Epirubicin extravasation

Anthracyclines Doxorubicin, epirubicin Myelosuppression, cardiomyopathy Alopecia, nausea, vomiting, stomatitis, ulceration necrosis with extravasation, red-colored urine, radiation-recall effect... 

Epirubicin-monitor cumulative dose for cardiac toxicity (not to exceed 1000 mg/M2) vesicant—avoid extravasation... 

Epirubicin -anthracycline antitumor antibiotic—DNA intercalating agent -bone marrow suppression -nausea and vomiting -mucocutaneous effects (mucositis, stomatitis) -cardiotoxicity (1000 mg/M2) -vesicant if extravasated -rash and hyperpigmentation -alopecia... 

Daunorubicin, doxorubicin, epirubicin, and idarubicin usually are administered intravenously. Careful infusion over 10-15 minutes is recommended to prevent extravasation, since severe local vesicant action may result. The drugs are cleared by a complex pattern of hepatic metabolism and biliary excretion. The plasma disappearance curve for doxorubicin is multipha-sic, with elimination half-lives of 3 hours and - SO hours. All anthracyclines are converted to an active alcohol intermediate that plays a variable role in their therapeutic activity. Idarubicin has a tj of 15 hours, and its active metabolite, idarubicinol, has a tj of - 40 hours. There is rapid upt e of the drugs in the heart, kidneys, lungs, liver, and spleen. They do not cross the blood-brain barrier. Daunorubicin and doxorubicin are eliminated by metabolic conversion to a variety of aglycones and other inactive products. Idarubicin is primarily metabolized to idarubicinol, which accumulates in plasma and likely contributes significantly to its activity. Clearance is delayed in the presence of hepatic dysfunction, and at least a 50% initial reduction in dose should be considered in patients with elevated serum bilirubin levels. 

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