Protonix IV

[midwestRN]

Our doctors are suddenly prescribing protonix IV to every pt. I don't think it is very cost efficient because it requires its own IV tubing and filter every time. I know the tubing costs $50.00+ in our facility. Any thoughts on whether this drug is better than some of the other old reliables that are easier to give and cheaper. Are your seeing it prescribed at your facility?

[shannonRN, BSN, RN]

i have found that many of the docs at my hospital are switching to protonix as well.

the choice of drug should depend on the severity of symptoms as well as the presence of complications. the Washington manual guidelines state that H2-antagonists, like Pepcid, should be used first as they are the most cost-effective and work well in patients without complications. high doses often work better. if patients are refractory to the h2-antagonists, have severe symptoms, or have esophagitis, proton pump inhibitors (Protonix, Prevacid, Prilosec, Nexium, Aciphex) should be used. they are more effective overall, however they are very expensive. doctors should, of course, use oral therapy whenever possible, and protonix is the only ppi that is avaliable in both oral and iv forms.

if you want you can check out this link. hope it helps!

http://www.nursespdr.com/headlines/marheadlines_arch.html#proto

[cactus wren]

I have been seeing alot of Protonix, also..I figure that the salesmen must be doing a super job...........

[christianRN]

almost all of our ICU pts are on Protonix IV. THinking along cactus wren's lines, I figured the docs had been to a conference or golf party promoting Protonix!!

[norinradd]

It is now our threaputic substitution for pepcid, zantac and others. The insert lists more side effects and we have found alot of people not using the filter.

In po form it has replaced our regulars to.

We were told we were part of a study and the med was either free or cheap to us. I have not seen it to be any better and some docs are going back to zantac and saying no substitutions.

It's a good marketing ploy. Say it's a study, give it to them and get them used to using it and then start charging.

There is less difference between drug reps and and pushers every day.

[Zee_RN, BSN, RN]

Our ICU patients receive Protonix also, IV or PO. It cannot be crushed so those receiving tube feedings must get the IV form. We occasionally use Pepcid. Some patients have problems with pepcid because it messes with platelets.

We use regular IV tubing for Protonix but a filter must be added.

[fab4fan]

I think it's just the "darling drug of the month." We're seeing it being prescribed more...very expensive, and I haven't seen any definitive info showing that it is superior to the other H2 blockers.

[RN-PA, RN]

I've been seeing more and more Protonix, IV and PO, at our hospital, too.

I have a question about the IV Protonix. Our pharmacy says that there's little information out about what IV Protonix is compatible with, so we have to give it separately from IV's containing Dextrose or LR. I think Protonix comes in a NSS diluent so if patient's primary IV is NSS, we can infuse it along with IV, but otherwise, we're supposed to stop IV fluids, and flush before and after Protonix is infused with 10 cc NSS before restarting primary IV.

What's the protocol at your facilities?

[bellehill, RN]

It is hard to find a patient who is not on Protonix. All Prevacid, Pepcid, Zantac...PO get changed to Protonix automatically. The IV Protonix is a pain to hang because of the reasons RN-PA mentioned. Our pharmacy insists it has to be run on it's own line, not as a secondary. This requires multiple tubing changes and IV settings. I guess it is the drug-of-the-month. Hopefully they come up with something better soon!

[plumrn, BSN, RN]

Our inservice on Protonix IV taught us to use a dedicated line or clamp off the primary and flush the tubing with ns before and after infusion. We give it in the closest port, and infuse it at 400cc/hr. I guess it loses its potency or something very fast. Also, you have to use the filter that pharmacy sends out with it and the tubing is to be used only once, then discarded.

When my mother was in the hosp. recently, none of the above was done except for the filter and one time use on the tubing.

Anyone else hear of similar instructions?

[karmcq]

We also use a lot of protonix.... dedicated line and the like that has already been said.....but.......never knew pepcid messed with platelets......thanks for the new info, zee rn......will have to look into that one!!

I spose you do learn something new everyday.

[SharonH, RN]

This is interesting. At our hospital, Protonix is given with regular IV tubing but with the dedicated filter that is provided by pharmacy. We have been only instructed to change the filter each time, not the tubing. Also, we do not piggyback it into running IVF's but we do not have to stop the primary infusion either; we just run it through the y-extension. So far we haven't experienced any problems with this protocol.