vin-KRISS-teen
High Alert
Absorption: IV administration results in complete bioavailability.
Distribution: Rapidly and widely distributed; extensively bound to tissues.
Half-Life: 10.5–37.5 hr.
Contraindicated in:
Use Cautiously in:
Derm: alopecia
EENT: cortical blindness, diplopia
Endo: syndrome of inappropriate antidiuretic hormone (SIADH)
GI: nausea, vomiting, abdominal cramps, anorexia, constipation, ileus, stomatitis
GU: gonadal suppression, nocturia, oliguria, urinary retention
Hemat: anemia, leukopenia, thrombocytopenia(mild and brief)
Local: phlebitis , tissue necrosis (from extravasation)
Neuro: ascending peripheral neuropathy, agitation, depression, insomnia, mental status changes
Resp: bronchospasm
Drug-drug:
Lab Test Considerations:
Fatalities have occurred with chemotherapeutic agents. Before administering, clarify all ambiguous orders; double-check single, daily, and course-of-therapy dose limits; have second practitioner independently double-check original order, dose calculations, and infusion pump settings. Do not administer SUBQ, IM, or intrathecally (IT). IT administration is fatal. Vincristine must be dispensed in an overwrap stating "For IV use only." Overwrap should remain in place until immediately before administration.
Should be administered by individuals experienced in the administration of this medication.
IV Administration:
Vincristine is a vesicant. If extravasation occurs, immediately stop infusion. Leave needle/cannula in place temporarily but do not flush the line. Gently aspirate extravasated solution; then remove needle/cannula. Elevate patient's extremity and apply dry warm compresses for 20 min 4 times day for 1–2 days. Initiate hyaluronidase antidote by injecting 1–6 mL (150 units/mL) into existing IV line; usual dose is 1 mL for each 1 mL of extravasated drug. If needle/cannula has been removed, inject SUBQ in a clockwise manner around area of extravasation or administer 1 mL as five separate 0.2-mL injections SUBQ into extravasation site; may repeat several times over next 3–4 hr.