IV medication that can not run fast

[kinmei]

I only know that

1. vancomycin

- will cause red man syndrome.

2. Potassium, KCL

- will extravasate and cause necrosis to the surrounding tissue. Can cause MI if run too fast.

Other examples please. So that be mindful when giving IV medications. Appreciate your reply.

How about

- phenytoin to adults should never exceed 50 mg/min (because of the risk of severe hypotension and cardiac arrhythmias)?

-Ondensetronn will caused blurred of vision and arrhythmia?

[offlabel]

CRNA here...Potassium in a peripheral IV in an awake patient really hurts. I'll give 10 meq over 15-20 minutes routinely through a central line, recheck K+ and repeat if necessary. I also bolus 4 mg of ondansatron in sedated or asleep patients. Many of the cautions about giving meds too fast involve patient discomfort and nothing more. That's a good reason to go slowly, but if in the event things go faster than intended, the odds of harm in many cases are low. Obviously, things like chemotherapy and meds such as amphotericin are exceptions.

Not saying you should do this...just saying that these things are done without harm every day.

[brownbook]

Your question is excellent. Unfortunately there is no easy answer. I would hope, assume, your IV drugs are coming up from your pharmacy labeled?

I did most of my floor nursing a million years ago without the aid of a pharmacist/pyxis, etc. (Night shift, no pharmacist.) Without easy access to cell phones/computers, etc., so I was always worried about how much, how fast. I found it easiest to simply make a list of the most common IV drugs I commonly gave and studied up on them, or kept a written cheat sheet.

Don't feel stupid to ask co-workers or the doctor. I always thought I was supposed to know every drug, dose, route, rate, etc. Finally I realized, as I started asking experienced co-workers how much, how fast, that NO ONE knew all the answers. And you shouldn't even always trust their knowledge!

I taped a list of a few common drugs that should always be given slow to the back of my name badge. Unfortunately I only vaguely remember now what they were so I can't help you! (Darn old age!)

[datalore]

Furosemide, ototoxicity means you can cause hearing damage if pushed too fast.

[Lev, MSN, RN, NP]

Reglan too fast can cause severe anxiety. I routine mix in minibag.

[Wuzzie]

Solu-Medrol will make the patients nether regions burn like fire when pushed too fast.

Fentanyl causes chest wall rgidity.

[MissEm]

Azithromycin hurts if run too fast. Usually slowing the infusion helps a lot!

[vintagemother, BSN, CNA, LVN, RN]

Yes!! To the above posters!! Probably better to make a list of IV meds that can be pushed fast---the list would be shorter!!

[Orca, ADN, ASN, RN]

CRNA here...Potassium in a peripheral IV in an awake patient really hurts.

I was given this during a hospital stay once. I couldn't tolerate it. Within about 30 seconds, my arm felt like it was on fire. I shut off the pump and called the nurse.

[WeirdNurseKelly, BSN, RN]

Phenergan. It can cause tissue necrosis and lead to amputation. Just after learning about this in nursing school I ended up in the hospital over night with a gallbladder attack. I was given Phenergan for the nausea. Freaked me out! It was administered IVPB in I believe 50 mls of NS.

[AJJKRN]

Do you have access to something like micromedex via work computer? I always look up new drugs or revisit ones I haven't used or don't use very often and I always check iv compatibility (even with ivf's) with a drug program available to me at work...