IV Compatibilities / TPN

Question 1

Acyclovir

Storage
Solution for reconstitution
Solution for IV infusion

Answer 1

Fridge

Sterile water

D5W, NS, LR

Question 2

Ampicillin

Storage
Solution for reconstitution
Solution for IV infusion

Answer 2

Room temp

Sterile water

NS

Question 3

Ertapenem

Storage
Solution for IV infusion

Answer 3

Fridge

NS only

Question 4

Ciprofloxacin and levofloxacin

Storage

Answer 4

Room temp

Question 5

Vancomycin

Storage
Solution for reconstitution
Solution for IV infusion

Answer 5

Powder in room temp but premade is FROZEN

D5W or NS

Question 6

Daptomycin

Storage
Solution for reconstitution

Answer 6

Fridge

NS or LR

Question 7

Linezolid

Storage
Solution for reconstitution
Solution for IV infusion

Answer 7

Room temp

D5W

Question 8

Tedizolid

Storage
Solution for dilution
Solution for IV infusion

Answer 8

Room temp

NS for both

Question 9

Synercid

Storage
Solution for dilution
Solution for IV infusion

Answer 9

Refrigerator

D5W for both

Question 10

Bactrim

Storage
Solution for dilution
Solution for IV infusion

Answer 10

Room temp

D5W for both

Question 11

Metronidazole

Storage
Solution for dilution
Solution for IV infusion

Answer 11

Room temp

NS for both

Question 12

Rifampin

Storage
Solution for dilution
Solution for IV infusion

Answer 12

Room temp

NS, D5W

Sterile water

Question 13

AmphoB

Storage
Solution for dilution
Solution for IV infusion

Answer 13

Fridge

SW

D5W

Question 14

Capsofungin

Storage
Solution for dilution
Solution for IV infusion

Answer 14

Fridge

NS or LR for both

Question 15

Nitroglycerin

Storage
Solution for dilution
Solution for IV infusion

Answer 15

Room temp

D5W for both

Question 16

Nitroprusside

Storage
Solution for dilution
Solution for IV infusion

Answer 16

Room temp WRAPPED in aluminum

D5W for both

Question 17

Lorazepam

Storage
Solution for dilution
Solution for IV infusion

Answer 17

Fridge

D5W or NS for both

Question 18

Amiodarone

Storage
Solution for dilution
Solution for IV infusion

Answer 18

Room temp in glass (can do PVC for max 2 hours)

D5W or NS for both

Question 19

Cyclosporine (sandimmune)

Storage
Solution for dilution
Solution for IV infusion

Answer 19

Room temp

D5W or NS

Question 20

Octreotide

Storage
Solution for dilution
Solution for IV infusion

Answer 20

Fridge

D5W or NS

Question 21

Propofol

Storage
Solution for dilution
Solution for IV infusion

Answer 21

Room temp

D5W

Question 22

Phenytoin

Storage
Solution for dilution
Solution for IV infusion

Answer 22

Room temp

NS for both

Question 23

Fosphenytoin

Storage
Solution for dilution
Solution for IV infusion

Answer 23

Fridge

D5W or NS

Question 24

Levothyroxine

Storage
Solution for dilution
Solution for IV infusion

Answer 24

Room temp

NS for both

Question 25

What are the advantages of a central TPN?

Answer 25

High calorie intake Long term therapy >3 weeks Nutritionally, more complete than PPN

Question 26

What is the max OsMos for PPN?

Answer 26

Ideally < 600 but MAX 900mOsm

Question 27

What percent should carbs and fat be in the TPN?

Answer 27

Carbs - 60-70% Fat - 20-30%

Question 28

What are the cal/g for: Carb Protein Fat

Answer 28

3.4cal/g 4cal/g 9cal/g

Question 29

What is the minimum daily requirement of protein?

Answer 29

1-1.5g/kg/day IBW

Question 30

Does fat contribute to the osmolarity of TPN's?

Answer 30

Nope

Question 31

What are the cal/mL for lipid emulsions at 10% 20% 30%

Answer 31

1.1cal/mL 2cal/mL 3cal/mL

Question 32

What is the rule for phosphate and calcium in TPNS?

Answer 32

Add phosphate first, then calcium

Question 33

Should you give iron with TPN's?

Answer 33

No , it can crack

Question 34

Is HCO3 okay to add in TPN?

Answer 34

No, it can precipitate Ca2+

Question 35

What is the micron filter size for 2:1 TPN? what about 3:1?

Answer 35

2:1 - 0.22 micron 3:1 - 1.2 micron

Question 36

Nitrogen balance formula What does positive vs negative NB mean?

Answer 36

NB = nitrogen intake - nitrogen loss Positive = anabolic state and is the GOAL Negative = catabolic state and means muscle wasting

Question 37

What is refeeding syndrome and what labs change?

Answer 37

Feeding too fast in a malnourished patients causes sude glucose levels and high release of insulin which can decrease potassium, magnesium, and phosphate.

Question 38

How do you handle TPN;s differently in : Renal patient Cirrhosis patients CHF pateints COPD patients

Answer 38

decrease protein to 0.8-1 g/day decrease protein to 0.8-1 g/day Decrease volume Decrease dextrose