Download Approved Areas for IV Medications (Infusions and IVPB)

Approved Areas for IV Medications (Infusions and IVPB)
(For IV Push please consult the adult or pediatric IV Push list found online)
Last updated: 9/30/2016
Medication
Abciximab (Reo Pro®) infusion
Adenosine (Adenocard®) IV
Alteplase tPA (Activase®) - Acute Ischemic Stroke,
or PE
Alteplase tPA (Activase®) – Vascular
Intensive Care
Unit/ ED/
PACU/
Procedural
Areas
Intermediate
Care Unit
Heart and
Vascular
Center
(HVC)
√
√MD
√
√MD
√ST
√MD
Oncology
(ONC) Unit
Medicine /
Surgical Units
(4-North, 5North,
ACE,GSU,
JSC, M/B,
MSU, Neuro,
OBS, & WSU)
√MD
√MD
√
√
√
√
√
√
√ Thoracic
Surgery
RESTRICTED
√PB
√
√
√PB
√ ICU Level I
√PB
√
√
√
√
√PB
√
√
√
√
√
√
√PB
√PB
√PB
√PB
Diltiazem (Cardizem®)
√
√
√@15mg/hr
√@15mg/hr
√@15mg/hr
(All but WSU)
Dobutamine
√
Dofetilide (Tikosyn®) Oral
√
Dopamine infusion
√
√@15mcg/k
g/min
√
√@10mcg/
kg/min
√PB
√@7mcg/kg/
min
√
√@5mcg/
kg/min
√PB
√PB
√PB
√ST
√ST
Amiodarone (Cordarone®) Infusion and IVPB
Anticoagulant Citrate Dextrose Solution (ACD-A)
for CRRT
Bivalirudin (Angiomax®)
Bumetanide (Bumex®) Infusion
Calcium chloride IVPB
Calcium chloride infusion for CRRT
Calcium gluconate IVPB
Cisatracurium (Nimbex®)
Dexmedetomidine (Precedex®)
Enalaprilat (Vasotec®) IVPB
Epinephrine infusion
Eptifibatide (Integrelin®)
Esmolol (Brevibloc®)
Fenoldopam (Corlopam®) for HTN Crisis
Fentanyl Drip (Continuous IV drip, does not include
PCA) – Restricted by service or patient type: ICU
or Pain/Clinical Pharmacist Service or those
patients with diagnosis of comfort/palliative/hospice
care patients
Furosemide infusions
Heparin infusions
Heparin Infusion for CRRT
Hydromorphone Drip (Continuous IV drip, does not
include PCA)
Restricted to intensivist, oncologist, palliative
prescribers or with a consult to Pain and/or
Clinical Pharmacy Services
Ibutilide (Corvert®)
Insulin Drip
√ ICU Level I
√PB
√
√
√
√
√
√
√HO
√HO
√HO
√HO
√
√
√ ICU Level I
√
√
√
√
√
√
√
√
√
√HO
√HO
√HO
√HO
√
√
√
√ST
√ = May be used in this area
√MD = May be used in this area with a physician present
√PB = May be used in this area as IVPB only
√ST = May be used in this area at set doses, no titration
√@ = May be used in this area at low doses up to max dose noted, minimal titration only
√HO = May be used in this area for palliative care or comfort care or Hospice care patients only
Approved Areas for IV Medications (Infusions and IVPB)
(For IV Push please consult the adult or pediatric IV Push list found online)
Last updated: 9/30/2016
Medication
Isoproterenol
Labetalol (Normodyne®) Infusion and IVPB
Lidocaine
Lorazepam (Ativan®) Drip
Magnesium Sulfate
Methadone IVPB
Restricted to Pain Mgmt., Clinical Pharmacy
Services, and Palliative Care Service
Metoprolol (Lopressor®) Infusion and IVPB
Midazolam (Versed®) Drip
Milrinone (Primacor®)
Morphine Drip (Continuous IV drip, does not
include PCA)
Nesiritide (Natrecor®)
Nicardipine
Oncology
(ONC) Unit
Medicine /
Surgical Units
(4-North, 5North,
ACE,GSU,
JSC, M/B,
MSU, Neuro,
OBS, & WSU)
√PB
√PB
√HO
√PB
√HO
√PB
√
√
√
√PB
√PB
√PB
√PB
√ST
√ST
√
√HO
√HO
√HO
√HO
√
√
√
√
√@50
mcg/min
√@40
mcg/min
√
√
√
√
√ ONC
[morphine,
hydromorphone,
and fentanyl]
√ACE
[morphine and
hydromorphone]
√
√
√
√
√
√
Intensive Care
Unit/ ED/
PACU/
Procedural
Areas
Intermediate
Care Unit
Heart and
Vascular
Center
(HVC)
√
√
√
√
√ or L&D
√PB
√
√HO
√PB
√PB
√ST
√HO
√PB
√
√
√
√
√
Nitroglycerin
√
Nitroprusside
Norepinephrine
Octreotide
Opioid bolus dosing from infusion bag: Morphine,
hydromorphone, and fentanyl
Restricted to ICU, Oncology and ACE Units
Restricted to intensivist, oncologist, palliative
prescribers or with consult to Pain & Clinical
Pharmacy Services
√
√
√
Oxytocin (Pitocin®)
Pancuronium (Pavulon®)
Patient Controlled Analgesia (PCA):
Morphine, hydromorphone, and fentanyl
Fentanyl PCA restricted to Pain/Clinical Pharmacy
Service
Phenylephrine (Neosynephrine®)
Procainamide Drip
Propofol (Diprivan®)
Sodium bicarbonate drips
Subcutaneous Infusions: Morphine, fentanyl, and
hydromorphone ONLY
Restricted to palliative prescribers and intensivist
Tenecteplase (TNKase®) [for MI]
Vasopressin (Pitressin®)
Verapamil (Isoptin®)
√ (ICU)
√ (IMU)
√ or
L&D/MB/WSU
√
√
√
√
√
√
√HO
√
√
√
√HO
√
√
√
√ = May be used in this area
√MD = May be used in this area with a physician present
√PB = May be used in this area as IVPB only
√ST = May be used in this area at set doses, no titration
√@ = May be used in this area at low doses up to max dose noted, minimal titration only
√HO = May be used in this area for palliative care or comfort care or Hospice care patients only
√HO