What is intrathecal vincristine?
Inadvertent intrathecal vincristine administration occurs when a syringe containing vincristine intended for IV administration is mixed up with another syringe that contains a drug to be given intrathecally, such as methotrexate or cytarabine.
Which drugs must never be given by intrathecal administration?
Intrathecal chemotherapy Accidental administration of any vinca alkaloids—especially vincristine but also vinblastine, vinorelbine, or others—via the intrathecal route is nearly always fatal.
Can you give vinblastine intrathecally?
The intrathecal administration of vinblastine sulfate (vinblastine sulfate injection) usually results in death. Syringes containing this product should be labeled, using the auxiliary sticker provided to state ”FATAL IF GIVEN INTRATHECALLY. FOR INTRAVENOUS USE ONLY.”
Can vinca alkaloids be given intrathecally?
Vinca alkaloids can be fatal if given by the intrathecal route and must therefore ONLY be administered intravenously.
What happens if you give vincristine intrathecal?
Vincristine has a high neurotoxicity level. If given intrathecally by accident, it can cause ascending radiculomyeloencephalopathy, which is almost always fatal.
Is vincristine given intrathecal?
Vincristine, prepared in a syringe for intravenous administration, is mistaken as an injection to be given intrathecally. As a result, it is administered into the cerebrospinal fluid instead of, or in addition to, other medicines.
Can you give vincristine intrathecally?
Why is vincristine not given intrathecally?
Abstract. Vincristine has a high neurotoxicity level. If given intrathecally by accident, it can cause ascending radiculomyeloencephalopathy, which is almost always fatal. The authors report a rare case in which vincristine was accidentally injected intrathecally into a 32-year-old man.
How does vincristine cause death?
The cancer drug vincristine was mistakenly administered intrathecally into the teenage cancer patient. Both convictions were overturned by the High Court in 1993. Vincristine is for intravenous administration only and inadvertent intrathecal administration can cause severe neurotoxity, which is usually fatal.
Why is vincristine in a mini bag?
The Oncology Nursing Society4 recommends administering IV vinCRIStine and other vinca alkaloids via a minibag to prevent errors with intrathecal chemotherapy administration.
How do you prevent fatal intrathecally administered of vincristine?
Thus, a consensus exists that the most effective strategy available to prevent this tragic and frequently fatal event is to stop dispensing and administering IV vinCRIStine or other vinca alkaloids in syringes.
What happens if vincristine is given intrathecally?
What causes inadvertent intrathecal vincristine administration?
In most cases of published events, the causes of inadvertent intrathecal vinCRIStine administration have not been fully described.
What happened to vincristine in Australia?
In 2004, following the death from an inadvertent IT administration of vincristine in Australia, an editorial was published in the Journal of Oncology Pharmacy Practice (JOPP). 2 In addition to documenting the case, a series of recommendation were made with the aim of preventing further errors like this occurring.
How many cases of accidental vincristine it administration are there?
To my knowledge there have been at least 135 cases of accidental vincristine IT administration reported, and many more episodes have likely gone unreported. Thirty-five of these cases, with 28 fatalities, have been documented in the medical literature.
Does vincristine increase the risk of extravasation?
Very Low Extravasation Risk Some practitioners have expressed concern that administering diluted IV vinCRIStine via a mini-bag might increase the risk of extravasation and subsequent injury. However, data suggest that the risk of extravasation is very low, regardless of the method used to administer the drug.