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Drug Toxicity: Overview01:00

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Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
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A case of mitoxantrone extravasation.

Abraham Chang1

  • 1Pharmacy Department, Stanford Health Care, Stanford, CA, USA.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|January 7, 2020
PubMed
Summary

Mitoxantrone extravasation can cause severe tissue damage, necessitating prompt management. This case report supports classifying mitoxantrone as a vesicant, highlighting the need for careful handling during chemotherapy administration.

Keywords:
Chemotherapyextravasationmitoxantrone

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Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Medicine

Background:

  • Mitoxantrone is an antineoplastic agent used for various cancers and multiple sclerosis.
  • The classification of mitoxantrone as either a vesicant or irritant remains debated in medical literature.
  • Understanding its properties is crucial for safe administration and patient care.

Observation:

  • A patient experienced mitoxantrone extravasation during intravenous infusion.
  • The extravasation site showed edema and subcutaneous blue discoloration, accompanied by pain.
  • Delayed blistering occurred five weeks post-infusion, requiring surgical intervention.

Findings:

  • The case demonstrates a severe reaction to mitoxantrone extravasation, including delayed blistering and the need for surgical debridement and grafting.
  • Treatment with dexrazoxane and cold compresses provided initial pain relief but did not prevent tissue damage.
  • The clinical course supports categorizing mitoxantrone as a vesicant, similar to anthracyclines.

Implications:

  • This case underscores the vesicant potential of mitoxantrone, advocating for cautious administration protocols.
  • Healthcare providers should be vigilant for extravasation signs and manage them promptly.
  • Further research is needed to definitively classify mitoxantrone and establish standardized treatment guidelines for extravasation.