Zofran

untamable07 · Jun 18, 2008

I've heard from other nurses it will burn like HE** if it's pushed too fast.

StrwbryblndRN · Jun 18, 2008

I have never heard anyone complain about Zofran. Either from me pushing or anyone else. I have never had to push it without IV fluids though.

Phenergan on the other hand burns even diluted with fluids running.

(I have had it before, now I know what my pt's feel)

megananne7 · Jun 18, 2008

I have never heard anyone complain about Zofran. Either from me pushing or anyone else. I have never had to push it without IV fluids though.
Phenergan on the other hand burns even diluted with fluids running.
(I have had it before, now I know what my pt's feel)

I know Phenergan is a vesicant, but at my hospital we only give 6.25 mg a dose and we dilute it with 10mL NS and push very slow. Would it still burn with that much dilution?

kmoonshine, RN · Jun 18, 2008

I've never had a problem with Zofran - whether it be pushing it quickly, or slowly; pushing it through IVF, or just giving the med alone. However, the only med that I push "fast" is adenosine. I usually give all my meds slower, depending on what drug it is. For zofran, I give it over 30-60 seconds.

StrwbryblndRN · Jun 18, 2008

I have pushed 12.5 of phenergan diluted with fluids some have complained of burning and others have not. They may have felt it but not enough to say it is painful.

If 6.25mg is given diluted w/o fluids I would think it still will burn. But I guess it can affect everyone at different degrees.

I have had people complain with NS. (and not due to an infiltration)

scoopyjosh · Jun 18, 2008

What happened was, I'm just off orientation and I had 2 flushes with me and the Zofran and I pushed the Zofran first thinking it was the flush and my heart started pounding out of my chest because I didn't know what could happen.

kmoonshine, RN · Jun 18, 2008

IMO, zofran is one of the safest medications out there. Safe for elderly patients and patients with kidney disease, and no dose adjustment required. Its also safe in patients with liver failure (although dose should not exceed 8mg/day). Safe for peds with dose adjustment. Safe for bowel obstruction (unlike reglan). Not irritating to tissues (unlike phenergan). Relatively non-sedating (unlike compazine). No hyperactivity/anxiety/panic attacks (unlike reglan). I've never had a patient experience any side-effects from zofran (except for the cessation of N/V!!!). I love the stuff and I advocate for it to be given to all my patients with N/V since it works so well and is well-tolerated.

Make sure to label all your syringes - that way, you won't accidently push a med that you thought was saline. This was a good situation to realize your mistake; had it been another medication, there could have been grave consequences (ie metoprolol IVP fast -> asystole). Be safe and label all your med syringes!!

Burnt Out, ASN, RN · Jun 18, 2008

You should really push Zofran over at least 5 minutes. If you don't, you can give your patients a massive headache. I speak from experience because with my last pregnancy, I had severe hyperemesis gravidarum and could only take Zofran for the vomiting. Every time I was hospitalized and the nurses would push the Zofran, they would push it too fast and I would get a massive h/a on top of the one I already had. When the PharmD would come and check on me (I was on TPN and lipids), I would tell him about the Zofran and he agreed it was a side effect.

leslie :-D · Jun 18, 2008

i've had pts get ha's from po and iv.

and, it is listed as one of the se's, regardless of route.

leslie

CVICURN2003 · Jun 19, 2008

Zofran can have a proarrythmic affect related to lengethening of the QT interval.

HyperemesisPatient · Jan 9, 2012

As an OB patient with severe Hyperemesis, I was recently hospitalized for rehydration & nausea control. I also am highly sensitive and my body does not react well to meds. I had been taking the dissolving Zofran pills at 8mg 3x day. Once hospitalized, the nurses administered the same dosage of a slow 1-min. push of Zofran through syringe into my IV line. My side effects from both types of administration were lethargy, headaches, dizziness, persistent nausea, and (the taste of rubbing alcohol in the back of my throat through the syringe push). At least I could keep food down. What happened next really scared me.... The young on-call doctor decided to have the pharmacy mix the Zofran into my saline IV. After about an hour of this mixture, I woke up gasping for air, coughing and retching. It seemed surreal! The nurse came in yelling for me to calm down & then seemed to panic and started calling people on the phone. After a few minutes of me feeling like I was near death, the nurse disconnected me from the IV and the doctor came in. Both agreed that this was an " exaggerated effect" and that there is no way this episode was associated with the Zofran. The doctor said it was a panic attack. I had never had a panic attack before, so I felt like they were trying to cover up something. The home health nurse with 30+ years of experience says that the Zofran/saline IV was pushed too fast causing this episode, not a panic attack. Thinking back now the IV drip was dripping about 2x as fast as the original saline solution. The doctor admitted in later conversation how she and other doctors would try different things with patients IVs as a guinea pig method. I was not happy to be part of this doctor's "testing."