IV Compatibility Question

[Zee_RN, BSN, RN]

I'm making up some reference cards for commonly used drugs in our ICU. I'm referring to a drug book for compatibilities with other IV solutions.

There are different "types" of compatibilities. For instance, I understand "Y-site" compatibilities as being you can connect your dobutamine infusion into a port on your dopamine infusion. I understand "additive" compatibilities as you can add one solution into a bag of another (such as adding KCl to a IV solution). There is also listed, however, "syringe" compatibilities (e.g., heparin is listed as a syringe compatibility with nitroglycerin). I'm not sure what that means. They are compatible only in a syringe? As in only in small amounts for very limited time? Or you can give heparin only as IV push through a nitroglycerin line? Can someone explain "syringe" compatibility to me?

Thanks!

[renerian, BSN, RN]

I do not know and have not heard that term. I will watch this thread though and learn.

renerian

[gwenith, BSN, RN]

This is what we use as our "bible" of IV drug administration. It is extremely good and dog eared!!!

http://www.medicalbookcentre.com.au/detail.asp?mode=browse&id=66888

Unfortunately it is Australian so that not all the drug name are compatable but you might still find it useful.

[Zee_RN, BSN, RN]

I think I may have found an answer. The "syringe" is the syringe-type infusion pump, I believe. I copied this paragraph from an advertisement for a palm-pilot type of database:

"In the past, the potential for incompatibility or instability problems with IV drugs was minimized by using Y-site administration, in which the contact time of multiple solutions rarely exceeds one hour. However, with the advent of syringe pumps and compact ambulatory infusion pump systems, highly concentrated drugs are given over a prolonged period of time. If there is more than one concentrated drug combined in a syringe or pump reservoir, the possibility of incompatibility increases greatly. This creates the demand for accurate and comprehensive compatibility data."

So I would believe that if a drug is "syringe" compatible, it would also be Y-site compatible. Agree?

[P_RN, ADN, RN]

First I found this table.

http://www3.us.elsevierhealth.com/MERLIN/nursingdrugupdates/Gahart/solution_compatibility_chart.html

And this is the first data bank site aobut syringe, y site etc compatibility.

http://www.firstdatabank.com/knowledge_bases/nddf_plus/nddf_plus_modules/index.asp?module_id=20

Usually a call to the pharmacy is in order if there is any question.

I found out "ther hard way" that Valium and Pentobarbital turn into jello in a syringe when mixed.

[Zee_RN, BSN, RN]

LOL, P_RN....that second site is the one that I just referenced right above your post. Great minds think alike, eh?

[gwenith, BSN, RN]

PRN - that's nothing try mixing KCL with dilantin.

Zee_Rn excellent answer thank-you we all learnt something today.

[pickledpepperRN]

I remember an article 5 or 6 years ago in 'Critical Care Nurse' that patients on NTG are somewhat resistant to heparin.

Recommendations were to try to use a different line and be aware a higher dose of heparin may be needed.

If the patient is taken off the NTG and still needs heparin the PTT or APTT needs to be done often just like when the heparin is started.

LOVED the links. I printed them both for the reference notebook on my unit.

[Zee_RN, BSN, RN]

Yes, spacenurse, I have heard that IV nitro decreases the effectiveness of heparin also. Good thing to remember since we commonly infuse both heparin and tridil on our chest pains/MIs.

[hogan4736, BSN, RN]

Good syringe compatibility (for IV push - ER/Cath Lab):

Zofran/Benadryl mix well...Good for hyperemesis

Valium/Benadryl...Good cath Lab cocktail