Why Is Cipro IV on Hold?

[pagandeva2000, LPN]

I started working med-surg per diem, and even when I was a new grad doing med-surg for 6 weeks, I constantly saw Cipro IV ordered, but then, it is on hold for review. I asked once, and I think I remember them saying that it had to be reviewed by a cardiologist (???).

Now, I saw it again, but since it was not my patient and was on orientation, I decided to inquire at a later date. We have to call the doctor to tell them that it is on hold, for him to do whatever with the pharmacy to release it for us to administer. To me, this is a waste of time, only because at the moment, I don't know any better, however, I am sure that I will encounter this. Does anyone know? Thanks!

[GilaRRT]

Cipro is known to prolong the QTI and can lead to serious problems (polymorphic VT) when given to patients who are on class Ia & III medications. Your best bet; however, is to ask.

[IngyRN]

Actually, in our hospital it has to be cleared by Infectious Disease to make sure it is being prescribed appropriately.

Per WebMD

"Prescribing CIPRO I.V. in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria."

[GilaRRT]

Correct, many places no longer use cipro because of resistance issues; however, this does not account for holding the cipro because a cardiology consult is required.

[pagandeva2000, LPN]

Cipro is known to prolong the QTI and can lead to serious problems (polymorphic VT) when given to patients who are on class Ia & III medications. Your best bet; however, is to ask.

Does this go for PO Cipro as well?

[pagandeva2000, LPN]

Thanks for the clarity. I know this will probably come up again, and having an educated view is a great heads up for me. I did ask, but did not really comprehend how this happened, and now, I better understand between reading the answer here and comparing it to my drug book. Sometimes, I see so many details in drug guides that I have to be confronted with a situation to correlate the facts with the books.

[GilaRRT]

PO cipro could be a concern as well. It is not contraindicated with these medications; however, caution is advised when using both in combination. Who knows, there will always be the latest and greatest research out on medications, so the docs may have other concerns with cipro.

[cardiacRN2006, ADN, RN]

Strange, we have no restrictions for Cipro at all.

For Vanco, I hold the dose just after the trough (just until I see the results) to see if we want to adjust, and the only med that needs approval is Caspofungen.

[pagandeva2000, LPN]

Thanks for all of the information given. Since I will begin my per diem assignment next weekend, I was just mulling over some of the things I remembered to get a jump start on things and this was one of them. I really try my best to obtain whatever information I can in order to explain to patients while I am doing teaching while administering meds and treatments.