Infusionrelated

Infusionrelated (often written as infusion-related) describes adverse reactions that occur during or shortly after the intravenous administration of drugs, biologics, or other IV therapies. These reactions are not caused by extravasation but by systemic responses to the infused agent, including immune-mediated or cytokine-release phenomena.

Common manifestations include fever, chills or rigors, flushing, dyspnea or wheezing, chest or back pain, hypotension or hypertension, tachycardia, urticaria, pruritus, nausea, and in some cases confusion or anxiety. Timing is variable but most reactions occur during the first infusion or within hours of starting; repeated infusions may have attenuated or recurrent symptoms.

Differential diagnosis includes anaphylaxis, infection, or local IV site reactions. Distinguishing features are rapid onset after infusion and response to stopping the infusion or reducing rate, though severe IRRs may progress to life-threatening events requiring emergency treatment.

Risk factors for infusionrelated reactions include the use of monoclonal antibodies and other biologics, high infusion doses, rapid administration, or a history of previous infusion reactions; certain drugs, such as cytokine-release-prone therapies, pose higher risk.

Management emphasizes patient safety: promptly suspend the infusion, administer supportive care (oxygen, IV fluids) and symptomatic therapy (antipyretics, antihistamines, bronchodilators) as indicated; if symptoms resolve, rechallenge with slower infusion and with premedication as appropriate, under close supervision. Severe reactions require immediate treatment with epinephrine and escalation to advanced care.

Prevention strategies include premedication regimens, dose adjustments, slower infusion rates, desensitization protocols for selected agents, and vigilant monitoring during the initial infusions.