IV Compounding Policies

[Eagle63903]

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Hello, I am a new practitioner recently graduated Class of 2010. My hospital is looking for more information regarding IV compounding. I have done numerous searches but have not been too successful yet in finding the information I seek so I thought maybe somebody on here would know of good locations for information.

I am trying to find information about what other hospital do when it comes to withdrawing diluent from IV bags, since there will be a drug added (which was mostly like reconstituted) which will take up space and alter the concentration. Does anyone have information or guidelines from there institutions? The hospital I work at is pretty small and I am working toward improving programs. If you do not have guidelines any references you know of would be extremely helpful also.

Thank you in advance!

 

[rxlea]

<p>What do you mean? We make certain things total volume like voriconazole, epis and norepis, precedex (which is exact volume meaning we withdraw the exact amount of saline and drug and put it into an empty viaflex), and other meds. It depends if they are titrating, too. Otherwise, we just add to the bag if it &quot;fits&quot;. Some require too much volume so we make it total volume anyway.</p>

Most hospitals have set policies and will more often than not use the manufacturers' preparation guidelines.

 

[WVUPharm2007]

Hello, I am a new practitioner recently graduated Class of 2010. My hospital is looking for more information regarding IV compounding. I have done numerous searches but have not been too successful yet in finding the information I seek so I thought maybe somebody on here would know of good locations for information.

I am trying to find information about what other hospital do when it comes to withdrawing diluent from IV bags, since there will be a drug added (which was mostly like reconstituted) which will take up space and alter the concentration. Does anyone have information or guidelines from there institutions? The hospital I work at is pretty small and I am working toward improving programs. If you do not have guidelines any references you know of would be extremely helpful also.

Thank you in advance!

Depends on the situation. If it's an intermittent infusion, it doesn't really matter. If its a true continuous infusion, then it would theoretically matter, but in practice that type of thing is usually not clinically significant. What's important is being consistent. Especially with all of those critical care drugs that get titrated like Neo.

I hope that's the type of info you want...

 

[The Sonoran]

I am trying to find information about what other hospital do when it comes to withdrawing diluent from IV bags, since there will be a drug added (which was mostly like reconstituted) which will take up space and alter the concentration. Does anyone have information or guidelines from there institutions? The hospital I work at is pretty small and I am working toward improving programs. If you do not have guidelines any references you know of would be extremely helpful also.

Thank you in advance!

Volume wise - it's usual practice to remove existing volume from a large volume IV bag when the volume of solution to be added would exceed 10% of existing volume. (e.g. adding 150 meq (ml) of NaHCO3 to a D5W liter bag would require that at least 50 ml of D5W be removed first.)

Admixtures requiring specific concentrations (for stability, compatibility or titration issues) usually require equal exchange of volumes.

Like rxlea wrote, follow the manufacturer's guidelines. All hospitals should have policies and procedures on hand about how to handle each situation. I'm sure that if you call around to other hospital pharmacists, that they would be willing to share them with you to incorporate into your own facility.

Every hospital should have a copy of Trissel's

http://www.ashp.org/bookstore/DrugInformation/ProductDetails/tabid/191/Default.aspx?ProductId=4229

as a reference.