Implementation

• PO: Administer doses 30 min before meals and at bedtime

• IM: For prevention of postoperative nausea and vomiting, inject IM near the end of surgery

• Rect: Suppositories may be made by pharmacist. Administer 1 suppository 30–60 min before each meal and at bedtime

• Direct IV:
Administer IV dose 30 min before administration of chemotherapeutic agent

• Rate:
Doses may be given slowly over 1–2 min. Rapid administration causes a transient but intense feeling of anxiety and restlessness followed by drowsiness

• Intermittent Infusion:
Diluent: May be diluted for IV infusion in 50 ml of D5W, 0.9% NaCl, D5/0.45% NaCl, Ringer's solution, or LR. Diluted solution is stable for 48 hr if protected from light or 24 hr under normal light

• Concentration:
May dilute to 0.2 mg/ml or give undiluted at 5 mg/ml.

• Rate:
Infuse slowly (maximum rate 5 mg/min) over at least 15–30 min

• Syringe Compatibility:

» atropine

» benztropine

» bleomycin

» butorphanol

» chlorpromazine

» cisplatin

» cyclophosphamide

» cytarabine

» dexamethasone

» diphenhydramine

» doxorubicin

» droperidol

» fentanyl

» fluorouracil

» heparin

» hydrocortisone

» hydromorphone

» hydroxyzine

» leucovorin

» lidocaine

» magnesium sulfate

» meperidine

» methylprednisolone sodium succinate

» midazolam

» mitomycin

» morphine

» ondansetron

» pentazocine

» perphenazine

» prochlorperazine

» promazine

» promethazine

» ranitidine

» scopolamine

» vinblastine

» vincristine

• Syringe Incompatibility:

» furosemide

» pantoprazpole

• Y-Site Compatibility:

» acyclovir

» aldesleukin

» amifostine

» aztreonam

» bivalirudin

» bleomycin

» ciprofloxacin

» cisatracurium

» cisplatin

» cladribine

» cyclophosphamide

» cytarabine

» dexmedetomidine

» diltiazem

» docetaxel

» doxapram

» doxorubicin

» droperidol

» etoposide phosphate

» famotidine

» fenoldopam

» fentanyl

» filgrastim

» fluconazole

» fludarabine

» fluorouracil

» foscarnet

» gemcitabine

» granisetron

» heparin

» hydromorphone

» idarubicin

» leucovorin

» levofloxacin

» linezolid

» melphalan

» meperidine

» meropenem

» methadone

» methotrexate

» mitomycin

» morphine

» ondansetron

» oxaliplatin

» paclitaxel

» pemetrexed

» piperacillin/tazobactam

» quinupristin/dalfopristin

» remifentanil

» sargramostim

» sufentanil

» tacrolimus

» teniposide

» thiotepa

» topotecan

» vinblastine

» vincristine

» vinorelbine

» zidovudine

• Y-Site Incompatibility:

» allopurinol

» amphotericin B cholesteryl sulfate complex

» amsacrine

» cefepime

» doxorubicin liposome

» furosemide

» lansoprazole

» propofol

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