Mateu J, Alzamora M, Franco M, Buisán M J
Department of Pharmacy, Hospital Joan XXIII, Tarragona, Spain.
Ann Pharmacother. 1994 Nov;28(11):1243-4. doi: 10.1177/106002809402801106.
To report a case in which a local reaction is attributed to an ifosfamide extravasation. Previously, extravasated ifosfamide has been considered a nonirritant.
A 54-year-old woman with a non-Hodgkin's lymphoma in stage IV B developed a local reaction in her right arm after an ifosfamide extravasation. No pressure was prescribed, no bandaging was applied on the affected area, and the limb was elevated to the heart level. In addition, chondroitinsulfatase 150 turbidity-reducing units was administered subcutaneously around the area. This procedure was repeated 12 hours later, resulting in a satisfactory decrease in the inflammatory signs and pain.
The local reaction in the patient's arm cannot be attributed to the hypertonicity of the infusing solution or to the vehicle of the infusate. The antidote used was chondroitinsulfatase, an enzyme similar to hyaluronidase. It enhances the systemic uptake of the drug from the tissue.
Extravasated ifosfamide is a potential irritant. General measures applied after its extravasation can be potentiated strongly by local subcutaneous administration of chondroitinsulfatase or hyaluronidase, repeated if necessary.
报告一例局部反应被归因于异环磷酰胺外渗的病例。此前，外渗的异环磷酰胺一直被认为无刺激性。
一名54岁IV B期非霍奇金淋巴瘤女性在异环磷酰胺外渗后右臂出现局部反应。未采取加压措施，未对患处进行包扎，肢体抬高至心脏水平。此外，在该区域周围皮下注射了150浑浊度降低单位的硫酸软骨素酶。12小时后重复此操作，炎症体征和疼痛得到满意缓解。
患者手臂的局部反应不能归因于输注溶液的高渗性或输注液的载体。所使用的解毒剂是硫酸软骨素酶，一种与透明质酸酶类似的酶。它可增强药物从组织的全身摄取。
外渗的异环磷酰胺具有潜在刺激性。异环磷酰胺外渗后采取的一般措施可通过局部皮下注射硫酸软骨素酶或透明质酸酶得到显著加强，必要时可重复注射。
