Skills III: Drug Set 1

Bumetamide; Bumex

Hyperuricemia, Hypochloremia, Hypokalemia

Antihypertensive, Loop Diuretic

DD

Furosemide; Lasix

Hyperuricemia, Hypochloremia, Hypokalemia

Antihypertensive, Loop Diuretic

DD

Mannitol; Osmitrol

Nausea, Dysuria

Osmotic Diuretic

DD

May crystallize at room temperature, but this does not indicate that the drug is unusable. Inspect for crystals prior to administration; crystals can be dissolved by warming the solution. For mannitol concentrations ≥20%, use a ≤5 micron filter

Magnesium Sulfate

Flushing, Sweating, CNS Depression

ISMP High-alert medication

Antiseizure Agent, Electrolyte Supplement, Magnesium Salt

OTC

For IV administration, must dilute to a ≤20% solution for IV continuous infusion or IV push (IV push is only for ventricular fibrillation/pulseless ventricular tachycardia associated with torsades de pointes)

Potassium Chloride

Nausea/vomiting, Rash, Pain during Injection, Hyperkalemia

ISMP High-alert medication

Electrolyte Supplement

DD

Potassium must be diluted prior to parenteral administration. For IV infusion only; do NOT administer IV push.

The maximum rate of administration for peripheral infusion is 10 mEq/hour. ECG monitoring is recommended for peripheral or central infusions >10 mEq/hour in adults. With central line administration, higher concentrations and more rapid rates of infusion may be used; concentrations

of 20 to 40 mEq per 100 mL at a maximum rate of 40 mEq/hour via central line have been safely administered

Sodium Bicarbonate; Neut

Hypernatremia, Hypocalcemia, Hypokalemia, Metabolic alkalosis

Alkalinizing agent, Antacid, Electrolyte supplement

Sodium content of the drug should be counted when determining the osmolarity of the compounded solution, as this will affect the type of IV line required. Hypertonic/hypotonic solutions should be administered

via a central line

Sodium Chloride

Phlebitis, Extravasation, Sodium disorders

Electrolyte supplement, Genitourinary irrigant, Irrigant, Lubricant, Ocular, Sodium salt

OTC

Hypotonic/hypertonic saline solutions should be given via central line

Iron - Sodium Ferric Gluconate; Ferrlecit

Hypotension/Hypertension, Injection site reactions, Muscle cramps

Iron preparations

DD

A test dose should be administered in patients with a history of drug allergies

Alteplase; Activase, Cathflo

Intracranial hemorrhage, GI hemorrhage

ISMP High-alert medication

Thrombolytic agent

DD

Cathflo version (2 mg) is used to de-clot central venous catheters

Argatroban

Major bleeding

ISMP High-alert medication

Thrombolytic agent

DD

Bivalirudin; Angiomax

Major bleeding

ISMP High-alert medication

Anticoagulant, Direct Thrombin Inhibitor

DD

Eptifibatide; Integrilin

Major bleeding, Thrombocytopenia

ISMP High-alert medication

Antiplatelet agent, Glycoprotein IIb/IIIa inhibitor

DD

Enoxaparin; Lovenox

Major bleeding, Heparin-induced thrombocytopenia, Injection site reactions

ISMP High-alert medication

Anticoagulant, Low-molecular-weight heparin

DD

Fondaparinux; Arixtra

Major bleeding, Injection site reactions

ISMP High-alert medication

Anticoagulant, Factor Xa inhibitor, Synthetic pentasaccharide

DD

Heparin

Major bleeding, Heparin-induced thrombocytopenia

ISMP High-alert medication

Anticoagulant

DD

Epoprostenol; Flolan, Veletri

Flushing, Headache, Tachycardia, Flu-like symptoms, Hypotension

ISMP High-alert medication

Prostacyclin, Prostaglandin, Vasodilator