1. Schulmeister, Lisa MN, RN, APRN-BC, OCN, FAAN

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I commend Lynn Hadaway for her article on the important topic of vesicant extravasation (Emergency, "Infiltration and Extravasation," August). While it's true that the Oncology Nursing Society (ONS) guidelines, as she says, "in general do not recommend antidotes for extravasation," the guidelines state that the ONS "no longer recommends antidotes for extravasation (except sodium thiosulfate)," which neutralizes the chemotherapeutic agent mechlorethamine (Mustargen).1


Also, in September the Food and Drug Administration approved dexrazoxane (Totect; marketed as Savene in Europe), a new antidote to anthracycline extravasation. Mouridsen and colleagues reported that 53 of 54 (98.2%) patients given iv dexrazoxane for biopsy-verified anthracycline extravasation did not develop tissue necrosis.2 Only one of the 54 patients required surgical debridement.


Lisa Schulmeister, MN, RN, APRN-BC, OCN, FAAN


River Ridge, LA




1. Polovich M, et al., editors. Chemotherapy and biotherapy guidelines and recommendations for practice. 2nd ed. Pittsburgh, PA: Oncology Nursing Society; 2005. [Context Link]


2. Mouridsen HT, et al. Treatment of anthracycline extravasation with Savene (dexrazoxane): results from two prospective clinical multicentre studies. Ann Oncol 2007;18(3): 546-50. [Context Link]