Meds left in IV line

[Perrythedog]

Hi,

I am a new grad with a question about piggyback meds left over in the IV line. I hung an IV antibiotic this morning (meropenem). It is a refrigerated med. The previous bag that was used was still in the room and the tubing was still good for another 24 hours, so I hung the current bag using the old tubing. I forgot to backprime the old antibiotic out of the line before I hung the new one...not thinking about the antibiotic being a refrigerated one. What happens to the 12 hours old drug that has been hanging un-refrigerated all day? All I could find online is that it is "not stable". I feel awful that I forgot this step and I worry that I will have harmed the patient.

[PacoUSA, BSN, RN]

Meropenem is not a refrigerated drug at my hospital, and we reuse secondary lines with prior dose residue all the time, provided of course the line is less than 24 hours old. Never seen that harm a patient. Note however, our Meropenem IVPBs are add-a-vial style, so we have to premix just before we hang them. I seem to recall this mixed solution is stable at room temperature for a while too.

Is your Meropenem premixed at the pharmacy, which is why it requires refrigeration?

Sent from my iPad using allnurses

[KelRN215, BSN, RN]

Flush the lines with NS after giving the med and you won't have to worry about it.

[SierraBravo]

Meropenem that is compounded by pharmacy MUST be refrigerated immediately because of stability issues. It's been a while, but I remember that compounded solutions are good for 1 hour at room temp and around 12 hours refrigerated. I seem to remember that if the drug is admixed in D5W then the stability is of even shorter duration. Are you saying that you hung a bag that was at room temp for 12 hours? If so, it's likely that the potency was diminished and the patient didn't get the dose that they were supposed to get. You should backprime the secondary set not because one drug is refrigerated and the one that was hung wasn't, you should backprime to ensure that 2 drugs that aren't compatible don't mix in the tubing.