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sample jQuery tabs (these tabs are used if a drug is part of more than 2 of these collections):
How to make 3% saline using NS and concentrated NaCl:
component
volume
Normal Saline
500 ml
Sodium Chloride 23.4%
51.5 ml
total volume
551.5 ml
High Alert Drug: Factor Xa inhibitors
• Nurses and pharmacists verify dose and that patient is not on heparin or other anticoagulant prior to administration. • Two RNs independently verify dose prior to administration if the dosing requires manipulation (i.e. drawing up a portion of a vial, or giving a portion of a syringe}. • Anticoagulation comparison chart available on nursing units for reference. • Pharmacists/nurses provide patient education for oral anticoagulants. • Pharmacists monitor labs for appropriate dosing and prevention of adverse events. • Reversal agents and order sets for oral anticoagulants
Per policy, these medications require cardiac and/or special monitoring ("Y" = allowed)
generic (Brand) / Notes
ICU / CCU / ED
2N (Tele)
HB-SNF
Med / Surg
ICS
BirthPlace
abciximab (ReoPro) IV Key: order set
Y
Y
N
N
N
N
Iredell Memorial Hospital ICU Adult Infusion Guidelines
Note: This information is intended to serve as a guide outlining the most commonly accepted infusion rates to date. However, it is recognized that some patients may require safe and therapeutic doses outside of the stated range for medical management. Unless otherwise specified by the physician, infusions are to be initiated at the lowest dose and titrated accordingly to specified parameters while documenting patient response and tolerability.
Drug Name
Onset
Preparation
Compatible fluids
CISatracurium (Nimbex)
2-3 min
100 mg/250 ml D5W
NS and D5W
"Normal Dosage"
Titration Guidelines (for increasing and decreasing doses)
1 - 10 mcg/kg/min
by 1 mcg/kg/min q 10 min to TOF as specified by MD
Per policy, use of these medications is restricted as noted below:
Generic (Brand)
Restrictions
pamidronate (Aredia)
Outpatient Only (for osteoporosis)
Per policy, these drugs are subject to renal dosing adjustments by pharmacy.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX gloves , gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- purple bin , trace/packaging- trash
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: Hazardous only for women in late pregnancy
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand)
Dept.
Procedure Type (hover over entry for examples)
Stop Medication Prior To Procedure
abciximab (ReoPro) (not stocked at IHS)
Anesthesia
High-risk
2-5 days
Intermediate-risk
2-5 days
Low-risk
2-5 days
Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.
Radiology
Invasive Procedures
No data
Paracentesis/Thoracentesis
No data
Adult Extravasation Management
Generic (Brand)
Vesicant / irritant
Local Care
Comments / Treatment links
calcium salts
Vesicant
Cold compress
Enteral Drug Administration notes.
Generic (Brand)
Comments and Considerations
Recommendations for Administration with Enteral Nutrition
benzonatate (Tessalon Perles)
Do NOT alter integrity of dosage form. Mucosal irritant
Do NOT administer through feeding tube. Use therapeutic alternative.
Per policy, these hazardous drugs have special handling and/or waste requirements.
generic (Brand)
Handling Risk Level
Warnings (hover over entry for details)
Waste Requirements
arsenic trioxide (Trisenox)
High
IARC-1NTP-1FDA-D
If > 3% by weight of drug remains ⇒ BLACK BUCKET Trace amounts/uncontaminated PPE ⇒ YELLOW BUCKET
Per policy, these hazardous drugs have special handling and/or waste requirements.
Generic (Brand)
Waste Requirements
aclidinium (Tudorza Pressair)
Inhaler canister ⇒ BLACK BUCKET
Per policy, these hazardous drugs have special handling and/or waste requirements.
generic (Brand)
Handling Risk Level
Warnings (hover over entry for details)
clonazePAM (KlonoPIN)
Low
NotesFDA-D
Last updated: Aug. 21, 2024
Restricted Medications Non-Formulary
Renal Adjustment Policy DemoDrug is subject to adjustments by pharmacy.
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Refrigerator item
sample policy
• Two RNs independently verify dose prior to administration if the dosing requires manipulation (i.e. drawing up a portion of a vial, or giving a portion of a syringe}.
• Anticoagulation comparison chart available on nursing units for reference.
• Pharmacists/nurses provide patient education for oral anticoagulants.
• Pharmacists monitor labs for appropriate dosing and prevention of adverse events.
• Reversal agents and order sets for oral anticoagulants
(Brand)
• Indications
Comments
(Zovirax©)
• Chickenpox
Actual weight, use IBW for obese pts
CrCl 25 - 50: 20 mg/kg q12h
CrCl 10 - 24.5: 20 mg/kg q24h
CrCl < 10: 10 mg/kg q24h
(Zovirax©)
• Herpes Zoster
• HSV encephalitis
Actual weight, use IBW for obese pts
CrCl 25 - 50: 10 mg/kg q12h
CrCl 10 - 24.5: 10 mg/kg q24h
CrCl < 10: 5 mg/kg q24h
(Zovirax©)
• Herpes Simplex
Actual weight, use IBW for obese pts
CrCl 25 - 50: 5 mg/kg q12h
CrCl 10 - 24.5: 5 mg/kg q24h
CrCl < 10: 2.5 mg/kg q24h
(Zovirax©)
CrCl 10 - 25: 200 - 800 mg q8h
CrCl < 10: 200 - 800 mg q12h
Keep separate from aminoglycosides.
(hover over entry for details)
Preparation
Administration
Receiving /
Storage /
Preparation
minimal
Storage /
Admin.
low
Spills
(hover over entry for examples)
(ReoPro)
(not stocked at IHS)
(Brand)
(Tessalon Perles)
(hover over entry for details)
Trace amounts/uncontaminated PPE ⇒ YELLOW BUCKET
(hover over entry for details)