Diluting a medicine into a drip

[Faithnelly]

Hi dear nurses,

Im new. My name is Nelissa and im a nurse in A&E department. Just recently i move from my previous hospital to a new local hospital in Sabah Borneo, with new staff, doctors and all different management. My concern is, when carry out doctors plan.. i notice my doctor so often order maxolon 10mg in a n/saline 0.9% drip of 500mls. Sometimes they ask to mix hydrocortisone 100mg + maxolon 10mg in drip. And sometimes even controloc 40mg + maxolon 10mg in drip.

This is all new to me. I usually will give these medicine bolus. My question is, is that normal?

Because im concern about the effectiveness of the medicine to patient and sometimes some medicine cannot be mix with one or another.

Do you all have any comment?

Ps: i have try to do a research on this but, couldnt find

[RN403, BSN, RN]

If you ever question medication orders you can always clarify with the ordering physician or pharmacy.

They will provide you with the most appropriate answer.

[calivianya, BSN, RN]

This is really facility specific. You probably have access to Micromedex or something similar through your job - check that if you aren't sure of IV compatibility.

I had one job that always mixed Protonix into a 50ml bag of NS and infused over 30 minutes... every other job I've had has just given the 40mg IVP unless the patient is on a continuous drip. The stuff that varies from facility to facility is just straight up weird sometimes. I encourage you to look at your med administration P&Ps very closely whenever you get a new job, because I have yet to see two facilities be exactly the same in the way they do things. It's tedious reading, but it's worth the butt saving it provides if something is different than you're used to.

[icuRNmaggie, BSN, RN]

When I worked outside the US I checked everything on a pharmacy resource site called GlobalRph. It has a compatibility search function. There is no charge for using GlobalRph.

In the US, maxolon (metoclopromide) 5 - 10 mg is

given by IV push. I have never seen it ordered as an IV drip.

Controloc (pantoprazole) 40 mg IV is given diluted in 10cc and given IV push.

A patient with an active GI bleed will receive an IV push bolus of 80 mg of Controloc followed by an IV drip of Controloc at 8 mg per hour.

Maxolon drips and mixing maxolon and controloc in an IV drip is unheard of in the US.

Hydrocortisone 50-200 mg is given by IV push most often for septic shock and adrenal crisis. Hydrocortisone has many specific indications and dosages which are listed on GlobalRph. In the US it is not mixed with maxolon.