Vivitrol adverse reactions

Buprenorphine Post
MChaplin
Posts: 183

Postby MChaplin » Fri Jan 08, 2016 1:48 pm

unfortunately the vivitrol people have just come out with a new patient information guideline which informs patients of the risk of injection site reactions- it is available for review on their website and they sent me a beautiful color glossy on the importance of IM as opposed to subq injection.....the reactions do happen and can be very nasty and we wouldn't be doing our jobs if we didn't find a way of mentioning them...so now who is going to accept it??? sigh.

deegee
Posts: 137

Postby deegee » Fri Jan 08, 2016 1:48 pm

Hmm, agree that doesn't sound like a subcutaneous reaction. This is one of your patients? Do you have more info on the clinical course so that people can offer thoughts?

MChaplin
Posts: 183

Postby MChaplin » Fri Jan 08, 2016 1:48 pm

I was taught to Z track injections- a quick google search revealed these nice instructions- http://www.nursingcenter.com/upload/static/592775/take5_ztrack.pdf

tstinson
Posts: 16

Postby tstinson » Fri Jan 08, 2016 1:48 pm

I don't think that injecting into the gluteus maximus, medius or minimus would protect against these complications. The most recent complication involved myositis of the buttock muscles (myoglobinuria and greatly increased CPK). This would be an unlikely sequel to a subcutaneous injection.

entjwb
Posts: 180

Postby entjwb » Fri Jan 08, 2016 1:48 pm

I do a slide technique for the injection. When needle is about half way in, I slide the tissue by pulling downward and medially. That way the needle tract is not straight and should keep the injected suspension in the muscle.

deegee
Posts: 137

Postby deegee » Fri Jan 08, 2016 1:48 pm

This should not happen with IM injection. Local reactions usually are a result of a superficial injection, i.e. not deep enough, maybe in adipose. I use the 2" needle in all but the thinnest patients.

kcairns
Posts: 571

Postby kcairns » Fri Jan 08, 2016 1:48 pm

had one case w abcess requiring I and d

peterorrin
Posts: 267

Postby peterorrin » Fri Jan 08, 2016 1:48 pm

My vivitrol patients have experienced worse than 'localized tissue reactions.' One patient developed a sterile abscess that had to be surgically excised. Ouch!

DrBallester
Posts: 84

Postby DrBallester » Fri Jan 08, 2016 1:48 pm

Make sure the injection is deep IM and that the powder is in complete suspension. I use a massager/vibrator (like in the chemistry lab) to mix the suspension.


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