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Preface

This Year 2024 edition marks the 51st year of publication of Intravenous Medications. All previous editions are considered out of date. We would like to welcome the expert contributions from the National Coalition for IV Push Safety in this new edition. Intravenous Medications is designed for use anywhere intravenous medications are prepared and administered, such as in critical care areas, at the nursing station, in the office, in public health and home care settings, and by students and members of the armed services. Pertinent information can be found in a few seconds. Take advantage of its availability and quickly review every intravenous medication before administration. When a medication is prescribed, the nurse must evaluate it for appropriateness and may need to prepare it, administer it, and observe the effects. If, after reviewing the information in Intravenous Medications, you have any questions about any order you are given, clarify it with the physician, consult the pharmacist, or consult your supervisor. The circumstances will determine whom you will approach first. If the physician thinks it is imperative to carry out an order even though you have unanswered questions, never hesitate to request that the physician administer the medication instead of you. In this era of constant change, the physician should be willing to provide you, your supervisor, and/or the pharmacist with current studies documenting the validity and appropriateness of orders. All information presented in this handbook pertains only to the intravenous use of the drug and not necessarily to intramuscular, subcutaneous, oral, or other means of administration

Format and Content of Intravenous Medications

Designed to facilitate quick reference, each entry begins with the generic name of the drug in boldface type. Medications with a Black Box Warning are identified with a symbol in the main heading. Phonetic pronunciations appear just below the generic name. Drug categories follow. The primary category may be followed by additional ones representing the multiple uses of a medication. Associated trade names are under the generic name. Boldface type and alphabetical order enable the reader to verify correct drug names easily. The use of a Canadian maple leaf symbol ( ) after a trade name indicates availability in Canada only. Headings within drug monographs are as follows 

USUAL ADULT DOSE

Doses recommended are the usual range for adults unless specifically stated otherwise. This information is presented first to enable the nurse to verify that the medication order is within acceptable parameters while checking the order and before preparation. 

ALL AGE DOSE ADJUSTMENTS

Any situation that requires increasing or decreasing a dose is mentioned here. The range covers adjustments needed for elderly, debilitated, or hepatic or renal impairment patients; adjustments required by race or gender; or adjustments required in the presence of other medications or as physical conditions are monitored

DILUTION

Medications given IV push may be available in ampules, vials, manufactured prefilled syringes, compounded prefilled syringes, and ready-to-assemble products such as Carpuject™. It is important to note that routine dilution of IV push medications is contraindicated unless required by the manufacturer, hospital policy, or other evidencebased guidelines. It is not appropriate to use prefilled saline flush syringes to dilute or reconstitute IV medications unless approved for this use by the U.S. Food and Drug Administration (FDA; see the label of the product you use).

COMPATIBILITIES