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Discussion

Multiple infusions, having trouble

Hi,

Newbie here with a question. On our ward, we usually have orders for multiple meds IV at the same time. For instance, the morning could be Pantoprazole 40mg iv, Cefuroxime 1.5g iv, Paracetemol 1g iv. That's pretty normal, but there could be others thrown in there at the same time as well, in addition to any late-hour additions. I don't like giving medications simultaneously (newbie, sorry). Because of this, my meds can sometimes run an hour late.

Here's my question: Should I only be concerned with precipitate and interaction risks? Are those the only two things I should be worried about? We have a list that shows precipitates, but it doesn't list every drug that we use. For instance, Levetiracetam is NOT listed at all on the precipitate list (this is the first one that comes to mind). Because of this, I will run it alone due to the fear of it interacting with something not listed. I will also ask more today on the ward, but I like the responses on this website and would like additional perspective.

Thank you!

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    Check Micromedix or ask your pharmacist about incompatibilities if you are unsure. If two meds are incompatible together but time sensitive, you can start another PIV for the other medication. If the Protonix is IV Push, give it and flush well after, then you can infuse the other medication. Sometimes though you just have to prioritize and give the most important, time sensitive medication first and the other will just have to wait until it is done.

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    We frequently have 2 antibiotics due at the same time. One I see frequently is Rocephin and Vancomycin both due at 0900. In that instance, I'll start the Rocephin first at 0800 (it only runs for 30 min) and then the vanc after (2 hrs). If they have multiple things all day long I may start a new PIV or ask pharmacy if the stuff is compatible.

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    I agree with OKinOKC, give the quickest one first, then the one that runs longest second. Sometimes, you can call the pharmacy and ask them to re-time the meds so that they are not due at the same time. Q24 ones just have to be done when you have time, then have it retimed for the same time the following days.

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    I also agree with OKinOKC. If there is already a second IV running with a drip of some sort or you can't get a second line then I would definitely call pharmacy to check compatibility. Also, if there already is two lines then I will run the noncompatible in one line on its own then secondary the others into the other with the fluids (if receiving) or do another primary and hook it below the pump.

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