marty 08

Dear Northshore How are you administering Reglan IV push? I am cautious with this drug due to side effects. I know my friend from the ER has physician orders for IVPB infusions. What is your practice in diluting and giving this medication slowing IV push. Marty

Thanks Northshore I read an old thread that stated someone always diluted Toradol at their hospital? I also do not see Toradol routinely diluted but wondered what the best practice was?? Many nurses routinely dilute drugs in 10cc NS and others follow the IV drug books administration guide if determined safe to deliver undiluted with infusing IV but with specific duration. I am routinely checking with the IV book on the floor to confirm which drugs can be given undiluted. Thanks for the reminder regarding IM Toradol and to check carefully for IV medication route on vial... very true!! Marty

I understand diluting phenergan. WithToradol, if the order is 15mg, and it is 30mg in 1ml vial, draw up .5ml for 15mg in a 3cc syringe for needleless port. The medbook states it may be given undiluted and administer through a free-flowing IV or through three way stopcock or y-tube . It CAN form a precipitate with drugs incompatible such as demerol, morphine and phenergan, so it seems very important it pre and post flush. Rate of administration recommended is a single dose over 1-2 minutes prefered. I would think the running IV fluid(if compatible) will also help dilute? So, this is what I get from looking up in the medbook for administration....Would love to hear the concensus out there on the floor and your hospital policy to dilute Toradol? We are now very careful to limit the amount of maximum Toradol daily due to it's NSAID property. This analgesic (non-steroidal anti-inflammatory) works really well when alternated with a narcotic for pain relief. Marty

Thank you all for your great information on diluting drugs for IV infusions. I am looking up all drugs that are routinely used on my floor for compatible solutions and if they need dilution. The information on the anti-reflux valve was great, the info on Reglan also is important. I will take the cautionary side if a drug seems to be possibly irritating, it would be prudent to dilute and give slowly. I am thinking that Reglan may be helpful to dilute, 10mg is in 2ml and CAN be given undiluted if not exceeded 10mg per my drug book....but it could not hurt to dilute with 8ml of NS and deliver slowly....I am concerned about the risk of extrapyramidal symptoms( is that the jumping out of your skin feeling??) that requires benadryl as stated in the IV drug manual. Do many of you routinely dilute Reglan for a 10mg dose? We have the premade 10cc NS syringes...it seems to me to first draw up the correct amount of the drug and add that to the premixed NS syringe after discarding 2ml NS. I will look up Benadryl....states may be given undiluted but in 25mg increments over one minute Any comments? Also, on the pre and post medciation flushes, my research indicates 2 or 3cc flushes used for IV push at the distal or proximal port? I am such a detail person!! Marty

I appreciate this conversation regarding morphine. I have not given it yet IV, but some typical post-op orders are for 2mg Morphine increments for pain. Some nurses give 2mg undiluted but with running IV to dilute and give slowly. IF desired to dilute with NS...do many of you use the premade 10cc Normal saline syringes and add 9cc of the saline to the drawn up morphine in a 10cc needleless syringe? We are using needless ports on peripheral lines. Given slowly at the lower port near the hub and flushed pre and post, or only with the saline lock?

I would like some clarification on giving IV medication through a port with a peripheral line infusing LR. A drug such as Zofran 4mg, given undiluted through a port with the IV running...the medbook states it can be given undiluted but given slowly ( I think it stated over 2 to 5 minutes). Do you give the med at the further port for greater dilution factor or give close to the hub and still flush before and after med? I don't see anyone pinching off the tube above the port prior to an IV push drug or stopping the pump if the solution is compatible....any feedback on this? What experience does anyone have with Reglan and a peripheral line? Returning Nurse to the floor....