Assessing and managing venous irritation associated with vinorelbine tartrate (Navelbine)
OBJECTIVE
To determine the effect of duration of infusion time on venous irritation in patients receiving vinorelbine tartrate (Navelbine, Burroughs Wellcome Co., Research Triangle Park, NC) in combination with cisplatin or mitomycin.


METHODS
Prospective and descriptive.


METHODS
Five outpatient hematology/oncology units in southern Louisiana and Mississippi.


METHODS
96 patients receiving vinorelbine in combination with cisplatin or mitomycin through a peripheral vein.


METHODS
Nurses completed the Venous Irritation Record (VIR), on which they documented the incidence of irritation reactions on the day of infusion as well as 24 hours and one to two weeks later.


METHODS
Incidence and severity of venous irritation as well as the duration of administration.


RESULTS
Significantly lower incidence of venous irritation at 6-10 minute infusion rate was observed (p < 0.05). No difference in incidence was observed when vinorelbine was given with a vesicant (mitomycin) or a nonvesicant (cisplatin) drug.


CONCLUSIONS
Although venous irritation is a problem associated with peripherally administered vinorelbine, it does not necessitate central line placement. Incidence of this problem can be reduced with a shorter duration of administration. The VIR was feasible, easy to use, and could be adapted for other drugs and other toxicities. The National Cancer Institute Common Toxicity Criteria are not adequate for grading venous irritation reactions.


CONCLUSIONS
Vinorelbine should be administered in accordance with the manufacturer's recommendations as a 6-10 minute infusion. Determination of this rate came as a result of clinical nursing research. Nurses involved in clinical trials can and should play a role in describing emergent toxicities and investigating methods to prevent or minimize those toxicities.
Rittenberg
C N
CN
Ochsner Cancer Institute, New Orleans, LA, USA.
Gralla
R J
RJ
Rehmeyer
T A
TA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D015179:Colorectal Neoplasms / Q000188:drug therapy; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy / Q000451:nursing; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D009859:Oncology Nursing; D010689:Phlebitis / Q000139:chemically induced; D011446:Prospective Studies; D013997:Time Factors; D014652:Vascular Diseases / Q000139:chemically induced*; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077235:Vinorelbine
D000970:Antineoplastic Agents; D008937:Mitomycins; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine