Implementation

• High Alert: Fatalities have occurred with incorrect administration of chemotherapeutic agents. Before administering, clarify all ambiguous orders; double check single, daily, and course-of-therapy dose limits; have second practitioner independently double check original order, calculations and infusion pump settings. The number 5 in 5-fluorouracil is part of the drug name and does not refer to the dose

• Do not confuse Carac with Kuric (ketoconazole)

• Prepare solution in a biologic cabinet. Wear gloves, gown, and mask while handling IV medication. Discard IV equipment in specially designated containers

• Direct IV:

Diluent: May be administered undiluted
Concentration: 50 mg/mL

• Rate:
Rapid IV push administration (over 1–2 min) is most effective, but there is a more rapid onset of toxicity

• Intermittent Infusion:

Diluent: May be diluted with D5W or 0.9% NaCl
Use plastic IV tubing and IV bags to maintain greater stability of medication. Solution is stable for 24 hr at room temperature; do not refrigerate. Solution is colorless to faint yellow. Discard highly discolored or cloudy solution. If crystals form, dissolve by warming solution to 140°F, shaking vigorously, and cooling to body temperatureConcentration: Up to 50 mg/mL

• Rate:
Onset of toxicity is greatly delayed by administering an infusion over 2–8 hr

• Y-Site Compatibility:

» acyclovir

» alfentanil

» allopurinol

» amifostine

» amikacin

» aminophylline

» amphotericin B liposome

» ampicillin

» ampicillin/sulbactam

» anidulafungin

» azithromycin

» aztreonam

» bivalirudin

» bleomycin

» bumetanide

» butorphanol

» calcium gluconate

» carboplatin

» cefazolin

» cefepime

» cefoperazone

» cefotaxime

» cefotetan

» cefoxitin

» ceftazidime

» ceftriaxone

» cefuroxime

» cimetidine

» cisatracurium

» cisplatin

» clindamycin

» codeine

» cyclophosphamide

» cyclosporine

» daptomycin

» dexamethasone

» dexmedetomidine

» dexrazoxane

» digoxin

» docetaxel

» dopamine

» doripenem

» doxorubicin liposome

» enalaprilat

» ephedrine

» ertapenem

» erythromycin

» esmolol

» etoposide phosphate

» famotidine

» fenoldopam

» fentanyl

» fluconazole

» fludarabine

» foscarnet

» fosphenytoin

» furosemide

» ganciclovir

» gemcitabine

» gentamicin

» granisetron

» heparin

» hetastarch

» hydrocortisone

» hydromorphone

» ifosfamide

» imipenem/cilastatin

» inamrinone

» isoproterenol

» ketorolac

» labetalol

» leucovorin

» levorphanol

» lidocaine

» linezolid

» magnesium sulfate

» mannitol

» melphalan

» meperidine

» meropenem

» mesna

» methohexital

» methotrexate

» methylprednisolone

» metoprolol

» metronidazole

» milrinone

» mitomycin

» mitoxantrone

» morphine

» nalbuphine

» naloxone

» nesiritide

» nitroglycerin

» nitroprusside

» octreotide

» paclitaxel

» palonsetron

» pancuronium

» pantoprazole

» pemetrexed

» pentobarbital

» phenobarbital

» phenylephrine

» piperacillin/tazobactam

» potassium chloride

» potassium phosphate

» procainamide

» propofol

» propranolol

» ranitidine

» remifentanil

» rituximab

» sargramostim

» sodium acetate

» sodium bicarbonate

» sodium phosphates

» succinylcholine

» sufentanil

» teniposide

» theophylline

» thiopental

» thiotepa

» ticarcillin/clavulanate

» tigecycline

» tirofiban

» tobramycin

» trastuzumab

» vasopressin

» vecuronium

» vinblastine

» vincristine

» vitamin B complex with C

» voriconazole

» zidovudine

• Y-Site Incompatibility:

» aldesleukin

» amiodarone

» amphotericin B cholesteryl

» amphotericin B colloidal

» buprenorphine

» calcium chloride

» caspofungin

» chlorpromazine

» ciprofloxacin

» diazepam

» diltiazem

» diphenhydramine

» dobutamine

» doxycycline

» droperidol

» epinephrine

» epirubicin

» filgrastim

» haloperidol

» hydroxyzine

» idarubicin

» levofloxacin

» lorazepam

» midazolam

» nicardipine

» ondansetron

» pentamidine

» phenytoin

» prochlorperazine

» promethazine

» quinapristin/dalfopristin

» topotecan

» trimethobenzamide

» vancomycin

» verapamil

» vinorelbine

• Topical: Consult health care professional before administering topical preparations to determine which skin preparation regimen should be followed. Tight occlusive dressings are not advised because of irritation to surrounding healthy tissue. A loose gauze dressing for cosmetic purposes is usually preferred. Wear gloves when applying medication. Do not use metallic applicator

fluorouracil is a sample topic found in Davis's Drug Guide. All other sections of this record are viewable by clicking on the index in the left column, or by clicking on "Display all Sections" in the "Content Manager".

To find other Davis's Drug Guide topics, please login or purchase a subscription.