Pharmacy Foundations: IV medication principles Flashcards
When is IV route used for drug delivery
When gut needs to be bypassed or patients are NPO in hospital
Drugs with poor oral bioavailability
Fast onset is required
Peripheral vs Central lines
Peripheral are cheaper and easier to insert
Common veins for peripheral lines are cephalic or saphenous veins
Central lines empty into larger vein and medication diluted more quickly
Central lines are required for administration of….
Highly concentrated drugs (KCl > 20mEq/100ml)
Long term abx
Toxic drugs that would give phlebitis or tissue damage if peripheral
Drugs with pH or osmolality not similar to blood pH
Can also be used for patients with collapsed veins
Benefits of central lines….
can give higher volumes and faster infusion rates
Vesicant drug info
Drug that will cause severe tissue damage if catheter tip comes out of vein
Central lines are safer with central line
Examples of vesicants
Vasopressors (dopamine, norepi)
anthracyclines (doxorubicin)
vinca alkaloids (vincristine, vinblastine)
digoxin
foscarnet
nafcillin
mannitol
mitomycin
promethazine
IV promethazine issues
should not be given to children < 2 years old
IM preferred, intra-arterial/subQ shouldn’t be used
Chemical incompatibility causes….
hydrolysis
oxidation
decomposition
Physical incompatibilities occur between one of the following….
container
diluent
another drug
Container absorption vs adsorption
absorption: when drug moves into PVC container
adsorption: when drug adheres or sticks to container
Drugs that have leaching, absorption or adsorption issues can be placed into….
polyolefin, polypropylene or glass containers
Drugs with leaching, adsorption or absorption properties?
Leach
Absorbs
To
Take
In
Nutrients
Leach Absorbs To Take In Nutrients
L = Lorazepam
A = Amiodarone
T = Tacrolimus
T = Taxanes
I = Insulin
N = Nitroglycerin
Drugs that require Saline diluent solution
A DIAbetic Cant Eat Pie
A DIAbetic Cant Eat Pie
A = Ampicillin
D = Daptomycin
I = Infliximab
A = Ampicillin/Sulbactam
C = Caspofungin
E = Ertapenem
P = Phenytoin
Drugs that require Dextrose diluent solution
Outrageous Bakers Avoid Salt
Outrageous Bakers Avoid Salt
O = Oxaliplatin
B = Bactrim (SMX/TMP)
A = Amphotericin B
S = Synercid (Quinupristin/Dalfopristin)
Y-site vs Additive compatibility
Many drugs that cannot be mixed in container can be given together and have Y-site compatibility
Drugs spend less time together mixing in Y-site
Primary Sources for compatibility issues
Trissel’s
Kings
High-Risk incompatibilities
Calcium + Ceftriaxone*
Calcium + Phosphate**
- Lactated ringers contain Ceftriaxone
** when used in parenteral nutrition, methods have to be used to reduce risk of precipitate
Common Drugs that require filters
My GAL Is PAT who has a MaP
My GAL Is PAT who has a MaP
G = golimumab
A = Amphotericin B (lipid formulations)
L = Lipids - 1.2 micron size
Is = Isavuconazonium
P = Phenyoin
A = Amiodarone
T = Taxanes (cabazitaxel and paclitaxel)
Ma = Mannitol > 20%
P = Parenteral nutrition - 1.2 micron size
IV Drugs that shouldn’t be refrigerated
Dear Sweet Pharmacist, Freezing Makes Me Edgy
Dear Sweet Pharmacist, Freezing Makes Me Edgy
D = Dexmedetomidine
S = SMX/TMP
P = Phenytoin = crystalizes
F = Furosemide = crystalizes
M = Metronidazole
M = Moxifloxacin
E = Enoxaparin
Drugs that require protection from light during administration
Protect Every Necessary Med from Daylight
Protect Every Necessary Med from Daylight
P = Phytonadione, Vitamin K
E = Epoprostenol
N = Nitroprusside
M = Micafungin
D = Doxycycline
Drugs that shouldn’t be shaken or agitated
Protein/Blood products such as Albumin, immune globulins, monoclonal antibodies and insulins
Products that foam = alteplase, entanjrcept, rasburicase, Synercid
