Protonix IVP

jayne109, RN · Aug 17, 2005

I am having a heck of a time with my IVP Protonix doses at work. We give the 2 minute injections. The problem I am having is even when it is supposedly compatible with whatever is in-line, *POOF* we get precipitation :uhoh21: . I must have dc'd and changed tubing on nearly every pt I had last week.
Yes, I know, flush-push-flush. Honestly, though, I called pharmacy after the first time and verified the compatibility of all the meds. Still happened. Is it the experience of anyone else using this administration method for Protonix that no matter what you just have to pause, flush, push, flush?
-exasperated!

We never give protonix ivp. WE give it IVPB and it used to have to have a filter but they reformulated it so that we don't have to have a filter now. I have never heard of it given this way.

Just my two cents

Super_RN, BSN, RN · Aug 17, 2005

We recently switched to IVP instead of piggy back. I can't recall running into that problem yet. I'll be sure to keep my eyes open!

Jaime

UM Review RN, ASN, RN · Aug 17, 2005

We never give protonix ivp. WE give it IVPB and it used to have to have a filter but they reformulated it so that we don't have to have a filter now. I have never heard of it given this way.
Just my two cents

Same here. Never saw any precipitate.

Please report that problem to your pharmacy and save a sample of the med to show them. I believe they're required to report problems like this to a safety hotline, in case the problem is at the mfr's end.

YSADL · Aug 17, 2005

i am having a heck of a time with my ivp protonix doses at work. we give the 2 minute injections. the problem i am having is even when it is supposedly compatible with whatever is in-line, *poof* we get precipitation :uhoh21: . i must have dc'd and changed tubing on nearly every pt i had last week.
yes, i know, flush-push-flush. honestly, though, i called pharmacy after the first time and verified the compatibility of all the meds. still happened. is it the experience of anyone else using this administration method for protonix that no matter what you just have to pause, flush, push, flush?
-exasperated!
we give it ivpb over 20 minutes or so . separate from any other fluids. our pharmacist tell us its not compatible with anything else. we don't use a filter either. :)

bellehill, RN · Aug 17, 2005

We are told it is not compatible with any other meds or fluids, reconstitute it with NS and push over 2 minutes without a filter. If my patient has fluids running I stop the fluids and flush push flush just like you said. I haven't seen any problems with precipitate.

Burnt Out, ASN, RN · Aug 17, 2005

We are giving Protonix IVP too and I haven't had any problems myself nor have I heard from any of my co-workers having problems.

angelladyclaire · Aug 17, 2005

We do protonix IVPB and I've never had a problem either. We run it straight through the pump with their fluids...

unknown99, BSN, RN · Aug 17, 2005

We give it as a Piggy back. As far as I know, it is not compatible with any other meds or fluid except normal Saline.

capgirl · Aug 17, 2005

I never heard of giving it IVP either. We always give it as a mini, sent up premixed by pharmacy.

This is from the FDA website:

DOSAGE AND ADMINISTRATION

PROTONIX I.V. for Injection admixtures should be administered intravenously through a dedicated line, using the in-line filter provided. The filter must be used to remove the precipitate that may form when the reconstituted drug product is mixed with I.V. solutions.

Studies have shown that filtration does not alter the amount of drug that is available for administration. If administration through a Y-site is desirable, the in-line filter must be positioned below the Y-site that is closest to the patient. 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. PROTONIX I.V. for Injection should not be simultaneously administered through the same line with other intravenous solutions.

I can't tell how up to date this is, since we no longer use the filters either.

But I did see something VERY INTERESTING!

Laboratory Tests

There have been reports of false-positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving pantoprazole.

sun_chica · Aug 18, 2005

At my previous facility we always gave Protonix IVP over 2mins. Mix w/ NS to make 10ml. Stop any fluids going (I've heard Protonix is basically incompatible w/ most things), then SAS. Never had any problems:p

At current facility give IVPB, I prefer IVP, but that's me:D

babynursewannab · Aug 18, 2005

I never heard of giving it IVP either. We always give it as a mini, sent up premixed by pharmacy.
This is from the FDA website:
DOSAGE AND ADMINISTRATION
PROTONIX I.V. for Injection admixtures should be administered intravenously through a dedicated line, using the in-line filter provided. The filter must be used to remove the precipitate that may form when the reconstituted drug product is mixed with I.V. solutions.
Studies have shown that filtration does not alter the amount of drug that is available for administration. If administration through a Y-site is desirable, the in-line filter must be positioned below the Y-site that is closest to the patient. 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. PROTONIX I.V. for Injection should not be simultaneously administered through the same line with other intravenous solutions.
I can't tell how up to date this is, since we no longer use the filters either.
But I did see something VERY INTERESTING!
Laboratory Tests
There have been reports of false-positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving pantoprazole.

Yeah, that's the formulation most people are familiar with. There is a newer formulation that lets you reconstitute 40mg Protonix w/10cc NS to IVP over 2 minutes and then follow w/a 2 minute 10cc NS flush.

I think I'm just going to pause, flush, push, flush from now on. No point risking anything. Thanks for your answers everyone!