Question About Vidaza Injections

[Luke and Margaret]

We’re having trouble getting anyone to inject the Vidaza. The nurses here won’t do it because it isn’t approved, and our hemotologist figured he’d have to give three injections in order to get all of the drug in under the skin. He wasn’t comfortable with doing it either.

Can someone tell me how this is administered, and how you get so much serum under the skin?

Still not sure how this is going to get done; we’re hoping someone at Princess Margaret has the confidence to do it.

Also, does anyone have any sense of precautions that might be necessary if the patient has an underlying condition of conjestive heart failure?
Thanks,
Margaret

[Conrad]

Hi Margaret.
I have no experience myself (except for injecting plant leaves in the lab) but would one of the nurses at least instruct you even if they are unwilling to do it themselves?

Alternatively I found the following set of instructions on an infertility website. See below.
If the volume you need to administer is too much I presume it would be OK to do several sites. Anyway, better that you listen to someone with experience, not me. But hope the instructions below are some use. Good luck with the treatment.
Conrad

http://infertility.about.com/cs/medications/ht/SQHowTo.htm

How To Administer Subcutaneous Injections

Here are the step by step instructions.
Difficulty: Easy
Time Required: 10 minutes of less
Here’s How:
1. Find a clean, quiet and comfortable place where you will not be disturbed. Many women find their bathroom or kitchen to be a good spot. Clean a place on the countertop so that you can lay your supplies down. Wash your hands well and dry them thoroughly.
2. Gather your supplies. This includes your medications and any diluents (fluids to dilute the medications), syringes, needles for mixing drugs (usually bigger) and needles for injecting the drugs (usually smaller), alcohol swabs and sharps container. If you are injecting more than one drug (for example both Lupron and Gonal-F) you will want to separate the equipment for one drug from the equipment for the other.
3. Prepare (mix) all medications as directed- part I. Some meds require dilution, some meds require reconstitution (mixing a powder with the sterile liquid provided to make a solution for injection) and some medications may be drawn up directly from the vial in which they are provided. In all cases, you will want to wipe off the top of the vials with a new fresh alcohol sponge before you insert any sharps through the rubber stopper.
4. Prepare (mix) all medications as directed – part II. If your medication comes in a glass ampule, you will need to break off the top of the ampule to get to the medication. When the syringes are full of the prescribed amount of medication, remove the needles used for mixing and dispose of them in your sharps container. Then attach the injection needle(s), and taking care to keep the needles off the counter lay the syringe(s) down while you prepare your injection site.
5. Choose the injection site. There are many sites that can be used for subcutaneous injection. Probably the most convenient, easiest and comfortable site is the anterior abdomen (belly). Avoid the area directly around the belly button (umbilicus). Choose the specific area of the abdomen where you will give this injection and cleanse it with a new, fresh alcohol sponge. (These are available prepackaged at any pharmacy and most grocery stores.) Allow the area to air dry.
6. Inject medication. With your non-dominant hand (left hand for right handed people) pinch a fold of skin and hold it up. Then using your dominant hand pick up the syringe. Holding it like a pencil you want to QUICKLY dart it in to the skin fold. Insert the entire needle perpendicular to the skin and keep it there.
7. Make it comfortable. The key to a comfortable injection is swift needle entry followed by slow injection of fluid. Therefore, slowly push the plunger down then quickly withdraw the needle. You may use a clean alcohol sponge to hold pressure on the injection site for a moment or two.
8. Discard all sharps. Be sure to clean up your area and return your medications and supplies to their usual location so that they will be ready for next time. With a little bit of practice this will all become second nature. In time, you may find yourself mixing and injecting medications in some unlikely locations but the basic principles will always remain the same.
What You Need:
• Medications
• Syringes and Needles
• Alcohol Sponges
• Sharps Container

Quote:

Originally posted by Luke and Margaret:
We’re having trouble getting anyone to inject the Vidaza. The nurses here won’t do it because it isn’t approved, and our hemotologist figured he’d have to give three injections in order to get all of the drug in under the skin. He wasn’t comfortable with doing it either.

Can someone tell me how this is administered, and how you get so much serum under the skin?

Still not sure how this is going to get done; we’re hoping someone at Princess Margaret has the confidence to do it.

Also, does anyone have any sense of precautions that might be necessary if the patient has an underlying condition of conjestive heart failure?
Thanks,
Margaret

[Harold]

Margaret, I take my dose of Vidaza in two shots. Each shot is 3.2 cc (ml). It is injected in the stomach, straight into a fold of the skin as explained above. I believe the nurses use a 5/8 inch needle. Below is the Vidaza site which explains the preparation and administration. The medicine needs to be given soon after mixing; otherwise it will settle and clog up the needle. It can be rotated in the syringe to mix it up again.

http://www.vidaza.com/corporateweb/vidazaus/homeB.nsf/Content/Injections

[Terri]

Margaret, Bob gets his the same way as Harold two shots, same dose – Go to The website that Harold marked Above it has everything you need. Can you find a Private nurse or someone that will inject it, BOb received the Vidaza here from the National Institute before it was approved in the US. The doctors and nurses were all unfamiliar with it and even the OUtpatient nurses at the hospital for the weekends had to have training but they did it. Keep pushing. Print out the info from the website Harold marked and bring it in.
Good Luck.

[Luke and Margaret]

Did it. It didn’t look the least bit complicated to me. The picture on the web site is very clear! LOL! Changing a hospital gown around an IV tube is harder!

I have the feeling our oncologist decided that this was just too much of a pain in the butt and he wanted to push it off. This may be the nudge we need to deal with a transfer of health care providers. It would be a relief not to have to deal with this level of resistance any longer.

(As regards the nurses, private or public, pparently they all balk when it becomes clear that this is an unapproved drug in Canada and there could be liability issues).

Thanks for the information guys, I am now very well armed.
Margaret

[Terri]

Margaret, Just a thought but Maybe the National Institute of Health here in the States might give you some info, OR maybe Canada has something like it. When Bob got the drug pre approval it was 5 AZA at the time. Dr had to fill out paperwork for the NIH and they shipped the drug free to the Doctors office and only one weeks worth at a time. It was called Compassionate use. Maybe the NIH could help you even though you are in Canada.

[Luke and Margaret]

Hi Terri
I think I tried that – jard to remember now, I’ve tried so many things. Pharmion took over from the NIH, they said. But I’ll persue this, just in case it was a stone not overturned.

Thanks,
Margaret

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