Questions regarding infliximab/Remicade infusion

[Lilac]

Hello,

I'm a first year nursing student working on a paper for pharmacology. I've chosen infliximab as my topic (espcially in relation to inflammatory bowel disease), and one of the objectives of our assignment is to discuss the nursing implications regarding our topic.

I was wondering exactly how involved the nursing process is in infliximab infusions. Are nurses primarily responsible for ordering the drug per physician order and documenting the infusion, or are they also involved in the infusion process itself?

I would love to hear from anyone who has any experience in this arena.

Thank you.

[nurmac]

Lilac...I am an RN and Remicade recipient for my rheumatoid arthritis. I am currently looking to get back into nursing particularly into infusing Remicade. In answer to your question...when I recieve my infusions the RN is responsible for everything. She checks the order, mixes the drug, starts the IV, administers the drug and monitors me throughout the process which takes about 3 hours.

[atwtrn]

As a Crohn's patient, I have had about 18 infusions in the last three years. I never see the Doc during the infusion. My nurse schedules my apointment, orders the drug from the pharmacy, administers my allergy meds, then the remicade. She takes my BP periodically and then when it is finished she schedules my next one.. I don't know if this helps.

[bethin]

Hello,

I was wondering exactly how involved the nursing process is in infliximab infusions. Are nurses primarily responsible for ordering the drug per physician order and documenting the infusion, or are they also involved in the infusion process itself?

I would love to hear from anyone who has any experience in this arena.

Thank you.

As a Crohn's pt I rec'd alot of remicade until I developed a serious allergic reaction. I called my MD, either him or his nurse would call the hospital so they new I was coming and to order the drug. A nurse (usually a NM or supervisor) from the hospital would call me and give me dates and times to pick from and I would go in. I always rec'd mine in outpatient surgery except for once when they were very busy I rec'd it in ICU. The nurse got my weight, vitals, and asked about current medications. She would start an IV. After the IV was started she would call pharmacy and they would mix it as it is mixed based on weight. During the infusion, she would check vitals q 30 mins until done. Remicade can cause a decrease in BP and mine would go low so they watched that closely. After the infusion was complete, vitals again were taken and IV dc'd and I was free to go. They always gave me discharge instructions but left most of it blank as the only order they had from my MD was to treat with remicade. We do have standing orders if the MD wants them. The standing orders include a dose of benadryl and tylenol before administration.

I stopped receiving my remicade after developing hives (which we thought was unrelated - under alot of stress) but then my tongue started swelling and rushed to the ER. You need to be aware of the side effects of remicade.

Hope this helps!

[atwtrn]

After my second infusion, I had sudden hypotension so I also had to have benadryl and hydrocortisone. Luckily that helped. My twin brother also has Crohn's and he's never had a rxn. I guess it just depends on the patient. If you have any questions for your paper, please feel free to message me.

[mianders, RN]

I do Remicade infusions in our hospitals infusion suite. Most of the time it is for Chron's disease. The physician writes the order for the dose he wants. The RN starts the IV. Then there are usually pre-meds ordered such as benadryl and decadron. Our pharmacy mixes the remicade. The remicade is always infused with a 0.2 micron filter and put on a pump. The patient vs are monitored throughout the infusion. Most patients seem to tolerate remicade well but you must monitor for any type of reaction and be prepared to treat it. The doctor usually has a standing order for this. The infusion is usually done over several hours. A nurse is always responsible for their own documentation. I hope this helps.:wink2: