Dilantin and PICC catheters

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Recently, we have seen an increase in occluded PICC catheters after dilantin use.

TPA is not successful in opening these occlusions. Does your hospital have any policies about infusing dilantin through a PICC line? Any thoughts or ideas would be appreciated (other than not infusing dilantin through a PICC catheter). In all cases, this was the patients only venous access. Thank you.

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Dilantin can precipitate out of solution and can form crystals. Make sure to flush before and after infusion and make sure there are no crystals in the infusate. It can clog the line.

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Originally posted by IVRN:

Recently, we have seen an increase in occluded PICC catheters after dilantin use.

TPA is not successful in opening these occlusions. Does your hospital have any policies about infusing dilantin through a PICC line? Any thoughts or ideas would be appreciated (other than not infusing dilantin through a PICC catheter). In all cases, this was the patients only venous access. Thank you.

You did not say if the Dilantin was diluted, perhaps that is all you need to do.

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Sorry, forgot to mention that the dilantin is diluted. Our pharmacy mixes 100mg in 100 cc Normal Saline. Thanks.

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Tpa is most likely not the choice to declot a line suspected of clotting from dilantin infusion. TPA would only work if the line had a blood clot. Recommendations can be found for the use of NaHCO3 or HCL due to occlusion caused by drug precipitate particular mention is given to Dilantin.

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