IV Protonix tubing

[Crocuta, RN]

All -

I'm looking for some hard evidence regarding IV Protonix. In my hospital, we hang a lot of IV protonix and every nurse I've talked to says that it requires new pump tubing with each dose. When I ask why, the explaination is usually something about tube corrosion. I've looked in several med books, looked online, checked with our pharmacist, and reviewed our facility P&P and I can't find anything to support this practice.

In searching the boards here, I did find this thread, IV Protonix, which mentioned that tubing changes could be every 72 hours, but that's the only reference I've come across.

We stopped using the filters a while back, just in case anyone's wondering.

Does anyone have any solid, authoritative info that I can use to make a case for keeping the same tubing for 72 hours? With as much as we give it, daily tubing changes has to be a huge expense that we don't need to be making. Or, I'm open to info showing that we should be using dedicated tubing and changing with every dose if that's best practice.

Thanks!

[Zee_RN, BSN, RN]

I don't have any evidence for you except to say we sure don't do that at my hospital. It's every 72 hours just like most IV tubing. We even have people on continuous Protonix drips for 2 or 3 days; we've not had any trouble with the tubing.

[meownsmile, BSN, RN]

I would say use your pharmacy as your authority. They have the most recent information regarding Protonix and recommended safegards for IV use.

For information only, we only change secondary tubing on protonix every 72 hours and it can be piggybacked into primary fluids without filters now. At least that is what OUR pharmacy suggests.

[schroeders_piano, RN]

Actually, Protonix has been reconstituted so that it can be given iv push. You dilute with 9.6ml of NS and push over 2 minutes.

[lsyorke, RN]

When protonix first came out it had a filtered tubing.. that had to be changed each time. Now that it's using regular tubing that no longer applys.

[Crocuta, RN]

thanks everyone for the replies. i've seen that protonix has been formulated for ivp now, but our pharmacy isn't supplying it that way yet.

by the way, for reference, i found the product info on wyeth's site. this is all it has to say on the matter:

protonix i.v. for injection may be administered intravenously through a dedicated line or through a y-site. the intravenous line should be flushed before and after administration of protonix i.v. for injection with either 5% dextrose injection, usp, 0.9% sodium chloride injection, usp, or lactated ringer’s injection, usp. when administered through a y-site, protonix i.v. for injection is compatible with the following solutions: 5% dextrose injection, usp, 0.9% sodium chloride injection, usp, or lactated ringer’s injection, usp.

now, reading this, it seems that they're saying that when using a dedicated line for protonix, the line should be flushed before and after with d5w, ns, or lr, which would leave no protonix in the tubing between doses. do any of you read that differently?