Discussion: View Thread

​In outpatient setting, has administration of doxorubicin recently changed at anyone's facilities? For regimens such AC, CHOP or ABVD, do you administer doxorubicin IV push or IVPB? If you administer doxorubicin IVPB, how often do you check blood return and do you have a policy in place for IVPB administration of vesicant chemotherapy agents versus IV push?

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Rosamari Douglas RN BSN OCN
Oncology / Infusion RN
Beaumont Health
Clinton Township MI
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Original Message------

​In outpatient setting, has administration of doxorubicin recently changed at anyone's facilities? For regimens such AC, CHOP or ABVD, do you administer doxorubicin IV push or IVPB? If you administer doxorubicin IVPB, how often do you check blood return and do you have a policy in place for IVPB administration of vesicant chemotherapy agents versus IV push?

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Rosamari Douglas RN BSN OCN
Oncology / Infusion RN
Beaumont Health
Clinton Township MI
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​Sorry, I did not specify in my original discussion questions the IV access type. I am referring to administration of doxorubicin via a central line. It has been our past practice to administer doxorubicin IV push whether peripheral or central line. However, this is being changed to IVPB if using central line. I am just seeking feedback to see if many are seeing this change and how this has changed your policy at your facilities for checking for blood return with doxorubicin administration if giving IVPB. What would be the rational to changing IVP to IVPB?

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Rosamari Douglas RN BSN OCN
Oncology / Infusion RN
Beaumont Health
Clinton Township MI
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Original Message:
Sent: 01-02-2019 15:43
From: Hassan Zahreddine
Subject: Doxorubicin Administration

Hi, Rosamari,

We haven't made such changes at our facility. Doxorubicin (anthracyclines in general) is always administered IV push for a patient with peripheral IV access due to the high risk of extravasation. It is administered as IVPB for patient with a Central Venous Access Device.

The only vesicants that we administer as IV push are the Vinca alkaloids due to the risk of inadvertent IT administration. This is usually a rapid small volume minibag infusion. We stay with the patient throughout the infusion, and we check blood return by gravity every 2 minutes. 

Original Message------

​In outpatient setting, has administration of doxorubicin recently changed at anyone's facilities? For regimens such AC, CHOP or ABVD, do you administer doxorubicin IV push or IVPB? If you administer doxorubicin IVPB, how often do you check blood return and do you have a policy in place for IVPB administration of vesicant chemotherapy agents versus IV push?

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Rosamari Douglas RN BSN OCN
Oncology / Infusion RN
Beaumont Health
Clinton Township MI
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​Good afternoon,


I hope all is well. We do not administer Adriamycin peripherally @ Henry Ford Macomb.   Any regimen that involves Adriamycin requires Mediport or Central Venous Catheter placement prior to beginning therapy. Blood return is established before, every 10 minutes during, and post therapy.  Our staff is required to document appropriately and any issues or changes pertaining to access or blood return sare reported to the physician for further workup.  I hope this helps.




Thank you,

Monica Poulock Buckner RN,BSN
Nurse Manager
Henry Ford Cancer Institute- Macomb
Cancer Care &  Rapid Treatment
Phone: 586-263-2259
Fax: 586-263-2241


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[Monica [Buckner [Designation]
[RN
[Henry Ford Macomb
[Clinton Township] [Mi]
[586-263-2240]
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Original Message:
Sent: 01-02-2019 14:56
From: Rosamari Douglas
Subject: Doxorubicin Administration

​In outpatient setting, has administration of doxorubicin recently changed at anyone's facilities? For regimens such AC, CHOP or ABVD, do you administer doxorubicin IV push or IVPB? If you administer doxorubicin IVPB, how often do you check blood return and do you have a policy in place for IVPB administration of vesicant chemotherapy agents versus IV push?

------------------------------
Rosamari Douglas RN BSN OCN
Oncology / Infusion RN
Beaumont Health
Clinton Township MI
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