Vasopressin

From the manufacturer, eh? Sounds like a good way to sell 25% more vasopressin....

Found this

http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/204485Orig1s000lbl.pdf

From the FDA. That file is the same as the one I found on the manufacturers site.

The bags we use are 100 ml and have to be sent up from pharmacy each time we need a new bag. It's not efficient, but it is much less wasteful.

Same, we use 100ml bags and also get them from the pharmacy. 500ml bags would be nice however when we are running the max GI Shock dose and it's running at 60ml/hr.

500mL bags?! Woah. I guess that would be nice for the patients on rocket fuel with vaso @ 0.12 (Canadian Fellows brought that into our practice ) but I have actually seen it work so I can't really knock them on it.

Our bags are only 100mL and running it at the standard 0.04 for 12mL/hr, it runs dry in less than a shift. Our standard unit protocol is to change the bags out q24 hours. Like someone mentioned above, their guidelines would definitely help increase the sales of units of vaso .

I don't believe I have heard having to get rid of it within 18 hours. On our floor, 99% of any IV bags need to be discarded after the 24 hour mark. I have only heard that diprivan tubing needs changed after 12 hours.

Same, we use 100ml bags and also get them from the pharmacy. 500ml bags would be nice however when we are running the max GI Shock dose and it's running at 60ml/hr.

I have never given Vasopressin beyond 2.4 units an hour or in California 0.04 units per min. What does 60ml translate to in terms of units? Since Vasopressin is given to the patient in UNITS not ML's why would there be a need for 500ml bag, very wasteful

We discard after 24hrs and we only use 100mL bags. Since there's no titration with vasopressin (and in my experience, the patient usually expires before 24hrs if they're on it), we never end up using the whole amount and discarding anyway.

I have never given Vasopressin beyond 2.4 units an hour or in California 0.04 units per min. What does 60ml translate to in terms of units? Since Vasopressin is given to the patient in UNITS not ML's why would there be a need for 500ml bag, very wasteful

I agree that this would be wasteful when using vasopressin at the 0.01-0.04 units per minute typical dosing. However, when using the GI hemorrhage dosing of 0.2-0.4 units per minute, it would not be wasteful.

0.4 units/hr in a 40unit per 100ml bag gives you a rate of 60ml/hr.

I would also like to point out that yes, the patient does receiving the dosing in units, as you have stated, but if you do the math, it is also the same exact thing in milliliters if you know the infusion concentration. Either way, the patient is receiving the correct dose and the correct milliliters, and I do believe it is important to know both and be prudent that these are correct.

I was simply stating that I have had a RATE of 60ml/hr which made my infusion bags run out very quickly, at a DOSE of 0.4units/min. In these circumstances, a 500ml bag does seem appropriate.

We discard after 24hrs and we only use 100mL bags. Since there's no titration with vasopressin (and in my experience, the patient usually expires before 24hrs if they're on it), we never end up using the whole amount and discarding anyway.

Titration of vasopressin is allowed at my facility, per nursing judgement. I have had patients on vasopressin for much longer than 24 hours, definitely depends on the patient.

We don't titrate at my facility. Set rate of 0.03 units. I forgot to stipulate "in my facility." And like I said, "in my experience" :-)