zofran question

[Nurse Lulu]

I was thinking maybe onc nurses/someone else might know. I work in IICU and recently had a patient with a zofran gtt, on his MAR. Anyone else seen this? I am a relatively new nurse but was a pharm tech for six years, and have never seen this. This patient never even needed his push zofran for me..... I'm confused. CAT

[leslie :-D]

i infuse zofran over 15 min, quite often.

many of my hospice pts use this route.

leslie

[I love my cat!]

HI!

It said: gtt, meaning drops? I though Zofran could only be administered IV or IM, but I could be wrong. IV/IM are the only two routes that I have ever administered it.

Did you get it figured out?

[meandragonbrett]

If it said "Zofran gtt" it would be likely talking about a zofran drip rather than zofran drops. A zofran drip would be totally worthless in my opinion (unless if the MAR reflects that it's given IVBP over 10-15 minutes).

[EmmaG, RN]

I've seen it given as a continuous infusion.

[nrsang97, BSN, RN]

I have only given it IVP. I learned in nursing school that it is NOT compatible with LR by the way. RN on the floor gave it through the same line and it precipitated.

[wtbcrna, MSN, DNP, CRNA]

From Lexi-Comp's Drug Information Handbook: "24-hour continous infusions have been reported, but are rarely used".

I would ask the physician what the rationale is for the order. I have found when physicians come up with these strange orders it is usually based on some study they just read.

[Nurse Lulu]

Thanks guys this was a continuous infusion-odd. Thanks again for the info CAT

[NurseRatched67]

Used as a 15 minute premedication IVPB in chemo patients.

I have never seen it as continuous.....

[GrumpyRN63, ADN, RN]

I've worked onc forever,I've never seen it as a gtt

[EmmaG, RN]

I've worked onc forever,I've never seen it as a gtt

This was back when it first came out. Premed, then a continuous infusion after the chemo. Our docs played with this for a while, but it didn't seem to be any more effective.

Pharmacokinetics: Pharmacokinetic studies in human volunteers showed peak plasma levels of 20 to 30 ng/mL at around 1 1/2 hours after an 8 mg oral dose of ondansetron. An 8 mg infusion of ondansetron reached peak plasma levels of 80 to 100 ng/mL. Repeat dosing of an 8 mg tablet every 8 hours for 6 days increased the peak plasma value to 40 ng/mL. A continuous i.v. infusion of 1 mg/hour after the initial 8 mg loading dose of ondansetron maintained plasma levels over 30 ng/mL during the following 24 hour period.

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Initial Dose: 8 mg infused i.v. over 15 minutes given 30 minutes prior to chemotherapy; or 8 mg infused i.v. over 15 minutes, given 30 minutes prior to chemotherapy, followed by 1 mg/h by continuous infusion for up to 24 hours; or 32 mg diluted in 50 to 100 mL of saline or other compatible infusion fluid and infused over not less than 15 minutes**, given 30 minutes prior to chemotherapy.

**No significant differences in terms of emesis control or grade of nausea have been demonstrated between the 32 mg single dose, the 8 mg single dose, or the 8 mg dose followed by the 24 hour 1 mg/hour continuous infusion.**

http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20Z)/ZOFRAN.html

[burnoutward, BSN, RN]

I have given Zofran PO and Zofran IVP, but never IM. I have never heard of a drip, but guess it isn't impossible.