| Drug |
Standard
Dilution |
Infusion
Rate |
Diluents* |
| FAMOTIDINE
(PEPCID) |
20 mg/ 100 ml
40 mg/ 250 ml |
30 min |
D5W / NS |
Stability/Misc.
 |
EXP: 14 DAYS (REF).
Recommended concentration for infusion: 0.2 mg/ml |
|
| FENOLDOPAM
(CORLOPAM) |
10 mg/ 250 ml (40
mcg/ml)
20 mg/ 500 ml (40 mcg/ml) |
Titrate |
NS / D5W |
Stability/Misc.
|
EXP: 1 Day
(RT). Indications: Short term treatment (up to 48hrs) of severe hypertension
when rapid, but quickly reversible, emergency reduction of blood pressure is
indicated. May be discontinued abruptly or tapered gradually. Dosing: Usual
initial rate: 0.1 mcg/kg/min, increased by increments of 0.05 to 0.1
mcg/kg/min at 15-20min intervals until target blood pressure reached. Usual effective
doses: 0.1 to 1.6 mcg/kg/min. Generally, lower initial doses (0.03 to 0.1
mcg/kg/min) titrated slowly, have been associated with less reflex tachycardia.
Never given by IV bolus. MOA: Selective dopamine (D1) agonist which
decreases peripheral vascular resistance; increases renal blood flow; increased
diuresis and natriuresis. 6 times as potent as dopamine in producing renal
vasodilation. Onset: 10 minutes. Supplied: 10mg/ml-1&2 ml
ampules. |
|
| FENTANYL |
| Usual
Diluents |
| NS, D5W |
| Standard
Dilutions [Amount of drug] [Infusion volume]
[Infusion rate] |
[0 - 5000 mcg] [50-250ml]
[Titrate]
[2500 mcg] [250 ml] [Titrate]
[5000 mcg] [250 ml] [Titrate]
(May concentrate further)
[2500 mcg] [ 50 ml] (50 mcg/ml)
|
|
Stability/Misc.
|
EXP:
2 Days (RT / REF).
Some studies indicate stability up to 30 days.
Continuous infusion: 1 to 3 mcg/kg/hr.
Minimum dilution: 2500 to 5000 mcg/ 50 ml. |
|
| FILGRASTIM
(NEUPOGEN) |
300
mcg/ 19 ml (15 mcg/ml) |
15-30 min |
D5W |
Stability/Misc.
|
EXP: 6
hours (REF). Note:
if Neupogen is diluted to a concentration below 15 mcg/ml, it should be protected
from absorption to glass and plastic by the addition of albumin to a final
concentration of 2 mg/ml. ANC (absolute neutrophil
count)= (% segs + % bands) x
WBC. |
|
| FLUCONAZOLE
(DIFLUCAN) |
200 mg/ 100 ml
(ready-to-use)
400 mg/ 200 ml |
1 hour
2 hours |
NS |
Stability/Misc.
|
EXP:
7 DAYS (RT) if
solution is transferred. Label: Do not Refrigerate. Maximum IV rate: 200
mg/hr. Oral: Oropharyngeal candidiasis: 200mg orally x 1, followed by
100mg orally once daily. Esophageal candidiasis: 100-200 mg orally once
daily (up to 400mg/day).
Cryptococcal meningitis: 400mg orally x 1, followed by 200mg orally once
daily x 10-12 weeks
(Suppression: 50-200mg orally once daily). Onychomycosis: 200-300mg once weekly or 100-200mg
orally every other day (further studies needed). IV: since oral absorption
is rapid
and essentially complete--IV dose=oral dose. Renal dosing:
>50/ no change || <50 / 50% of usual dose. || Alternatively: 20 to
50/ give normal dose q48h. || <20 / 50% of usual dose q48h. ||
Hemodialysis: give 100-200mg after each dialysis. || CAPD: give 50% of
usual dose at usual interval. |
|
| FOMEPIZOLE
(ANTIZOL) |
Prescribed
dose/ 100 ml |
30 min |
NS / D5W |
Stability/Misc.
|
Dosing: loading dose:
15 mg/kg, followed by 10 mg/kg q12h x 4 doses, then 15 mg/kg q12h thereafter until
ethylene glycol levels <20 mg/dl. Dialysis should be considered in
addition to fomepizole in the case of renal failure, significant or
worsening metabolic acidosis, or a measured ethylene glycol level >50
mg/dl. Fomepizole is dialyzable and should be given q4h during
hemodialysis. MOA: complexes and inactivates alcohol dehydrogenase thus
preventing formation of the toxic metabolites of the alcohols. Supplied: 1
g/ml-1.5 ml vial. |
|
| FOSCARNET
(FOSCAVIR) |
See
comments |
|
D5W / NS |
Stability/Misc.
|
EXP: 1 DAY
(RT). Stock solution has a concentration of 24 mg/ml. The prescribed dose must be diluted
with an equal volume of D5W or NS to yield a concentration of 12 mg/ml for
peripheral administration. Initial doses are usually given q8h and infused
over 1 hr. Maintenance doses are usually given once daily and infused over 2
hours. Must
adjust dose based on renal function. |
|
| FOSPHENYTOIN
(CEREBYX) |
100
to 1250 mg PE/ 50 ml |
10 min
(max rate: 150 mg PE/min) |
D5W / NS |
Stability/Misc.
|
Water soluble prodrug
of phenytoin. Status epilepticus: loading: 15 to 20 mg PE/kg.
Maintenance dose: 4 to 6 mg PE/kg/day. Fosphenytoin offers many advantages
over phenytoin: minimum phlebitis, complete IM absorption, and the ability
to administer the drug much more rapidly. Cerebyx (IM / IV) can be
substituted 1:1 for oral phenytoin. IM Cerebyx
is not recommended for
treatment
of status epilepticus. |
|
| FUROSEMIDE
(LASIX) |
All
doses/ 50 ml |
(Max rate = 4mg/ min IV). |
D5W / NS |
Stability/Misc.
|
EXP: 1 DAY
(RT)
Label:
Do not Refrigerate. Recommended routes: IM, IV push, Continuous
infusion. Doses up to 6 grams/day have been used in patients with renal
failure. Dosing: 20 to 40 mg initially. Increase by 20 mg increments every
1 to
2 hours until response. Continuous infusion: 20 to 160 mg/hr. IV bolus:
Usual doses (eg <80 mg) can be given slowly over 1-2 minutes. If higher
doses are needed, a continuous infusion is recommended-usually greater
efficacy as well as decreased risk of side effects. |
|
| GANCICLOVIR
(CYTOVENE) |
| Usual
Diluents |
| NS, D5W, LR |
| Standard
Dilutions [Amount of drug] [Infusion volume]
[Infusion rate] |
[5 to 6 mg/kg] [100 ml]
[60 min]
|
|
Stability/Misc.
|
EXP:
1 DAY (REF). Exception: IV ganciclovir, when reconstituted with
sterile water for injection, further diluted with 0.9% Sodium Chloride
Injection, stored refrigerated at 5°C (41°F) in polyvinyl chloride (PVC)
bags, remains physically and chemically stable for 14 days.
Reconstitute vial with 10 ml of Sterile Water for Injection (do not use
bacteriostatic water), and shake well to dissolve drug. Vial stability:
stable at room temperature for 12 hours (Do not refrigerate).
Remember when further diluted with NS or D5W, final solution should be
refrigerated until ready for use.
Label: Refrigerate. In-line 0.22m filter recommended.
Maximum concentration: 10 mg/ml.
Follow chemotherapy handling precautions when preparing.
Must adjust dose in renal failure. |
|
GATIFLOXACIN
(TEQUIN) |
| Usual
Diluents |
| D5W, NS,
D5NS, D5LR |
| Standard
Dilutions [Amount of drug] [Infusion volume]
[Infusion rate] |
[400 mg] [200 ml] [60
min]
[200 mg] [100 ml] [60 min]
Also available in premixed bags – same concentration as above. |
|
Stability/Misc.
|
EXP:
14 days RT or REF.
Usual dose: 400 mg po/IV qd
Cannot be given IM.
[CRCL >40]: No changes.
[<40 ]: 400mg x1, then 200mg qd |
|
| GENTAMICIN |
0 to 40 mg/ 50 ml
All other/ 100 ml |
30 min |
NS / D5W |
Stability/Misc.
|
EXP: 1 DAY
(RT)
; 4 DAYS (REF). Increased Vd:
CHF, peritonitis, ascites, acute burn, hypoalbuminemia, immediate post
partum. Adjusted body wt: (Actual body wt - IBW) (0.4) +
IBW. |
|
| GLUCAGON |
5 mg/ 50
ml
10 mg/ 100 ml
20 mg/ 200 ml
(Recommended concentration= 0.1 mg/ml) |
May be given as a bolus or continuous infusion. |
D5W / NS |
Stability/Misc.
|
Stability:
Reconstituted solutions should be used immediately; any unused portion
should be discarded. Use diluent provided only if dose is < 2 mg
otherwise dilute vials with sterile water or D5W to prevent phenol toxicity.
After all of the vials have been reconstituted, follow the dilutions
listed above: eg 10mg/100 ml D5W or NS.
Beta-blocker overdose: Separate glucagon receptors stimulate
adenylcyclase improving heart rate, blood pressure and conduction defects.
Adults: 3 - 5 mg (up to 10 mg) rapid IV push followed by an IV drip of
0.07 mg/kg/hr (usually 1 to 5 mg/hour) (The dose used to increase glucose
in hypoglycemic patients is only 0.5 - 1 mg IV push). Note: bolus dose may
be repeated in 10 minutes. Usually causes nausea and vomiting. May give
Reglan IV, Compazine or Tigan. Monitor blood glucose levels in
hypoglycemic patients until they are asymptomatic; effective in treating
hypoglycemia only if sufficient liver glycogen is present; since liver
glycogen availability is necessary to treat hypoglycemic patients,
glucagon has virtually no effects on patients in states of starvation,
adrenal insufficiency, or chronic hypoglycemia. // Glucagon (recommended
routes): IM, IV, or SC. Half-life: 8 to 18
minutes. |
|
| GRANISETRON
(KYTRIL) |
0
to 1 mg/ 50 ml |
5 min |
D5W / NS |
Stability/Misc.
|
EXP: 1 DAY
(RT) Supplied: 1 mg/ml vial. Dosage: 10 mcg/kg IV over 5 minutes.
30 minutes prior. |
|
