Experimental infusion phlebitis: Tolerance pH of peripheral vein.

Kubo, Takashi; Asanami, Shougo; Kawauchi, Yoshiyuki; Kubo, Shuji

doi:10.2131/jts.24.113

Cited by 44 publications

(25 citation statements)

References 13 publications

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“…Epirubicin is a vesicant drug, which is known to have a strong toxicity against vascular endothelial cells. Further to the stimulus property of the drug, the pH (the range between 5 and 9 is advisable) and the osmotic pressure of the infused solution is considered to be associated with the drug-induced venous toxicity [5]. In our hospital, epirubicin was diluted with isotonic physiological saline to keep appropriate osmotic pressure.…”

Section: Discussionmentioning

confidence: 99%

Change of formulation decreases venous irritation in breast cancer patients receiving epirubicin

Nagata

Egashira

Yamada

et al. 2011

Support Care Cancer

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Section: Discussionmentioning

confidence: 99%

Change of formulation decreases venous irritation in breast cancer patients receiving epirubicin

Nagata

Egashira

Yamada

et al. 2011

Support Care Cancer

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“…In addition to the stimulus properties of the drug, the osmotic pressure and the pH (a range between 5 and 9 is advisable) of the infused solution are associated with drug-induced venous toxicity. 17) However, since the osmotic pressure ratio of saline-diluted bendamustine solution (0.4 mg/mL) to normal saline is about 0.9, 11) it is unlikely to be a factor in venous irritation. The pH of salinediluted bendamustine solution is relatively low (0.4 mg/mL; pH= 3.69), but an increase in volume of bendamustine dissolution has only a slight effect on the ph (0.32 mg/mL: ph= 3.76; 1.2 mg/mL: ph= 3.41).…”

Section: Discussionmentioning

confidence: 99%

Decrease in Venous Irritation by Adjusting the Concentration of Injected Bendamustine

Watanabe

Ikesue

Tsujikawa

et al. 2013

Biological & Pharmaceutical Bulletin

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Intravenous injection of bendamustine often causes venous irritation and also deteriorates the patient's quality of life. Thus, we evaluated the risk factors associated with venous irritation induced by bendamustine in patients with follicular lymphoma or mantle cell lymphoma. We also evaluated the effectiveness of intervention of changing the preparation procedure for bendamustine. All data were retrospectively collected from the electronic medical record system. In the initial analysis of the total 43 courses of bendamustine therapy, most patients (88%) were administered bendamustine with 250 mL of diluent according to the bendamustine package insert in Japan. The median concentration of bendamustine solution (0.56 mg/ mL vs. 0.24 mg/mL) and the incidences of venous irritation (66% vs. 0%, p=0.01) were significantly different between the patients receiving bendamustine at 250 mL and 500 mL of diluent. Based on this result, we proposed changing the final volume of bendamustine dissolution from 250 to 500 mL, which is recommended in other countries. After this intervention, the incidence of venous irritation was significantly reduced from 58 to 20% (p=0.02). The incidence of venous irritation increased in a concentration-dependent manner (≤0.40 mg/mL: 6%; 0.41-0.60 mg/mL: 62%, p<0.001; >0.60 mg/mL: 75%, p<0.001). We conclude that a high concentration bendamustine solution is a risk factor for venous irritation and that 500 mL of diluent is ideal. To further reduce the incidence of venous irritation, the concentration of bendamustine solution is recommended to be 0.40 mg/mL or less.

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“…Nonetheless, many patients have experienced side eŠects such as phlebitis and venous pain, which have proved to be related to an unphysiologically low solution pH. 5) Kuwahara et al 8) reported that phlebitis was less likely when the solution of Plas-amino was neutralized to pH 5.93 when given to rabbits, and was nearly eliminated when the pH was raised further to 6.49. Thus the occurrence of phlebitis and venous pain may decrease when the pH of infusion solution is kept between 6.0 and 7.4.…”

Section: Discussionmentioning

confidence: 99%

Consideration on Prevention of Phlebitis and Venous Pain from Intravenous Prostaglandin E<sub>1</sub> Administration by Adjusting Solution pH: <i>In Vitro</i> Manipulations Affecting pH

et al. 2008

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Prostaglandin E 1 (PGE 1 ; Alprostadil Alfadex) is a potent vasodilator and inhibitor of platelet aggregation used to treat patients with peripheral vascular disease. The main adverse eŠects of intravenous PGE 1 administration, phlebitis and venous pain, arise from the unphysiologically low pH of infusion solutions. When PGE 1 infusion solutions with a pH value greater then 6 are used, phlebitis and venous pain are considered to be avoidable. Beginning with a PGE 1 infusion solution with pH greater than 6, we add the amount of 7％ sodium bicarbonate needed to bring the solution to pH 7.4 if phlebitis or venous pain develops. In the present study we established a convenient nomogram showing the relationship between the titratable acidity of various infusion solutions and the volume of 7％ sodium bicarbonate required to attain pH 7.4 for preventing the phlebitis and venous pain associated with PGE 1 infusion.

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Experimental infusion phlebitis: Tolerance pH of peripheral vein.

Cited by 44 publications

References 13 publications

Change of formulation decreases venous irritation in breast cancer patients receiving epirubicin

Change of formulation decreases venous irritation in breast cancer patients receiving epirubicin

Decrease in Venous Irritation by Adjusting the Concentration of Injected Bendamustine

Consideration on Prevention of Phlebitis and Venous Pain from Intravenous Prostaglandin E<sub>1</sub> Administration by Adjusting Solution pH: <i>In Vitro</i> Manipulations Affecting pH

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