McGraw-Hill's I.V. Drug Handbook (McGraw-Hill Handbooks)

786 Pages·2008·4.97 MB·English

by  Patricia Schull

McGraw-Hill’s
I.V.
DRUG
Handbook
Notice
Medicine is an ever-changing science.As new research and clinical experience broaden
our knowledge,changes in treatment and drug therapy are required.The authors and
the publisher ofthis work have checked with sources believed to be reliable in their
efforts to provide information that is complete and generally in accord with the standards
accepted at the time ofpublication.However,in view ofthe possibility ofhuman error
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from use ofthe information contained in this work.Readers are encouraged to confirm
the information contained herein with other sources.For example and in particular,
readers are advised to check the product information sheet included in the package
ofeach drug they plan to administer to be certain that the information contained in
this work is accurate and that changes have not been made in the recommended dose
or in the contraindications for administration.This recommendation is ofparticular
importance in connection with new or infrequently used drugs.
McGraw-Hill’s
I.V.
DRUG
Handbook
Patricia Dwyer Schull, MSN, RN
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DOI: 10.1036/0071548637
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Contents
Foreword vii
Advisors ix
Contributors and reviewers x
Preface and user’s guide xi
Part 1
Drugs A to Z 3
Safe I.V.drug administration
I.V.drug compatibilities S2
Conversions and calculations S6
Drug infusion rates S7
Venipuncture and peripheral venous access S10
Preventing and treating extravasation S16
High-alert drugs S17
Hazardous I.V.drugs S18
Guidelines for administering hazardous drugs S19
Avoiding dangerous abbreviations S23
Common abbreviations S24
I.V.drugs and drug names that look or sound alike S26
Monitoring blood levels S28
Anaphylaxis:Treatment guidelines S30
Adult cardiac arrest:Treatment guidelines S31
Pediatric cardiac arrest:Treatment guidelines S32
Part 2
Less commonly used drugs 661
Part 3
Appendix
Common laboratory values 692
Body surface area in adults 695
Body surface area in children 696
v
vi Contents
I.V.drug and solution compatibilities 697
Effects ofdialysis on drug therapy 700
Identifying life-threatening adverse reactions 703
Selected references 710
Index 712
Foreword
N
ot so long ago,when I was an ICU nurse,the pharmacy printed pocket cards to
serve as handy references for intravenous (I.V.) drugs.The concept ofgiving hospital
staffa fast,easy-to-use guide to I.V.drugs is still a good one.In fact,the need for such
a guide is greater than ever—considering the number ofI.V.drugs given today,the
complexity ofI.V.therapy,increasing patient acuity,and our growing responsibilities
surrounding drug administration.
Many I.V.drugs are powerful medications.Not only are more patients receiving them
today;a significant number receive multiple I.V.drugs at the same time.Frequently,
these patients are the sickest—and the most susceptible to life-threatening conse-
quences ofa medication error.
As you’re undoubtedly aware,patient safety recently has taken center stage—to a de-
gree we’ve never seen before.Over the last decade,numerous studies have explored
the problem ofmedication errors,including which drugs are most often involved,
how the errors come about,and what the consequences are.Ofparticular significance
for I.V.drugs,a 2007 study in the Archives ofInternal Medicinefound that from 1998
to 2005,the number ofserious adverse drug events (ADEs) reported to the Food and
Drug Administration (FDA) increased 260% and ADE-related deaths rose 270%.Of
the nearly 1,500 drugs linked to ADEs,a subset of51 (most ofwhich are adminis-
tered I.V.and designated high-alert or hazardous) accounted for 43% oftotal ADEs.
In every year studied,the FDA received 500 or more reports on each ofthese 51
drugs.
Furthermore,not only are those drugs commonly involved in errors,but they pose an
increasedrisk ofcausing significant harm when used in error.Although mistakes may
or may not be more common with these drugs,the consequencesofthese mistakes are
more devastating.Ofthe drugs deemed high-alert by the Institute for Safe Medication
Practices,the majority are given I.V.The same is true ofhazardous drugs (those that
can cause cancer,genetic mutations,reproductive or developmental problems,and
certain other harmful effects).
Studies have found that multiple factors contribute to medication errors.So no matter
how hard an individual healthcare provider tries to prevent medication errors,trying
harder isn’t the answer—or at least,not the only answer.To meet the challenge ofad-
ministering I.V.drugs safely,healthcare providers require reliable,updated,easily ac-
cessible information on the drugs they give.
TheMcGraw-Hill’s I.V.Drug Handbookis the 21st-century version ofthe old pharma-
cy pocket card.It’s compact,so you can carry it with you just about anywhere,includ-
ing on your PDA.But don’t let its compact size fool you:this book is comprehensive.
You’ll be impressed by the number ofdrugs covered and the depth ofcoverage,as
well as the vital supplementary information it contains.The handbook provides
full,detailed monographs on more than 300 I.V.drugs.
vii
Copyright © 2009 by The McGraw-Hill Companies, Inc. Click here for terms of use.
viii Foreword
Ofcourse,each drug monograph covers the essentials—generic and trade drug
names,mechanism ofaction,pharmacokinetics,available forms,approved indica-
tions,contraindications,precautions,adverse effects,and patient teaching.
Above and beyond these basics,you’ll find additional crucial data:
●the latest FDA boxed warnings
●actions to take before you administer the drug (including supportive therapy to give)
●detailed instructions on preparing admixtures,which solutions to dilute,which to
avoid,and correct administration rates
●dosing schedules and critical dosage adjustments
●essential patient monitoring.
The book’s benefits don’t stop there.Each high-alert or hazardous drug is specially
marked for easy identification,and crucial warnings and instructions are highlighted
with “Clinical alert”icons.A special 32-page full color insert includes sanctioned guide-
lines on treating cardiac arrestand stroke and administering hazardous I.V.drugs,a
step-by-step illustrated procedure for starting an I.V.line,I.V.drug compatibility
charts—and more.And you can download the full text to your PDA at no extra cost.
Like me,you’ll appreciate the thought and planning that went into creating this
impressive book.The writing (concise and jargon-free) and the design (customized for
busy healthcare workers) make for easy reading and allow you to instantly find the
information you seek.I’m certain that within the pages ofthe McGraw-Hill’sI.V.Drug
Handbook,you’ll find all the informationyou need to administer I.V.drugs with
confidence.
Vicki L.Buchda,MS,RN,CNAA
Vice-Chair,Division ofNursing Services
Mayo Clinic
Phoenix,Arizona