Anyone noticing this trend with IV Avelox?

Nurses General Nursing

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Specializes in LTC, New to Tele/ Cardiac!.

Hey everyone! Just curious, maybe this is completely coincidental, but.. In the past few months, I've taken care of about 4 patients after receiving IV Avelox. 3 of them received the IV dose in the ER. According to ER documentation and per the pts account, they started getting a red line going up the arm where their IV site was almost immediately after the Avelox started infusing. The IV site was perfectly fine, no inflammation or infiltration and it didn't appear to be phlebitis. The ER nurse stopped the infusion, flushed with NS, and after a few minutes the red line diminished, IV site was patent and working beautifully. Pts were all fine afterwards and transferred up to my floor. ER documented this occurrence each time. The 4th pt was already on my floor- I hung the IV Avelox no differently than I always do, and the exact same s/s occurred again with this pt. I stopped the infusion, flushed w/ NS and the red line diminished... So I guess my question is: Has anyone else been finding this trend when hanging IV Avelox? Its only been in the past 2 months or so! I've never had an issue with Avelox prior to this. Is it possible the company made a bad batch? Just curious! My mind is wondering... :rolleyes:

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Specializes in Home Health.

That sounds scary to me. I think I would call the company myself.

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Specializes in cardiology/oncology/MICU.
Hey everyone! Just curious, maybe this is completely coincidental, but.. In the past few months, I've taken care of about 4 patients after receiving IV Avelox. 3 of them received the IV dose in the ER. According to ER documentation and per the pts account, they started getting a red line going up the arm where their IV site was almost immediately after the Avelox started infusing. The IV site was perfectly fine, no inflammation or infiltration and it didn't appear to be phlebitis. The ER nurse stopped the infusion, flushed with NS, and after a few minutes the red line diminished, IV site was patent and working beautifully. Pts were all fine afterwards and transferred up to my floor. ER documented this occurrence each time. The 4th pt was already on my floor- I hung the IV Avelox no differently than I always do, and the exact same s/s occurred again with this pt. I stopped the infusion, flushed w/ NS and the red line diminished... So I guess my question is: Has anyone else been finding this trend when hanging IV Avelox? Its only been in the past 2 months or so! I've never had an issue with Avelox prior to this. Is it possible the company made a bad batch? Just curious! My mind is wondering... :rolleyes:

That is very interesting. I had a patient last week that had the same thing happen in the ER. They stopped the infusion and called it an allergy. Who knows:confused:

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Specializes in CEN, CPEN, RN-BC.

This is interesting. Were these patients also on corticosteroids? From what I've read there can be serious complications when these two are ordered for a patient.

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Specializes in ER.

I see this occasionally when I give IV Avelox....flush and slow the infusion down. No other s/s of allergic reaction or phlebitis/infiltrate. I work in the ER.

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Specializes in LTC, New to Tele/ Cardiac!.

I'm not sure if the other pt's were on corticosteroids, but I wouldn't be surprised since they're mostly all respiratory patients! I'm glad that other people have noticed this.. I guess I'll just slow the infusion next time.. Very interesting though! Thanks!

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Specializes in ER.

Fluoroquinolones are known to cause this type of localized phlebitis. It's not a drug allergy. The proper action when this is noted is to stop infusion and check the patient for any s/s of drug allergy, flush line and notify doc. This can be minimized by infusing at the proper rate or slower, the majority of time I've seen it was when the drug was infused too fast. Avelox by the book is 1hr but can run slower if need be.

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I've seen this exact same reaction with levaquin. We pulled the IV, restarted in the other arm, and started the levaquin at a slower rate. No subsequent problems.

I've been giving these drugs for years and never saw such a reaction; now I've seen it 3 times in the last year. I don't know what has changed, but it seems awfully suspicious.

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Specializes in LTC, New to Tele/ Cardiac!.

I agree BluegrassRN, Just a little too strange/ coincidental for me!

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

http://www.drugs.com/pro/avelox.html#i4i_interactions_id_s8.3

I see injection site reaction is one of the side effects. Looks like using a sledgehammer to tap a loose tack.

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My mother was prescribed oral Avelox today $$$ even with insurance.

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Specializes in Infusion Nursing, Home Health Infusion.

Yes you can see this reaction when administering certain medications. It is similar to a flare reaction. I tend to see it a lot with KCL administration. The ph of this drug tends to be acidic (4.1-4.6) so already you know it will not be that easy on the veins..so pick a large vein (not in an area of flexion) and use a small catheter to get good hemodilution. Of course administer slowly and monitor during the infusion. You can proactively apply a little heat prior to administration if you are stuck using a not so great vein and or the pt is elderly. For greater than 5-6 days of IV administration and if you are having a persistent problem you may need to get a PICC order.

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