Diluting Ativan?

[Guest838984]

OK, my ER peeps. So my new boyfriend is an ICU nurse, and we somehow came on the subject of Ativan, and he told me that it HAS to be diluted. I was like, "What?? I've never done that, or been told to do that, or seen any other nurse do that". But when I look it up, it says to dilute it. I've been working for six years and feel like a complete idiot for not knowing this before. I want all your input on this. Just out of curiosity, really. 

[PunkBenRN]

It doesn't have to be diluted; it's so dense that it hurts if you don't. It's like maple syrup. It also gives you more control over how fast you push it if that's an issue.

[igtgrnokbye]

Consult your hospital's guidelines/drug guide.

If that fails, ask yourself how you would want it administered to yourself.

[JKL33]

Nicole5128 said:

I asked my ED pharmacist the other day, and she said there's no need to dilute it, and I asked if it would prevent it from being caustic to the veins. She said no

I would ask this individual to provide sources of information supporting her professional opinion that you can review. Because when I call my pharmacist for things like administration specifics (such as when it wasn't as easy to access complete labeling information quickly), the labeling information is precisely what the pharmacist would consult.

This is not to call her bluff; it's because if she has the information, it will be good to know what it is and where you may access similar information for other scenarios in the future. She should be able to provide it if she isn't just talking.

[kitten0509]

I've always diluted per pharmacy guidelines for my 13 years of nursing.

 

[speedynurse, ADN, BSN, RN, EMT-P]

I dilute most meds. The exception is the more benign meds like Zofran—opioids, benzos, Compazine, Reglan, etc. In the ER, I often diluted these in a ten cc syringe and gave it through a distal port in the IV saline tubing. I did this because I had some patients with significant reactions when I shared some of these not diluted enough. They had many more side effects or had that uncomfortable head rush or dizziness with the opioids. In general, the results are the same with dilution, and my patients don't become traumatized with adverse reactions from giving a med too fast or too undiluted. Everyone's body is different, and I do think some people can't handle meds given too fast. 

[Archana Shrestha, BSN, RN]

Immediately prior to intravenous use, Lorazepam Injection USP must be diluted with an equal volume of compatible solution. When properly diluted the drug may be injected directly into a vein or into the tubing of an existing intravenous infusion. The rate of injection should not exceed 2 mg/minute.

[MaxAttack, BSN, RN]

Archana Shrestha said:

Immediately before intravenous use, Lorazepam Injection USP must be diluted with an equal volume of compatible solution. When correctly diluted, the drug may be injected directly into a vein or the tubing of an existing intravenous infusion. The rate of injection should not exceed 2 mg/minute.

Either you brought a two-year-old post back from the dead because you didn't read any threads to see the manufacturer label was already linked multiple times, or Allnurses is experimenting with some weird AI-automated posts.

Whichever it is, it made me giggle, and it was a fun start to my day, but yes, you're technically correct. I think the exact reason why is the bigger question.