内容紹介
Methods of Preventing Phlebitis Induced by Infusion of Fosaprepitant
Summary
At our hospital, we use aprepitant for nausea and vomiting when administering highly emetic anticancer agents, according to“Guidelines for the Appropriate Use of Antiemetic Agents”given by the Japan Society of Clinical Oncology. We initiated the intravenous administration of fosaprepitant for better compliance compared with aprepitant; however, we observed phlebitis after the infusion of fosaprepitant. Therefore, we investigated measures to reduce phlebitis associated with the infusion of fosaprepitant. For the first premedication, fosaprepitant(150 mg)was dissolved in 100 mL of saline and administered for 30 minutes; 1 of 2 patients showed grade 4 phlebitis. For the modified premedication, fosaprepitant, dexamethasone, and 5-HT3 antagonist were dissolved in 100 mL of saline and administered for 30 minutes. The modified premedication was administered to a total of 27 patients; 5 patients developed mild phlebitis(grade 1), but infusion could be continued by treating their phlebitis with a hot pack. We used a combination of dexamethasone and 5-HT3 antagonist with fosaprepitant as a modified premedication in order to avoid drug-induced vascular damage, which resulted in the pH decreasing to 6.20-7.55(close to neutral)and a shorter infusion time.
要旨
当院では,催吐性リスク高度のがん薬物療法の嘔気対策は日本癌治療学会作成の「制吐薬適正使用ガイドライン」に準じてアプレピタントカプセル(AP)を使用している。APのコンプライアンス改善を目的に,注射用ホスアプレピタント(FAP)の使用を一部で開始した。初期premedicationであるFAP 150 mgを混合した生理食塩液100 mLを30分で投与中に,2症例中1症例にgrade 4の静脈炎が発生した。そこで,FAP 150 mgとデキサメタゾン注,5-HT3受容体拮抗薬を混合した生理食塩液100 mLを30分で投与するpremedicationに変更した。変更後premedicationを27症例に投与した結果,5症例に軽い血管痛(grade 1)を発生したが,早期にホットパックを使用することでがん薬物療法の継続は可能となり,点滴時間も短縮できた。変更後premedicationは初期premedicationに比べ,輸液のpHはより中性に近づき,静脈炎の軽減効果が期待できるデータが得られた。
目次
Summary
At our hospital, we use aprepitant for nausea and vomiting when administering highly emetic anticancer agents, according to“Guidelines for the Appropriate Use of Antiemetic Agents”given by the Japan Society of Clinical Oncology. We initiated the intravenous administration of fosaprepitant for better compliance compared with aprepitant; however, we observed phlebitis after the infusion of fosaprepitant. Therefore, we investigated measures to reduce phlebitis associated with the infusion of fosaprepitant. For the first premedication, fosaprepitant(150 mg)was dissolved in 100 mL of saline and administered for 30 minutes; 1 of 2 patients showed grade 4 phlebitis. For the modified premedication, fosaprepitant, dexamethasone, and 5-HT3 antagonist were dissolved in 100 mL of saline and administered for 30 minutes. The modified premedication was administered to a total of 27 patients; 5 patients developed mild phlebitis(grade 1), but infusion could be continued by treating their phlebitis with a hot pack. We used a combination of dexamethasone and 5-HT3 antagonist with fosaprepitant as a modified premedication in order to avoid drug-induced vascular damage, which resulted in the pH decreasing to 6.20-7.55(close to neutral)and a shorter infusion time.
要旨
当院では,催吐性リスク高度のがん薬物療法の嘔気対策は日本癌治療学会作成の「制吐薬適正使用ガイドライン」に準じてアプレピタントカプセル(AP)を使用している。APのコンプライアンス改善を目的に,注射用ホスアプレピタント(FAP)の使用を一部で開始した。初期premedicationであるFAP 150 mgを混合した生理食塩液100 mLを30分で投与中に,2症例中1症例にgrade 4の静脈炎が発生した。そこで,FAP 150 mgとデキサメタゾン注,5-HT3受容体拮抗薬を混合した生理食塩液100 mLを30分で投与するpremedicationに変更した。変更後premedicationを27症例に投与した結果,5症例に軽い血管痛(grade 1)を発生したが,早期にホットパックを使用することでがん薬物療法の継続は可能となり,点滴時間も短縮できた。変更後premedicationは初期premedicationに比べ,輸液のpHはより中性に近づき,静脈炎の軽減効果が期待できるデータが得られた。