. Certain drugs cause vasospasms, which result in back pressure at the intravenous (IV) site and may expand the puncture site in the vein, allowing leakage to occur drugs that act as vasoconstrictors can also cause tissue ischemia. Osmolality is also a consideration, as differences in osmotic pressure can damage endothelial cells, leading to potential for drug leakage from vessels. 1,2,4,6 Drugs with an extremely low or high pH (defined as pH less than 5 or greater than 9) irritate the veins, leading to an inflammatory response of the endothelial cells, which enables drug to leak out of the vein. This article summarizes the latest recommendations for treatment of extravasation, and updates a similar article prepared by our group in 2015.Ī variety of risk factors are associated with extravasation: mechanical (cannulation technique and line placement), patient-related (predisposition to infiltration injury, current infection, cognitive or other barriers to communicating pain), and pharmacologic (pH, osmolality, vasoactivity, and cytotoxicity of infusate). For vesicant drugs and chemotherapeutic agents, the incidence has been reported to range from 0.01% to 6%. 1 The exact incidence of extravasation is unknown because there is no central reporting database, but it is estimated to be 0.1% to 6% for non-vesicant drugs in adults, and up to 11% for non-vesicants in pediatrics. Damage from extravasation can progress to a significant degree, causing permanent disability and disfigurement, and necessitating surgical debridement or skin grafting. However, vesicants are differentiated from non-vesicants in that they can cause tissue necrosis, blistering, and ulceration. 2,3 Initial symptoms of extravasation are similar to infiltration and include persistent pain, burning, stinging, swelling, and either blanching or erythema at the site of injection or along the course of the vein. 1 Infiltration, often used in reference to extravasation, refers to leakage of a non-vesicant drug or solution. And as always happy nursing.Extravasation is defined as the leakage or inadvertent administration of a vesicant drug or solution from a vein into the extravascular space. So with these drugs, they should be separated if each are oral, but if one is given by IV and the other, not, then this interaction is not an issue It for magnesium sulfate or mgs oh four. When used orally magnesium sulfate, it can interact with fluroquinolone. And with this, we see things like respiratory depression, as well as a loss of deep tendon reflexes and decrease cardiac output. And it is important that the patient knows that magnesium toxicity can occur. So that is important in the event of an overdose. The antidote for magnesium sulfate is calcium glute. Be sure to monitor your patient's EKG, the rest respiratory rate, as well as of course, their magnesium levels use caution in patients who have renal insufficiency when administering magnesium sulfate, be sure that you are checking the dose with a secondary practitioner with IV doses. Let's take a look at a few of the nursing considerations for magnesium sulfate. Some of the side effects that we see with magnesium sulfate are things like hypotension, muscle weakness, arrhythmias, and a decrease respiratory rate. We use magnesium sulfate for the treatment of hypomagnesemia hypertension, preterm labor for SOS asthma, and as an anti convulsant with eclampsia. So how does magnesium work? Well, magnesium plays a role in muscle. Okay guys, remember when we are talking about therapeutic class of a drug, we are talking about how it works in the body and for magnesium sulfate, this is a mineral and electrolyte replacement or supplement and for the pharmacologic class or the chemical effect of the drug for magnesium sulfate, this is a mineral and electrolyte. This is an injectable medication, as you can see here, and it also can be given orally. Hey guys, let's talk about magnesium sulfate also known as mgs oh four.
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