Extent of extravasation: Patients on parenteral plant alkaloids

Abstract

ABSTRACT Background: Plant alkaloids remain an essential part of many chemotherapeutic regimens. Although many adverse effects have been studied with appropriate management guidelines, extravasation (EV) is one adverse event that is yet to be studied at a regional scale to frame population-specific guidelines. Methodology: A hospital-based observational study was done for 1 year to understand the extent of extravasation among patients on parenteral plant alkaloids. Clinical pharmacists congregated information about patients satisfying the study criteria. The incidence of EV injuries associated with parenteral plant alkaloids was assessed. The severity was scored using the Common Terminology Criteria for Adverse Events (CTCAE) v4.3. The ESMO-EONS guidelines were followed for the classification of chemotherapeutic agents as well as management of the incidents of EV. Results: Among the 80 patients recruited into the study, 26.25% of patients experienced EV injuries, of which 66.67% were grade 2 and 33.33% were grade 3. Females were prevalent at 62% among the injured group. Patients in the age group 31–50 years and 51–60 years sustained 28.57% of the injuries each. In 76.19% of injured patients, ambulation status was positive during the infusion. ESMO-EONS drug classification showed that 54.84% of the drugs prescribed were vesicants. Paclitaxel was seen in 33.33% of prescriptions in the injured group, among other plant alkaloids. Conclusion: Our study saw a trend of vesicant-induced extravasation injury among patients prescribed parenteral chemotherapeutic regimens with a combination of plant alkaloids, indicating the significant risk they may pose.