Thursday, June 15, 2017

IM Dicofenac : can it be given as IV?

Availability
  • Injection Diclofenac Injection 75mg/3ml (Dicloran)
Route of administration
  • Based on product information, mode of administration specified is Intramuscular
  • No information on administration via other routes
Administration via Intravenous Route
  • There are several products available that can be given as IV
  • However these products are specifically made for such routes / should not be interchanged
  • Complications of wrong administration
  • Not much information on effect and management of IM injection administered as IV
  • Based on several case reports of administration intravenously into arterial route, symptoms seen are gangrene and burning sensations.
  • Vasospasm, intravascular thrombosis, chemical endoarteritis are the proposed pathophysiological mechanism
  • Intravenous drug administration has been associated with the occurrence of Thrombophlebitis
  • Rare adverse events (based on IV diclofenac): cannula site reaction, infusion site discomfort or burning, injection site stinging, or pyrexia
Contraindications for IV Route
  • Concomitant NSAID or anticoagulant use (including low dose heparin).
  • History of haemorrhagic diathesis, a history of confirmed or suspected cerebrovascular bleeding.
  • Operations associated with a high risk of haemorrhage.
  • A history of asthma.
  • Moderate or severe renal impairment (serum creatinine >160μmol/l).
  • Hypovolaemia or dehydration from any cause
References:
  1. https://www.ncbi.nlm.nih.gov/pubmed/25738031
  2. https://www.medicines.org.uk/emc/medicine/1339
  3. http://www.apicareonline.com/letters-to-editor-accidental-intra-arterial-injection-of-diclofenac-sodium-and-their-consequences-report-of-two-cases/

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.