IV medication principles

Question 1

peripheral lines are delivered through

Answer 1

percutaneous venous catheters into small veins- cephalic vein

can cause phlebitis thrombosis and extravasation

Question 2

central lines are

Answer 2

larger vein- superior vena cava
highly concentrated drugs K >20meq/100ml
long term abx
toxic drugs like chemo
ph and osmolality not too close to blood

Question 3

what are some vescants that should be applied through PICC instead of peripheral lines

Answer 3

vasopressors like dopamine and norep
anthracyclines
vinca alkaloids
digoxin, foscarnet, nafcillin, mannitol, promethazine

Question 4

where to check inncompatibilites

Answer 4

handbook on injectable aka trissels
king guide

Question 5

chemical incompatibility

Answer 5

hydrolysis
oxidation
decomposition

Question 6

physical incompatibilities

Answer 6

container
diluent
with another drug

Question 7

container in compatibility includes

Answer 7

PVC–> DEHP that can leach and damage liver and testes
adsorption and absorption can cause less drug concentration- insulin

Question 8

what drugs can cause leaching/adsorption and absorption issues

Answer 8

Leach absorbs to take in nutrients
Lorazepam
amiodarone
tacrolimus
taxanes
insulin
nitroglycerin

Question 9

IV drugs with saline and NO DEXTROSE

Answer 9

A dIAbetic cant eat pie
Ampicillin
daptomycin
Infliximab
Amp/sul (unasyn)
caspofungin
ertapenam
phenytoin

Question 10

IV with Dextrose and NO SALINE

Answer 10

outrageous bakers avoid salt
Oxaliplatin
Bactrim
amp B
Synercid

Question 11

what are some high risk incompatibilites

Answer 11

Ceftriaxone and Calciium (lactated ring)
calcium and phosphate

Question 12

what is the filter size used for drugs and lipids

Answer 12

drugs 0.22 micron
lipid 1.2 microns

• liposomal formulations and chemo drugs must not be filtered

Question 13

what drugs require filter

Answer 13

GAL PLAT
golimumab
amiodarone
lorazepam (not for IV push)
phenytoin (not for IV push)
lipids
Amph B
taxanes

Question 14

which drugs should not be refrigerated

Answer 14

dear sweet pharmacist freezing makes me edgy
Dexmedetomidine (precedex)
bactrim
phenytoin
furosemide
metronidazole
moxifloxacin (avelox)
enoxaparin (lovenox)

Question 15

what drugs should be protected from light

Answer 15

Protect every necessary meds from Daylight
Phytonadione (vit K )
epoprostenol (flolan)
nitroprusside (nitropress)
Micafungin
doxycycline

Question 16

what drugs should not be shaken

Answer 16

Hormones
protein
albumin
alteplase
immunoglobins
insulins
rasburicase and
vaccines

Question 17

what drugs and what color changes occur with oxidation

Answer 17

chlorpromazine dark yellow
dacarbazine pink
dobutamine pink but can be used
dopamine- dark yellow
epinephrine pink to brown
isoproterenol pink
morphine dark
nitroprusside orange to brown to blue
norep- brown
tigecycline - green