Implementation

• Do not confuse Zofran (ondansetron) with Zosyn (piperacillin/tazobactam)

» First dose is administered prior to emetogenic event

• PO: For orally disintegrating tablets, do not attempt to push through foil backing; with dry hands, peel back backing and remove tablet. Immediately place tablet on tongue; tablet will dissolve in seconds, then swallow with saliva. Administration of liquid is not necessary

• Direct IV:
Administer undiluted (2 mg/mL) immediately before induction of anesthesia or postoperatively if nausea and vomiting occur shortly after surgery

• Rate:
Administer over at least 30 sec and preferably over 2–5 min

• Intermittent Infusion:

Diluent: Dilute doses for prevention of nausea and vomiting associated with chemotherapy in 50 mL of D5W, 0.9% NaCl, D5/0.9% NaCl, D5/0.45% NaCl. Solution is clear and colorless. Stable for 7 days at room temperature following dilution

• Concentration:
1 mg/mL

• Rate:
Administer each dose over 15 min

• Syringe Compatibility:

» alfentanil

» atropine

» fentanyl

» glycopyrrolate

» meperidine

» metoclopramide

» midazolam

» morphine

» naloxone

» neostigmine

» propofol

• Syringe Incompatibility:

» droperidol

• Y-Site Compatibility:

» aldesleukin

» amifostine

» amikacin

» azithromycin

» aztreonam

» bleomycin

» carboplatin

» carmustine

» cefazolin

» cefotaxime

» cefoxitin

» ceftazidime

» ceftizoxime

» cefuroxime

» chlorpromazine

» cimetidine

» cisatracurium

» cisplatin

» cladribine

» clindamycin

» cyclophosphamide

» cytarabine

» dacarbazine

» dactinomycin

» daunorubicin

» dexamethasone sodium phosphate

» dexmedetomidine

» diphenhydramine

» docetaxel

» dopamine

» doxorubicin

» doxorubicin liposome

» doxycycline

» droperidol

» etoposide

» etoposide phosphate

» famotidine

» fenoldopam

» filgrastim

» floxuridine

» fluconazole

» fludarabine

» gemcitabine

» gentamicin

» haloperidol

» heparin

» hydrocortisone sodium succinate

» hydrocortisone sodium phosphate

» hydromorphone

» ifosfamide

» imipenem/cilastatin

» linezolid

» magnesium sulfate

» mannitol

» mechlorethamine

» melphalan

» meperidine

» mesna

» methotrexate

» metoclopramide

» mitomycin

» mitoxantrone

» morphine

» oxaliplatin

» paclitaxel

» pentostatin

» piperacillin/tazobactam

» potassium chloride

» promethazine

» prochlorperazine edisylate

» ranitidine

» remifentanil

» sodium acetate

» streptozocin

» teniposide

» thiotepa

» ticarcillin/clavulanate

» topotecan

» vancomycin

» vinblastine

» vincristine

» vinorelbine

» zidovudine

• Y-Site Incompatibility:

» acyclovir

» allopurinol

» aminophylline

» amphotericin B

» amphotericin B cholesteryl sulfate

» ampicillin

» ampicillin/sulbactam

» amsacrine

» cefepime

» cefoperazone

» furosemide

» ganciclovir

» lansoprazole

» lorazepam

» methylprednisolone sodium succinate

» pemetrexed

» sargramostim

» sodium bicarbonate

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