21. IV Drug Storage, Compatibility & Administration Flashcards Preview

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Flashcards in 21. IV Drug Storage, Compatibility & Administration Deck (31):
1

Which of the following represent uses and benefits of administering drugs by the intravenous route? (Select ALL that apply.)

A. The intravenous route is the fastest way to deliver medications throughout the body.
B. The intravenous route is the safest way to administer medication.
C. The intravenous route allows for 100% bioavailability of the medication delivered.
D. The intravenous route should be used for all medications in the inpatient setting.
E. The intravenous route can be used when a patient is NPO.
 

A, C, E. The intravenous route is routinely used for a variety of reasons including the need for rapid/immediate drug onset (as in acute situations), when a patient is unconscious or cannot receive anything by mouth, or to administer fluids rapidly. When drugs are given intravenously, bioavailability is 100%.

1

Which of the following IV medications should be stored at room temperature? (Select ALL that apply.)

A. Ceftazidime
B. Dexmedetomidine
C. Propofol
D. Moxifloxacin
E. Enoxaparin
 

B, C, D, E. Dexmedetomidine, propofol, and enoxaparin should be stored at room temperature, cold storage of these drugs is permitted but not required. Moxifloxacin should be stored at room temperature only.

1

Drugs known to exhibit sorption to PVC include the following: (Select ALL that apply.)

A. Amiodarone
B. Carmustine
C. Lorazepam
D. Sufentanil
E. Thiopental
 

A, B, C, D, E. Amiodarone if the infusion is greater than two hours duration.

amiodarone, carmustine, lorazepam, sufentanil, thiopental, regular human insulin, nitroglycerin

"ACLS TIN"

1

All of the following drugs require light protection during administration EXCEPT?

A. Phytonadione
B. Linezolid
C. Heparin
D. Sulfamethoxazole/Trimethoprim
E. Verapamil
 

C. Phytonadione, linezolid, sulfamethoxazole/trimethoprim, and verapamil all require protection from light.

Common light protection drugs during administration: dopamine, doxycycline, epoprostenol (Flolan), linezolid (Zyvox), metronidazole (Flagyl), micafungin (Mycamine), nitroprusside (Nitropress), norepinephrine (Levophed), phytonadione (vitamin K), SMX/TMP (Bactrim), verapamil

1

All of the following drugs are compatible with saline only and cannot be put in dextrose EXCEPT which drug?

A. Infliximab
B. Bactrim
C. Caspofungin
D. Invanz
E. Unasyn
 

B. Infliximab, caspofungin, Invanz, and Unasyn are all compatible in saline only.

NS only: ampicillin, ampicillin/sulbactam (Unasyn), caspofungin (Cancidas), daptomycin (Cubicin), phenytoin, ertapenem (Invanz), infliximab (Remicade)

2

Doreen is in the intensive care unit receiving seven intravenous medications, many of which are not compatible with one another. Which of the following statements is correct regarding the use of a central intravenous line?

A. Central lines have a lower risk of causing bleeding, infection, and thromboembolism.
B. Central lines are not difficult to place; any nurse or physician can insert one.
CCentral lines contain multiple lumens allowing for multiple medications to be given at once.
D. Central lines provide no advantage for patients experiencing phlebitis with a peripheral line.
E. Central lines are not used for medication administration.
 

C. Central intravenous lines allow for multiple medications to be given at once even if they would not be compatible within a single catheter. A peripheral intravenous line is a single catheter inserted into a peripheral vein, usually in the patient's wrist or arm.

3

Which of the following medications require a "protect from light" covering while infusing? (Select ALL that apply.)

A. Furosemide
B. Linezolid
C. Imipenem
D. Metronidazole
E. Piperacillin-Tazobactam
 

A, B, D. Furosemide, linezolid, and metronidazole are light sensitive.

Common light protection drugs during administration: dopamine, doxycycline, epoprostenol (Flolan), linezolid (Zyvox), metronidazole (Flagyl), micafungin (Mycamine), nitroprusside (Nitropress), norepinephrine (Levophed), phytonadione (vitamin K), SMX/TMP (Bactrim), verapamil

4

Which of the following drugs require filtration? (Select ALL that apply.)

A. Lorazepam
B. Cefazolin
C. Golimumab
D. Aztreonam
E. Doxycycline
 

A, C. Lorazepam and golimumab both require filtration.

Filtration required during administration: albumin, amiodarone, amphotericin B liposomal (AmBisome), golimumab (Simponi), lorazepam (Ativan), phenytoin (Dilantin), parenteral nutrition

4

What is the definition of incompatibility?

A. When a product fails to meet good manufacturing practices
B. When a product is modified because of storage conditions and loses more than 10% of its potency
C. When one product is combined with another resulting in a product unsuitable for patient use
D. When one product is levigated with another product and a solid material forms
E. When two products come together and form a visible precipitous gel
 

C. Incompatibility is when one product is mixed or combined with another and changes occur that make the product unsuitable for patient use.

5

Which of the following statements concerning IV medications are correct? (Select ALL that apply.)

A. Furosemide and metronidazole IV bags are not refrigerated.
B. Phenytoin IV requires a filter due to the potential for precipitation.
C. Sulfamethoxazole/trimethoprim and phenytoin IV are diluted with NS only.
D. Phenytoin IV has a maximum infusion rate of 50 mg/min.
E. Metronidazole IV does not require protection from light.
 

A, B, D. 

Sulfamethoxazole/Trimethoprim is compatible with D5W only (not saline). Phenytoin is compatible with saline only (not dextrose).

5

Which of the following drugs are compatible with dextrose only? (Select ALL that apply.)

A. Amphotec
B. Ativan
C. Synercid
D. Unasyn
E. Bactrim
 

A, B, C, E. Amphotericin B (Amphotec), lorazepam (Ativan), quinupristin/dalfopristin (Synercid), and sulfamethoxazole/ trimethoprim (Bactrim) are all compatible in dextrose solution only.

6

Drugs known to leach to PVC bags include the following: (Select ALL that apply.)

A. Tacrolimus
B. Meropenem
C. Imipenem
D. Docetaxel
E. Paclitaxel
 

A, D, E. tacrolimus, temsirolimus, teniposide, cabazitaxel, docetaxel, etopiside, ixabepilone, paclitaxel

"tic, tac, toe, craving delicious, excellent, irresistible pho"

7

A patient will receive a central line. Which of the following statements are true concerning central lines? (Select ALL that apply.)

A. Central lines are used by dialysis patients.
B. Central lines are used by patients receiving long-term enteral therapy.
C. Central lines are used for long-term antibiotic therapy, and most commonly, a PICC line is used.
D. Central line associated blood stream infections are very rare and not likely if the line is placed properly.
E. A central line is also called a central venous catheter.
 

A, C, E. Central lines are used by patients receiving long-term parenteral (not enteral) therapy. Enteral therapy is administered by a patient eating, or using a gastric tube (typically via the nose, or NGT), or sometimes through the jejunum (J tube).

9

A patient comes to the emergency department with acute coronary syndrome. Intravenous nitroglycerin therapy is started. Which of the following statements regarding intravenous nitroglycerin is correct? (Select ALL that apply.)

A. This medication will be adsorbed by polyvinyl chloride bags.
B. Intravenous nitroglycerin should not be used in patients with ACS.
C. This medication can be given for a maximum of 18 hours.
D. This medication requires non-polyvinyl chloride tubing sets for administration.
E. Intravenous nitroglycerin must be protected from light.
 

A, D. Adsorption occurs with soft plastic such as polyvinyl chloride. This can cause the nitroglycerin to leach out and adhere to the plastic. Non-polyvinyl chloride bags and tubing sets are recommended with the use of intravenous nitroglycerin.

10

Which of the following medications require protection from light during administration?

A. Adenosine
B. Sodium nitroprusside
C. Milrinone
D. Dexmedetomidine
E. Nitroglycerin
 

B. Sodium nitroprusside should be wrapped in aluminum foil or placed in an opaque bag while it is being infused.

Common light protection drugs during administration: dopamine, doxycycline, epoprostenol (Flolan), linezolid (Zyvox), metronidazole (Flagyl), micafungin (Mycamine), nitroprusside (Nitropress), norepinephrine (Levophed), phytonadione (vitamin K), SMX/TMP (Bactrim), verapamil

11

Which of the following is an example of a physical incompatibility that can occur with a drug? (Select ALL that apply.)

A. Drug degradation due to hydrolysis
B. Drug toxicity due to oxidation
C. Drug decomposition
D. Drug that cannot be placed into PVC container
E. Drug incompatible with NS
 

D, E. Physical incompatibility can occur with the containers that drugs are placed into (e.g., PVC container) or the solutions (e.g., diluent, such as NS). The other choices are examples of chemical incompatibilities.

13

A patient is receiving a furosemide infusion. The total daily dose the patient received of intravenous furosemide is 40 mg. What would be the oral equivalent dose of furosemide for this patient?

A. 20 mg
B. 40 mg
C. 80 mg
D. 120 mg
E. 200 mg
 

A. Furosemide has an intravenous to oral ratio of 1:2.

15

A nurse calls the pharmacy to see if she can infuse diltiazem via Y-site into the same line with heparin. What is a reputable resource for this compatibility information?

A. Critical Care Handbook
B. The ICU Book
C. The Drug Information Handbook
D. Harrison's Principles of Internal Medicine
E. Trissel's Handbook on Injectable Drugs
 

E. Trissel's Handbook on Injectable Drugs is a well-known resource for intravenous compatibility information. It comes in print and electronic versions. King's Guide is another reputable source for this information.

16

Which of the following medications must be protected from light during administration? (Select ALL that apply.)

A Flolan
B. Amantadine
C. Phytonadione
D. Cisplatin
E. Vancomcycin
 

A, C. Flolan is epoprostenol.

Common light protection drugs during administration: dopamine, doxycycline, epoprostenol (Flolan), linezolid (Zyvox), metronidazole (Flagyl), micafungin (Mycamine), nitroprusside (Nitropress), norepinephrine (Levophed), phytonadione (vitamin K), SMX/TMP (Bactrim), verapamil

17

One of the nurses on the floor has called the pharmacy concerning a vial of norepinephrine. She notes it is a dark brown color. What is the best course of action?

A. A dark brown color is acceptable for use.
B. As long as the vial was protected in an amber light-sensitive cover, then the drug is permissible to use.
C. Norepinephrine turns yellow when it has undergone discoloration. Double check to make sure it is the correct medication.
D. Discard the vial.
E. Instead of using norepinephrine, switch to epinephrine instead.
 

D. Norepinephrine turns brown when it is oxidized. If discolored, then it should not be used.

19

Which of the following drugs are compatible with saline? (Select ALL that apply.)

A. Ampicillin
B. Unasyn
C. Daptomycin
D. Phenytoin
E. Lorazepam
 

A, B, C, D. Ampicillin, Unasyn, daptomycin, and phenytoin are all compatible in saline solution.

19

Which color would indicate that chlorpromazine is acceptable for use?

A. Light yellow
B. Dark yellow
C. Orange
D. Pink
E. Brown
 

A. A slightly yellow color of chlorpromazine is acceptable. Anything darker than light yellow is not acceptable for use.

20

Drugs that cause leaching issues into PVC containers include which of the following drugs? (Select ALL that apply.)

A. Amiodarone
B. Thiopental
C. Ixabepilone
D. Carmustine
E. Lorazepam
 

C. Ixabepilone can leach into PVC containers.

tacrolimus, temsirolimus, teniposide, cabazitaxel, docetaxel, etopiside, ixabepilone, paclitaxel

"tic, tac, toe, craving delicious, excellent, irresistible pho"

22

When compounding IV medications from ampules what is used to prevent particulates from getting into the IV bag?

A. Filter needles
B. Tuberculin syringes
C. Y-sites
D. Multidose vials
E. PVC containers
 

A. Filter needles are used to prevent particulates from getting into the IV bag.

24

A pharmacy technician has finished preparing IV medications and needs to be instructed on how the medications should be stored. Which of the following IV agents are not refrigerated? (Select ALL that apply.)

A. Ceftriaxone
B. Cefazolin
C. Moxifloxacin
D. Phenylephrine
E. Bactrim
 

C, D, E. Moxifloxacin, phenylephrine, and Bactrim are not refrigerated.

Stored at room temperature: dexmedetomidine (Precedex), enoxaparin (Lovenox), propofol (Diprivan)

26

Which of the following drugs require filtration?

A. Clevidipine
B. Vancomycin
C. Propofol
D. Sulfamethoxazole/Trimethoprim
E. Amiodarone
 

E. Amiodarone administered via continuous infusion requires filtration.

27

Which of the following IV medications require filtration? (Select ALL that apply.)

A. Albumin
B. Amphotericin B, liposomal
C. Lipids
D. Phenytoin
E. Parenteral Nutrition (PN)
 

A, B, C, D, E. All of these require filtration prior to administration.

28

All of the following drugs require light protection during administration EXCEPT:

A. Levophed
B. Mycamine
C. Flagyl
D. Brevibloc
E. Doxycycline
 

D. Levophed, Mycamine, Flagyl, and doxycycline all require light protection during administration.

Common light protection drugs during administration: dopamine, doxycycline, epoprostenol (Flolan), linezolid (Zyvox), metronidazole (Flagyl), micafungin (Mycamine), nitroprusside (Nitropress), norepinephrine (Levophed), phytonadione (vitamin K), SMX/TMP (Bactrim), verapamil

29

Drugs known to leach to PVC bags include the following: (Select ALL that apply.)

A. Temsirolimus
B. Metronidazole
C. Cabazitaxel
D. Teniposide
E. Levofloxacin
 

A, C, D. tacrolimus, temsirolimus, teniposide, cabazitaxel, docetaxel, etopiside, ixabepilone, paclitaxel

"tic, tac, toe, craving delicious, excellent, irresistible pho"

30

The majority of drugs that require filters use what size filter?

A. 0.10 micron
B. 0.15 micron
C. 0.20 micron
D. 0.22 micron
E. 0.50 micron
 

D. The majority of drugs that require filters use a 0.22 micron filter (1 micron = 1/1,000 mm).

31

Which drugs exhibit sorption issues? (Select ALL that apply.)

A. Regular human insulin
B. Tacrolimus
C. Paclitaxel
D. Nitroglycerin
E. Etoposide
 

A, D. Regular human insulin and nitroglycerin exhibit sorption issues.

amiodarone, carmustine, lorazepam, sufentanil, thiopental, regular human insulin, nitroglycerin

"ACLS TIN"

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