IV Drug Compatibility

[Adang93]

Hi everyone, 

I don't know if any of us here came across giving albumin IVPB with D5W/NaBicarb as a primary solution. The other night I hung these two for my patient, my patient was having D5W/NaBicarb running, but I just checked Albumin and D5W compatibility and they are fine together, I totally forgot about the NaBicarb part. I realized it when I got home and I was so worried if there's anything happening to my patient. I checked and there's no data about albumin IVPB with D5W/NaBicarb given together.  I am a new grad and just started in stepdown ICU a few months ago. 

So my question is, does any of you have an idea about the interaction between these drugs when given IV? 
Thank you.

Amy

[NRSKarenRN, BSN, RN]

Unable to help as no experience with Albumin and D5W/NaBicarb co-administration. Always consult your facility's pharmacy for best advice regarding IV infusion compatibility.  

[JBMmom, MSN, NP]

Sodium bicarbonate is an alkaline solution and it is incompatible with many different drugs, often those being administered in a critical care environment. Generally, the incompatibility is highest with drugs that are more acidic in nature. I don't have lexicomp in front of me, but albumin is also an alkaline solution so there is unlikely to be an incompatibility issue, but as already recommended by NRSKaren, lexicomp is the best bet. 

As an aside, for your information as a newer ICU/step down nurse, bicarb is generally administered in D5 or 1/2 NS because administration of large volumes of normal saline can induce a hyperchloremic acidosis. And if your patient is on a bicarb trip, you're probably already dealing with an acidosis situation. 

[Okami_CCRN, BSN, RN]

I generally like to give albumin by itself or through a saline line; since most albumin (5% and 25%) goes in within 10-30 minutes. 

As other people posted when in doubt always refer to your hospital's compatibility guides (lexicomp and/or micromedex)