FormWeb • OH Nurse Mixing Instructions for Free-Standing EDs and Non-24-Hour Pharmacies after hours

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Medications listed are available on OH EPIC Formulary, unless otherwise noted.
Not all formulary medications are available at each facility. Please refer to your local pharmacy for available inventory.

Ochsner Health

Ochsner Health System Formulary

Formulary Addition Request Questions or Suggestions?

OH Nurse Mixing Instructions
alteplase (ACtivase) 50 mg injection alteplase (ACtivase) 100 mg injection ampicillin 30 mg/mL in 0.9% NaCl IV syringe (PEDS) azithromycin (Zithromax) 2 mg/mL in D5W IV syringe/IVPB (PEDS) cefTRIAXone 40 mg/mL in D5W IV Syringe (PEDS) CroFab (crotalidae - antivenin polyvalent) in 0.9% NaCl 250 mL dantrolene 20 mg/60 mL SWFI (0.33 mg/mL) injection diltiazem 125 mg in D5W 125 mL epinephrine 5 mg/250 mL D5W fentaNYL 2,500 mcg/250 mL D5W or 0.9% NaCl folic acid 1 mg/100 mL D5W or 0.9% NaCl FOSphenytoin (Cerebyx) in D5W 100 mL gentamicin 5 mg/mL in D5W IV syringe (PEDS) insulin regular 100 units in 0.9% NaCl 100 mL Kcentra (Prothrombin Complex Concentrate, human) in SWFI labetalol 500 mg/100 mL IV Infusion levETIRAcetam (Keppra) 15 mg/mL in 0.9% NaCl IV syringe (PEDS) withdrawing from a premix bag levETIRAcetam (Keppra) 15 mg/mL in 0.9% NaCl IV syringe (PEDS) use only when premix bag is unavailable	methylPREDNISolone 2.5 mg/mL in D5W IV syringe (PEDS) multiple vitamins injection (Infuvite Adult) 10 mL in 1,000 mL 0.9% NaCl naloxone 4 mg/100 mL D5W nitroPRUSSide 50 mg/100 mL D5W NORepinephrine 32 mg/250 mL D5W octreotide (SandoSTATIN) 500 mcg/100 mL 0.9% NaCl oxytocin 15 units/250 mL 0.9% NaCl phytonadione (vitamin K) 10 mg/50 mL D5W promethazine in 0.9% NaCl 50 mL IVPB remdesivir 200 mg/250 mL 0.9% NaCl (LOADING DOSE) sincalide - nuclear med mixing instructions sodium bicarbonate 75 mEq/1,000 mL 0.45% NaCl sodium bicarbonate 150 mEq/1,000 mL D5W tenecteplase 5 mg/mL for Acute Ischemic Stroke thiamine 100 mg/100 mL D5W or 0.9% NaCl vancomycin 5 mg/mL in D5W IV syringe (PEDS) vasopressin 100 units/100 mL D5W

OH Nurse Mixing Instructions

alteplase (ACtivase) 50 mg injection

alteplase (ACtivase) 100 mg injection

ampicillin 30 mg/mL in 0.9% NaCl IV syringe (PEDS)

azithromycin (Zithromax) 2 mg/mL in D5W IV syringe/IVPB (PEDS)

cefTRIAXone 40 mg/mL in D5W IV Syringe (PEDS)

CroFab (crotalidae - antivenin polyvalent) in 0.9% NaCl 250 mL

dantrolene 20 mg/60 mL SWFI (0.33 mg/mL) injection

diltiazem 125 mg in D5W 125 mL

epinephrine 5 mg/250 mL D5W

fentaNYL 2,500 mcg/250 mL D5W or 0.9% NaCl

folic acid 1 mg/100 mL D5W or 0.9% NaCl

FOSphenytoin (Cerebyx) in D5W 100 mL

gentamicin 5 mg/mL in D5W IV syringe (PEDS)

insulin regular 100 units in 0.9% NaCl 100 mL

Kcentra (Prothrombin Complex Concentrate, human) in SWFI

labetalol 500 mg/100 mL IV Infusion

levETIRAcetam (Keppra) 15 mg/mL in 0.9% NaCl IV syringe (PEDS) *withdrawing from a premix bag

levETIRAcetam (Keppra) 15 mg/mL in 0.9% NaCl IV syringe (PEDS) *use only when premix bag is unavailable

methylPREDNISolone 2.5 mg/mL in D5W IV syringe (PEDS)

multiple vitamins injection (Infuvite Adult) 10 mL in 1,000 mL 0.9% NaCl

naloxone 4 mg/100 mL D5W

nitroPRUSSide 50 mg/100 mL D5W

NORepinephrine 32 mg/250 mL D5W

octreotide (SandoSTATIN) 500 mcg/100 mL 0.9% NaCl

oxytocin 15 units/250 mL 0.9% NaCl

phytonadione (vitamin K) 10 mg/50 mL D5W

promethazine in 0.9% NaCl 50 mL IVPB

remdesivir 200 mg/250 mL 0.9% NaCl (LOADING DOSE)

sincalide - nuclear med mixing instructions

sodium bicarbonate 75 mEq/1,000 mL 0.45% NaCl

sodium bicarbonate 150 mEq/1,000 mL D5W

tenecteplase 5 mg/mL for Acute Ischemic Stroke

thiamine 100 mg/100 mL D5W or 0.9% NaCl

vancomycin 5 mg/mL in D5W IV syringe (PEDS)

vasopressin 100 units/100 mL D5W

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