Malignant pleural effusions

Adverse reactions -

Cardiovascular - tachycardia, myocardial infarction, hypotension, hypovolemia,
                             and asytolic arrest.

Respiratory -      hypoxemia, dyspnea, unilateral pulmonary  edema, pneumonia,
                             ARDs, bronchopleural fistula, hemoptysis and pulmonary emboli

Miscellaneous-    infection complications reported include empysema

Delivery procedure - adverse reactions due to delivery procedure and chest tube include,
                                     pain, infection at site of thoracostamy  or thoracospy , localized
                                     bleeding, and subcutaneous empyema      

Not known

Special Precautions/Warnings-

Future procedures - possibilty of future diagnostic and therapeutic procerdures involving
the hemithorax to be treated must be considered prior to administering sterile talc powder.
Talc sclerosis may complicate or procedure future ipsilateral lung resective surgery,
including pneumonectomy for transplantation purposes.

Use in potentially curable disease -  talc has no knwon antineoplastic activity and should
not be used alone for potentially curable malignant effusion secondary to potentially
curable lymphoma

Pulmonary complications- acute pneumonitis and respiratory distress syndrome ARDS 
have been reported in association with intrapleural talc administration

Pregnancy -  drug should not be used during pregnancy unless benefits  outweighs the risk.

Children-  safety and efficacy of sterile talc powder in pediatric patients have not been
established 

Indication-

Malignant pleural effusions

Dosage -
Sterile talc should be administered after adequate drainage of the effusion
The recommended dose if 5g dissolved in 50 to 100ml sodium chloride injection.
Although the optimum dose for effective pleurodesis is unknown 5g was the most 
frequently reported in the published literature

Pregnancy - 
Drug should not be used during pregnancy unless benefits  outweighs the risk.

Children- 
Safety and efficacy of sterile talc powder in pediatric patients have not been
established