Chapter 7: Learning IV Medications Flashcards

1
Q

Another name for a venous catheter

A

Line

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2
Q

Where is a common vein where a peripheral catheter can be inserted?

A

cephalic vein in the arm

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3
Q

What is a limitation of administering drugs into smaller veins?

A

Phlebitis (vein irritation), venous thrombosis and fluid extravasation

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4
Q

Where does a central line empty into?

A

larger veins

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5
Q

Central lines provide secure, long-term vascular access and are required for administration of:

A
  • highly concentrated drugs
  • long term antibiotics
  • toxic drugs that can cause phlebitis (e.g. chemo)
  • drugs with a pH or osmolality that is not close to blood pH or osmolality (e.g. parenteral nutrition)
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6
Q

Where can central lines be placed?

A
  • Into a large vessel like the superior vena cava
  • Into a smaller vein and advancing the catheter through the vein until the tip ends in the superior vena cava (called a PICC - peripherally inserted central catheter)
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7
Q

What are examples of common vesicants

A
  • Vasopressors (dopamine, NE)
  • Anthracyclines (e.g. doxorubicin)
  • Vinca alkaloids (e.g. vincristine)
  • Promethazine
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8
Q

Name 3 primary compatibility and stability sources for parenteral medications

A
  • Trissel’s Handbook on Injectable Drugs
  • King guide to Parenteral Admixtures
  • Package insert
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9
Q

Drugs that have leaching or adsorption/absorption issues with PCV containers can be placed in:

A

Polyolefin, polypropylene or glass containers (these are known as non-PVC containers)

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10
Q

Key drugs with leaching/adsorption/absorption issues with PVC containers

A
  • Lorazepam
  • Amiodarone
  • Tacrolimus
  • Taxanes
  • Insulin
  • Nitroglycerin

Remember: Leach Absorbs To Take In Nutrients

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11
Q

What are key drugs that cannot be put into dextrose & can only be used with saline?

A
  • Ampicillin
  • Daptomycin (cubicin)
  • Infliximab (Remicade)
  • Ampicillin/sulbactam (Unasyn)
  • Caspofungin (Cancidas)
  • Ertapenem (Invanz)
  • Phenytoin (Dilantin)

Remember: A DIAbetic Cant Eat Pie

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12
Q

What are key drugs that cannot be put into saline & can only be used with dextrose?

A
  • Bactrim
  • Oxaliplatin
  • Amphotericin B
  • Synercid (Quinupristin/Dalfopristin)

Remember: BOAS will strangle the pharmacist who puts these drugs into anything but dextrose

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13
Q

What are two examples of high-risk incompatibilities?

A
  1. Ceftriaxone and any calcium-containing solutions due to risk of precipitates (e.g. lactated ringers contains calcium and cannot be mixed with ceftriaxone)
  2. Calcium and phosphate
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14
Q

What is a 1.2 micron filter used for?

A

Lipids

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15
Q

What size filter should you use for parenteral nutrition?

A

0.22 micron filter, which will catch calcium-phosphate particulates

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16
Q

What are common drugs with filter requirements?

A
  • Golimumab
  • Amiodarone
  • Lorazepam (when administered by continuous infusion)
  • Phenytoin (when administered by continuous infusion)
  • Lipids (1.2 micron)
  • Amphotericin B (lipid formulations; use 5 micron filter)
  • Taxanes (except docetaxel)

Remember: That’s my GAL, PLAT

17
Q

Which key IV drugs crystalize if kept cold and are stored at room temperature?

A
  • Dexmedetomidine (Precedex)
  • Sulfamethoxazole/Trimethoprim (Bactrim)
  • Phenytoin (crystalizes)
  • Furosemide (crystalizes)
  • Metronidazole
  • Moxifloxacin (Avelox)
  • Enoxaparin (Lovenox)

Remember: Dear Sweet Pharmacist, Freezing Makes Me Edgy

18
Q

What are key drugs that must be protected from light during administration?

A
  • Phytonadione (Vitamin K; Mephyton)
  • Epoprostenol (Flolan)
  • Nitroprusside (Nitropress)
  • Micafungin (Mycamine)
  • Doxycycline

Remember: Protect Every Necessary Med from Daylight

19
Q

Which drugs are easily destroyed if shaken/agitated?

A
  • Albumin
  • Alteplase
  • Immune globulins
  • Insulins
  • Monoclonal antibodies
  • Rasburicase
  • Some vaccines, including zoster
20
Q

In most cases, discoloration of a drug indicates _____ or another type of decomposition

21
Q

Oxidation of dobutamine turns the solution slightly ____, but potency is not lost

22
Q

If nitroprusside turns ____, it indicates complete dissociation to cyanide

23
Q

Which two IV drugs come as a red solution

A

Anthracyclines and rifampin

24
Q

Which IV drug comes as a blue solution

A

Mitoxantrone

25
Physical incompatibilities occur between a drug and:
- The container - The diluent - Another drug
26
The majority of PVC containers use ____ as a "plasticizer" to make the plastic bag more flexible
DEHP
27
Why is DEHP dangerous in PVC containers
It's toxic & can harm the liver and testes if it leaches from the container and into the solution
28
When drugs are put into solution for IV administration in the pharmacy, they are commonly placed in 50 mL or larger IV piggybacks that contain:
5% dextrose or 0.9% sodium chloride
29
Lactated ringers solution contains
Calcium
30
If compounding IV medications packaged in glass ampules, what is used to prevent particulates from entering the IV bag
Filter needles or filter straws