Diltiazem IV infusion and oral concurrently?

[storyhill]

I am hoping to get some insight from others experience, thanks in advance. When I get orders for a protonix drip and I see the patient is already on oral protonix I know that the doctor doesn't want to continue the oral protonix. If I get an order for a heparin infusion and the patient is currently on scheduled heparin subq injections I know the doctor doesn't want them both. What about when a doc orders a diltiazem infusion and the patient is on it orally already do you think if there is no d/c oral diltiazem order that the doc wants the patient on both? Many of our physicans when they order infusions don't write to d/c the oral or injeciton form that they are on (heparin, protonix,etc ....) and it is just a defacto order to d'c them when we get the infusion order. What do you think about the diltiazem infusion situation? Thanks.

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[KKHeal]

Actually I have had both. Pt was on the oral diltiazem and the IV got ordered. Even tho the system flagged it, I put it through and sent a text to MD notifying him that pt is on both. And he replied saying that he knows. All I made sure was that the maximum recommended daily dose for diltiazem was not exceeded with both

 

[Sparda29]

I've seen it when they are started on the IV infusion and the doctor schedules the IV infusion to end once the first dose of diltiazem PO is given.

 

[Daiphon]

I've seen it when they are started on the IV infusion and the doctor schedules the IV infusion to end once the first dose of diltiazem PO is given.

Yep. When converting from IV to PO, it's recommended to keep the infusion running for at least an hour after the first oral dose.

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