In need of reconstitution medication help. Vancomyacin,Pip Taz.

loriangel14, RN · Apr 25, 2012

This the Canadian Nursing Forum. I am sure a moderator will be along soon to move your post to a more appropriate place.

Your question makes no sense. You need to provide more information.You have given meds and the instructions for reconstitution. There is no formula needed.

Fiona59 · Apr 25, 2012

I don't understand the problem. Vanco and Peptaz are usually only obtained from the pharmacy and not kept as ward stock (the stuff is bloody expensive).

Vanco is always premixed by our pharmacy and sent up with clearly marked expiry dates. Peptaz is one of those handy dandy vials that attaches to the iv solution bag (just like panto). The stuff is a female dog to mix and you've got to shake rattle and roll the vial to get the lumps broken down.

It's a fact of life, out of school, if you don't have to do the math, we don't. We just check our pharmacy on line monographs to ensure the concentration after the pharmacy has sent everything up in a "here's your expensive IV antibiotics kit"

psu_213, BSN, RN · Apr 25, 2012

I'm not sure what you are asking here. It is pretty straight forward. With Vanc, you take a vial of 1 g of 'powder' and and 10 mL of sterile H20. Mix well. Add to bag of fluid (we use 250 mL bags of NS) and invert several times to distribute in the fluid (don't forget to label this bag). Infuse via IV piggyback. There really is not a formula for this.

psu_213, BSN, RN · Apr 25, 2012

I don't understand the problem. Vanco and Peptaz are usually only obtained from the pharmacy and not kept as ward stock (the stuff is bloody expensive).

I don't know if this is just the difference between the US and Canada (or some other country), but in my ER in the US, we have Vanc and Zosyn (our brand name for Pip/Taz) in our floor stock and the RN reconstitutes. But, again, this is probably just a regional difference.

Columnist · Apr 25, 2012

Moved to Nursing and Patient Medications for more response.

Pediatric Critical Care Columnist · Apr 25, 2012

When reconstituting drugs it's always best to follow the monograph. There are reasons why the directions are written the way they are. Some drugs are reconstituted with sterile water, others with sterile saline... and a handful with sterile D5W. There are no handy dandy tricks that work for any and all drugs.

I work in the same system as Fiona59 but in a different hospital. Our Pyxis is stocked with all but the most esoteric antimicrobials because we have a standard that requires the first dose be given within 1 hour of the order being written and that isn't always possible when waiting on the pharmacy to prepare them. For patients in septic shock, the only intervention we do for them that saves their lives is prompt antibiotic administration. The rest of what we do is purely supportive. Vancomycin isn't expensive but pip/taz is. So is meropenem, another of our staples. We still have ward stock of both.

rgroyer1RNBSN, BSN, RN · Apr 26, 2012

Ours is in floor stock/ ed pyxis, it is pretty straight forward.

KelRN215, BSN, RN · Apr 26, 2012

I need help with reconstitution of medications. Is there a simple formula that someone is willing to share? Ratio and portion really Dont work well for me. Thanks so much in advance for your time and advice! Vancomyacin order- 1g the monograph states for reconstitution med available in 500mg vial:add 10 mls sterile water. final volume 10mls. Final concentration 50mg/ml. Pip/Taz order 2.275 monograph states available as combination of pipercillian 3g and tazobactrum 0.375g vial. dilute add 13 ns. final volume 15ml. final concentration 0.2 piperacillan/ml.

I don't understand what you're asking. You have instructions for how to reconstitute the medication, there is no formula.

If you're wondering how much you then need to give after it's reconstituted, your order for Vanco is 1g. You have 50 mg/mL so you need to draw up 20 mL and further dilute it in whatever your facility uses. My hospital used D5 for Vanco, I believe, but it was mixed by the pharmacy and diluted down to a final concentration of 5 mg/mL.