Talc
Class: Sclerosing Agents
CAS Number: 14807-96-6
Brands: Sclerosol
Introduction
Sclerosing agent.
Uses for Talc
Pleural Effusions
Sclerosis of pleural serosal surfaces (pleurodesis) to prevent recurrence of malignant pleural effusions in symptomatic patients.
Intrapleural talc has resulted in absence of reaccumulation of effusions (determined by clinical examination or chest radiograph) in about 93% of patients with recurrent, symptomatic malignant pleural effusions.
Talc Dosage and Administration
Administration
Administer intrapleurally as an aerosol during thoracoscopy or open thoracotomy or as a slurry instilled via a chest tube. Do not administer IV.
Prior to intrapleural administration as an aerosol or slurry, adequately drain the effusion from pleural cavity. Success of talc pleurodesis apparently is related to completeness of pleural fluid drainage and full lung reexpansion.
Intrapleural Administration as an Aerosol
For intrapleural administration as an aerosol, commercially available in single-use aluminum spray canisters containing 4 g of talc suspended in 25 g of inert propellant (1,1,1,2-tetrafluoroethane [HFA-134a]).
Administration Procedure
Shake aerosol canister well before use; securely attach actuator button with delivery tube (15 or 25 cm) to canister valve stem.
Insert delivery tube through the pleural trocar; avoid placing distal end of the tube adjacent to lung parenchyma or directly against chest wall.
For optimal distribution, always maintain canister in an upright position.
Firmly hold delivery tube and pleural trocar together in one hand; gently press actuator button on the canister.
While pointing distal end of delivery tube in several different directions, administer short bursts to distribute talc equally and extensively on all visceral and parietal pleural surfaces.
Discard canister and delivery tube after administration.
Duration of chest tube drainage following sclerosis is dictated by the clinical situation.
Rate of Administration
Commercially available single-use canister is fitted with a continuous spray valve that delivers talc at a rate of approximately 1.2 g per second, but is not considered to be a metered-dose delivery system. Dose delivered depends on extent and duration of manual compression of the actuator button.
Intrapleural Administration as a Slurry
For intrapleural administration as a slurry, commercially available in single-use 100-mL bottles containing 5 g of talc powder for extemporaneous preparation of slurry.
Preparation of Slurry
Prepare slurry in a laminar flow hood using aseptic technique.
Attach 16-gauge needle to a 60-mL Leur-Lok syringe and draw up 50 mL of 0.9% sodium chloride injection into the syringe.
Vent bottle containing 5 g of talc with a needle and slowly inject syringe contents into the bottle. Swirl bottle to disperse talc powder; continue swirling to keep powder from settling.
Divide the slurry into two 60-mL irrigation syringes by withdrawing 2...
