version 3 icu iv preparation guide d5w = dextrose 5% … · st george's healthcare nhs trust...

St George's Healthcare NHS Trust Version 3 ICU IV Preparation GuideD5W = Dextrose 5% Water

NS = Sodium Chloride 0.9% WFI = Water for Injections

VTBI = Volume To Be Infused mcg = Microgram

Drug / IndicationPump Type

Programmed Doses Dilution/Preparation Comments

Acetazolamide Syringe 250mg - 1000mg

Dilute dose to 20ml with WFI. 250mg in 20ml = 12.5 mg/ml; 500mg in 20ml = 25 mg/ml;

750mg in 20ml = 37.5 mg/ml; 1000mg in 20ml = 50 mg/ml

Use uncommon Volumat pump Administer 20ml over 5 minutes

(240 ml/hr) Caution Extreme pH - avoid

extravasation.

Acetylcysteine Load (Paracetamol Overdose)

Volumatic150 mg/kg (max = 16.5g)

Range = 4.5 - 16.5g

Add appropriate volume of injection to 200ml D5W or NS (final volume 234-

283ml)

Use uncommon Volumat pump Infuse over 60 minutes (234-283 ml/hr)

Acetylcysteine 4 hr (Paracetamol Overdose)

Volumatic

After loading dose administer 50 mg/kg (max = 5.5g)

over 4hr

Range = 1 - 5.5g


528ml)

Use uncommon Volumat pump Infuse over 4 hours

(128-132 ml/hr)

Acetylcysteine 16 hr (Paracetamol Overdose)

VolumaticAfter 4hr dose administer 100 mg/kg

(max = 11g) over 16hr Range = 2 - 11g


1055ml)

Use uncommon Volumat pump Infuse over 16 hours (64-66 ml/hr)

Acetylcysteine Liver Failure

Volumatic150 mg/kg/24hr

Range = 4.5g - 21gDilute to 500ml D5W

Use uncommon Volumat pump For liver failure only - 150 mg/kg into

500ml D5W over 24 hours (6.25 mg/kg/hr)

Note: There are 4 Volumat entries for Acetylcysteine Paracetamol and Liver

© St Georges Healthcare NHS Trust. Not for use outside St George’s. Uncontrolled copy when printed.

of 73 Author: J Peh M CecconiValidator: A Redfern

Approved: L Murdochv3 20 May 2014




Acetylcysteine Renal Volumatic 600mg or 1200mg Dilute to 100ml D5W

Renal protection against contrast media

Administer over 20 minutes (300 ml/hr)

Acetylcysteine Renal Protection

Syringe 600mg or 1200mgDilute to 20ml with D5W

600mg in 20ml = 30 mg/ml; 1200mg in 20ml = 60 mg/ml

For fluid restricted patients only. Preferably via CVC.

Renal Protection against contrast media.


Aciclovir Volumatic2.5 - 10 mg/kg

Range = 75 - 1000mg

Further dilute before infusion with NS to between 1.5 - 5 mg/ml: ≤ 250mg with 50ml

250-500mg to 100ml = 2.5 - 5 mg/ml 500-1000mg to 250ml = 2 - 4 mg/ml

Will need to calculate mg/ml to programme pump. MUST set pump to

administer dose over at least 60 minutes

Extravasation will cause tissue damage - check cannula.

Aciclovir CVC Syringe2.5 - 10 mg/kg

Range = 75 - 1000mgGive undiluted (25 mg/ml)

Ensure patient is well hydrated. Give via CVC only. Administer dose over at

least 60 minutes

Note: There is 1 Volumat and 1 Injectomat entry for Aciclovir

Note: There is 1 Volumat adn 1 Injectomat entry for Acetylcysteine Renal







Addiphos® (phosphate with potassium)

VolumaticMax rate: 40mmol phosphate over 4 - 6

hoursDilute 40 mmol to 500mls with NS or

D5W

Each 20ml vial contains 40mmol phosphate and 30mmol Potassium.

Infuse 500ml over 4 - 6 hours

4hr = 125 ml/hr 6hr = 84 ml/hr

Addiphos® CVC (phosphate with potassium)

Syringe Max rate: 10mmol phosphate/hourDilute 40 mmol phosphate to 40mls with

NS or D5W (1 mmol/ml)

Each 20ml vial contains 40mmol phosphate and 30mmol Potassium.

Infuse 40ml over 4 - 6 hours

Adrenaline Syringe 4, 8 or 12mg

Dilute to 50ml with D5W or NS 4mg = 0.08 mg/ml; 8mg = 0.16 mg/ml; 12mg = 0.24 mg/ml

Default: 0.05 mcg/kg/min Max: 1.5 mcg/kg/min

Programmed Bolus: 0.5 mcg/kg FAST

Albumin 20% Volumatic Infuse at 60 - 120 ml/hr 20% = 200 mg/ml

Alfentanil Syringe

Load: 1mg Programmed Bolus: 1mg

Maintenance Infusion: 0.5-6 mg/hr Soft max: 6 mg/hr

Hard max: 10 mg/hr

Dilute to 1mg/ml with D5W, NS or Hartmann's

Give loading dose of 1mg over 2 mins if necessary then begin infusion at 1

mg/hr and titrate to response. Exceed soft max rate only with Doctors

authorisation. Use programmed bolus to administer a further bolus of 1mg over 15-30 seconds if nec (minimum of 30 secs and under Drs supervision

for non-ventilated patients)

Note: There is 1 Volumat and 1 Injectomat entry for Addiphos







Alteplase PE < 65kg Syringe Pulmonary Embolism: 1.5mg/kg

Administer first 10mg as bolus then remainder over 2 hours

Use uncommon Volumat pump Use Loading Dose function to

administer initial 10mg over 1 - 2 minutes (60-120s). Then set pump to infuse remaining dose over 2 hours

Alteplase PE > 65kg SyringePulmonary Embolism: 10mg load then 90mg

over 2 hours

Use uncommon Volumat pump Use loading dose function to

administer initial 10mg over 1 - 2 minutes (60-120 seconds). Then run

remainder over 2 hours (45 mg/hr)

Alteplase Stroke (ischaemic)

Syringe 0.9 mg/kg (max = 90mg)

Reconstitute vial with WFI to a final concentration of 1 mg/ml or 2mg/ml

50mg with 50ml = 1mg/ml; 50mg with 25ml = 2 mg/ml

Use uncommon Volumat pump For acute ischaemic stroke dose = 0.9

mg/kg = 900 mcg/kg Give 90 mcg/kg (10%) as initial loading

dose over 5 minutes (300s)

Give remaining 810 mcg/kg over 60 mins

(810 mcg/kg/hr) Max weight for load and maintenance = 100kg

Note: There are 3 Injectomat entries for Alteplase

Reconstitute each vial with WFI to give a final concentration of

2 mg/ml 50mg with 25ml; 20mg with 10ml; 10mg with 5ml







Ambisome® (liposomal amphotericin)

Syringe Doses 100mg or lessDilute dose to 50ml with D5W. (variable

dilution 0.6 - 2 mg/ml)

NO TEST DOSE REQUIRED. Administer dose over

60 minutes (50 ml/hr)

Monitor patient for anaphylaxis/reaction in first 10mins

Ambisome® (liposomal amphotericin)

Volumatic1-5 mg/kg (max 500mg) Range = 100mg - 500mg

Dilute dose to 250ml D5W

NO TEST DOSE REQUIRED. Administer dose over


Monitor patient for anaphylaxis/reaction in first 10mins

Amikacin BD/TDS (conventional dosing)

Syringe

7.5 mg/kg BD or TDS (max 1500mg/day)

Use ideal body weight for dose calculations Range = 225mg - 750mg

Dilute dose up to 20ml D5W or NS (variable dilution 11 - 37.5 mg/ml)

Use uncommon drugs pump Administer over 5 minutes

(240 ml/hr)

Amikacin Once Daily Syringe15-20 mg/kg

Use ideal body weight for dose calculations Range = 450 - 2000mg

Dilute to 50mls NS or D5W (variable dilution 9 - 40 mg/ml)

Administer dose over 30 minutes (30 - 40 mg/kg/hr)

Measure levels as per protocol

Note: There are 2 Injectomat entries for Amikacin

Note: There is 1 Volumat and 1 Injectomat entry for Ambisome







Aminophylline Peripheral

Volumatic

Loading dose = 5mg/kg Maintenance dose = 500 mcg/kg/hr

Use max weight of 100kg to programme pump

Dilute to 250ml with NS or D5W. Choose from two set dilutions;

250mg/250ml 500mg/250ml

Use uncommon Volumat pump Continuous infusion adjusted

according to plasma-theophylline levels.

Give loading dose over 20 mins (1200s)

Aminophylline CVC SyringeLoading dose = 5 mg/kg

. Maintenance dose = 500 mcg/kg/hr

Give undiluted (25 mg/ml)

Use max weight of 100kg to programme pump

Continuous infusion adjusted according to plasma-theophylline

levels. Administer loading dose over 20

minutes (1200s) CVC only

Amiodarone - Maintenance

Volumatic 600mg, 900mg or 1200mg

Dilute all doses to 250ml with D5W Choose from three set dilutions;

600mg/250ml 900mg/250ml 1200mg/250ml

Use after loading dose. Administer over 24 hours (10.5 ml/hr)

Amiodarone 300mg Load

Volumatic 300mg Dilute to 100ml with D5W


May administer over 20 mins in emergencies (300 ml/hr)

Amiodarone CVC Load Syringe 300mgDilute 300mg to 50ml (6 mg/ml) with

D5W

Infuse over 60 minutes (300 mg/hr)

May administer over 20 mins in emergencies (900 mg/hr)

Amiodarone CVC Syringe 600mg or 900mg over 24 hours

Dilute to 50ml with D5W Choose from two set dilutions; 600mg in 50ml = 12 mg/ml 900mg in 50ml = 18 mg/ml

Administer as a continuous infusion over 24 hours

(2 ml/hr)

Note: There is 1 Volumat and 1 Injectomat entry for Aminophylline

Note: There are 2 Volumat and 2 Injectomat entries for Amiodarone







Amoxicillin Syringe 250mg, 500mg, 1g or 2g

Dilute to 20ml with WFI (or use undiluted for 1g and 2g doses)

Choose from three set dilutions: 250mg in 20ml = 12.5 mg/ml 500mg in 20ml = 25 mg/ml 1000mg in 20ml = 50 mg/ml 2000mg in 40ml = 50mg/ml

Administer 20ml over 5 minutes and 40ml over 10 minutes

(240 ml/hr)

Amphotericin See Fungizone® (amphotericin) or Ambisome® (liposomal amphotericin)

Caution: High Risk of confusion. Ensure that you have chosen the

correct formulation of amphotericin according to the prescription

Anidulafungin VolumatDay 1: Loading dose 200mg

Maintenance Dose: 100mg once a day

Reconstitute according to manufacturer’s instructions.

Loading dose:Add 200mg to 200ml NS or D5W;

(withdraw 50ml from 250ml bag) total volume 260ml; 0.77 mg/ml

Maintenance Dose:Add 100mg to 100ml NS or D5W (total

volume 130 ml, 0.77 mg/ml)

Infuse 100mg over 90 minutes(Max rate 1.1 mg/min)

Infuse 200mg over 180 minutes(Max rate 1.1 mg/min)

Only dilute as instructed as there is a risk of precipitation

Monitor serum potassium levels







Argatroban VolumatDefault: 0.5mcg/kg/min

Maximum: 10mcg/kg/minDilute 250mg (2.5mls) with 250mls NS or

D5W (1mg/ml)

Use Uncommon Volumat Pump See protocol for dosing guidelines NOTE: 80ml (1mg/ml) sterile bags can be

prepared by Aseptic Services in Pharmacy (preferred preparation).

Ask your ward pharmacist.

Artesunate NONEGive as a hand bolus

Dose 2.4 mg/kg

Reconstitute according to manufacturer's instructions then give undiluted

(May dilute up to 20ml if required)

Give over 2 minutes

Use actual body weight

Flush line after administration

Atenolol Syringe

Programmed Bolus: 2.5mg over 2.5 - 5 mins repeated at 5

minute intervals to a maximum of 10mg .

Intermittent Infusion: 150 mcg/kg

Give undiluted (0.5 mg/ml)

Use uncommon drugs pump. IV bolus:

Use Programmed Bolus function. Administer over 2.5 - 5 minutes (120 or 60 ml/hr, respectively)

Intermittent Infusion: Infuse 150 mcg/kg over 20 mins

(7.5 mcg/kg/min)

Atracurium Syringe

Loading dose: Default: 500 mcg/kg

Max: 600 mcg/kg Soft min: 300 mcg/kg

Infusion rate: Default: 300 mcg/kg/hr

Max: 600 mcg/kg/hr Programmed Bolus: Default: 500 mcg/kg

Max: 600 mcg/kg

Use undiluted (10 mg/ml)

Loading dose: over 1 min Infusion: 300 - 600 mcg/kg/hr

Programmed bolus: fast (1200 ml/hr).

For OBESE patients, use adjusted body weight to prevent toxicity i.e.

Adjusted Weight = Ideal Body Weight + 40% (Total Weight - Ideal Body

Weight)







ATG - Test Dose Volumatic 2.5mg Dilute 2.5mg to 100ml with NS

Use uncommon Volumat pump Antithymocyte Globulin (Rabbit)

Administer over 60 minutes (2.5 mg/hr)

ATG - Aplastic Anaemia

Volumatic3.75 mg/kg

Range = 100mg - 375mgDilute dose to 500ml NS

Use uncommon Volumat pump Antithymocyte Globulin (Rabbit). Administer over 12 - 24 hours:

12h = 41 ml/hr 18h = 27 ml/hr 24h = 21 ml/hr

ATG - Kidney Rejection Volumatic1.5mg/kg

Range = 50mg - 150mgDilute dose to 500ml NS

Use uncommon Volumat pump Antithymocyte Globulin (Rabbit).

Administer dose over 6-24 hours: 6h = 83 ml/hr 12h = 41 ml/hr 18h = 27 ml/hr 24h = 21 ml/hr

Azathioprine Syringe 25mg - 360mgReconstitute with 5ml WFI per

50mg vial (10mg/ml) and dilute dose to 50mls with NS or D5W

Use Uncommon drugs pump

Administer over 30 minutes

Very irritant, flush with 50ml NS

CVC preferred

Basiliximab Syringe 20mgDilute to 50ml with NS or D5W

(0.4 mg/ml)

Use uncommon drugs pump. Administer 20mg over 30 minutes

(0.66 mg/min) Monitor for severe hypersensitivity

reactions for 24 hours.

Note: There are 3 Volumat entries for ATG







Benzylpenicillin ICU Syringe 600mg, 1200mg, 1800mg or 2400mg Dilute all doses to 20ml with NS or D5W

600mg: Administer over 4 minutes (150 mg/min)

> 600mg: Administer over 4-8 minutes

(300 mg/min)

Blood VolumaticFlow rate set at 80 ml/hr

Max: 1500 ml/hr Flow rate set at 80 ml/hr

Max: 1500 ml/hr

Cannot set flowrate related to weight -MUST verify that flow rate

appropriate for age and weight

NB: Infuse blood within 4 hours of removal from fridge

For other blood product limits see transfusion policy

Bumetanide Syringe 1-2mg bolus or 3, 4 or 5mg infusion

INR < 4 = 20 units/kgINR > 4 = 30 units/kg

Max = 5000 units per dose1-2mg Bolus:

1mg vial to 20mls (50 mcg/ml) or 2mg vial to 20ml (100 mcg/ml)

with NS or D5W 3, 4 or 5mg Infusion:

Dilute dose to 50ml with NS or D5W. 3mg in 50ml = 60 mcg/ml; 4mg in 50ml = 80 mcg/ml; 5mg in 50ml = 100 mcg/ml

Use uncommon drugs pump 1-2 mg Bolus:

Select correct dilution (50 or 100 mcg/ml)

Start infusion - then use programmed bolus to administer 1mg at 600 ml/hr

(2 minutes) or 2mg at 600 ml/hr

(2 minutes). 3, 4, or 5mg Infusion:

Infuse 3mg over 30 minutes (100 mcg/min)

4mg over 45 minutes (88 mcg/min)

5mg over 60 minutes (83 mcg/min)







C1 Esterase Inhibitor Syringe20 units/kg

Range = 600 - 2,800 units Default = 1,400 units

Use undiluted (50 units/ml)

Use uncommon drugs pump. Administer as a slow IV injection over

5 minutes (4 units/kg/min)

Caffeine Base Syringe 300-500mg base Use undiluted (10 mg/ml)

Use uncommon drugs pump. Dose and dilution expressed as caffeine

base Administer at 15 mg/min: 300mg over 20 minutes; 500mg over 33 minutes

Calcitonin (Miacalcic®)

Volumatic5-10 units/kg + 20% (due to loss of potency

when diluted) Range = 180 - 1680 units

Dilute to 500ml NS

Use uncommon Volumat pump For acute severe hypercalcaemia.

Infuse over 6 hours (83 ml/hr)

Calcium Chloride Peripheral

Volumatic 20mmolAdd 40ml of 7.35% CaCl to 460mls NS or

D5W

7.35% CaCl contains 0.5 mmol/ml Ca++

Administer over 8-12 hours 8hr = 2.5 mmol/hr; 12hr = 1.7 mmol/hr

Calcium Chloride CVC Syringe

Loading dose: 10 mmol over 10 mins (600s)

. Infusion:

20mmol over 4 hours (5mmol/hr) Can be given over 2 hours

(10mmol/hr)

Use 40ml of 7.35% CaCl to give 20mmol Ca++.

7.35% injection contains 0.5mmol Ca++ per ml

Calcium Folinate See Folinic Acid

Note: There is 1 Volumat and 1 Injectomat entry for Calcium Chloride







Calcium Gluconate 10%

Volumatic 22 mmol over 6-8 hours

10ml of 10% = 2.2 mmol. Dilute 10 ampoules (22 mmol) to 500ml

NS or D5W (remove 100ml from 500ml bag first)

Use this regimen after bolus dose. Infuse over 6 - 8 hours (2.75 - 3.67 mmol/hr)

(Hypocalcaemia - severe acute or tetany; parathyroidectomy protocol)

Calcium Gluconate 10%

Syringe

Load:10ml (2.2 mmol) bolus over

5 mins (300 s)

Repeat with programmed bolus: 2.2 mmol over 10 mins (60 ml/hr) if

necessary

May follow with maintenance infusion of 13.5 mmol over 2 hours (6.75 mmol/hr) if

required

Use undiluted (0.22 mmol/ml)

13.5 mmol = 6 x 10ml ampoules CVC preferred

This concentration suitable for hypocalcaemia and

immunoadsorption, but dose different

Capreomycin Volumatic

Usual dose 500 mg – 1g

Lower doses may be needed in renal impairment

Reconstitute according to manufacturer's instruction

Dilute all doses in 100ml NS or D5W

Use uncommon Volumat pump Infuse over 30 – 60 minutes

(100 – 200ml/hr)

Monitor electrolyte levels

Note: There is 1 Volumat and 1 Injectomat entry for Calcium Gluconate







Carnitine (L-Carnitine)

Syringe 450mg - 4000mg Dilute to 50ml with NS or D5W

Use Uncommon drugs pumpAdminister over 3 hours

Hyperammonaemia: 4g OD for 3 days

Valporic acid toxicity 15mg/kg 4 hourly

(max 6 g /day)

Caspofungin Volumatic 50mg or 70mg

Add 50mg (0.19 mg/ml) or 70mg (0.27 mg/ml)

to a 250ml bag of NS For fluid restricted patients a 50mg may

be added to 100ml NS (0.45 mg/ml)

Do not remove fluid from bag.

Must calculate mg/ml in bag in order to programme pump. Administer

over 60 minutes (50 or 70 mg/hr)

Cefotaxime Syringe 500mg, 1000mg or 2000mg

Dilute dose to 20ml with WFI Choose from three set dilutions;

500mg in 20ml = 25 mg/ml 1g in 20ml = 50 mg/ml 2g in 20ml = 100 mg/ml

Administer each 1 gram over 5 minutes

(200 mg/min)

Ceftazidime Syringe 500mg, 1000mg, 2000mg or 3000mg

Dilute dose to 20ml with WFI Choose from four set dilutions;

500mg in 20ml = 25 mg/ml 1000mg in 20ml = 50 mg/ml 2000mg in 20ml = 100 mg/ml 3000mg in 20ml = 150 mg/ml

Administer 20ml over 5 minutes (240 ml/hr)







Ceftriaxone 1g Syringe 1 gramDilute 1000mg to 20ml with WFI

(50 mg/ml)Give over 5 minutes

(200mg/min)

Ceftriaxone 2g Syringe 2 grams 2000mg to 40ml with WFI

(50 mg/ml)Administer 2g runs over 30 minutes

(66.7 mg/min)

Ceftriaxone 2g or 4g Volumatic 2 or 4 gramsReconstitute and dilute to 100ml with

D5W or NS.

Infuse 2g over 30 minutes or 4g over 60 minutes

(rate = 4g/hr)

Cefuroxime Syringe 750mg, 1500mg or 3000mgDilute to 20ml with WFI. For

3000mg dose use undiluted 30ml (100mg/ml)

Administer over 5 minutes 750mg and 1500mg = 240 ml/hr

3000mg = 360ml/hr

Chloramphenicol Syringe12.5 or 25 mg/kg/dose. Range = 375 - 3500mg

Doses up to 2000mg dilute to 20ml with NS or D5W.

For doses above 2000mg, dilute to 40ml NS or D5W

Use uncommon drugs pump. Administer bolus dose via syringe

driver over 5 minutes: For 12.5 mg/kg dose administer at

2.5 mg/kg/min; For 25 mg/kg dose administer at 5

mg/kg/min

Chloramphenicol Volumatic12.5 or 25 mg/kg/dose. Range = 375 - 3500mg

Dilute required dose in 100ml in NS or D5W

Use uncommon Volumat pump Infuse over 30-60 minutes

Default = 100 ml/hr (60mins) Max rate = 200 ml/hr (30 mins)

Note: There is 1 Volumat and 1 Injectomat entry for Chloramphenicol

Note: There are 1 Volumat and 2 Injectomat entries for Ceftriaxone







Chlorphenamine NONE Give by hand over 1 minute. Infusion pump not required

Chlorpromazine Syringe 5-25mg Dilute dose to 1mg/ml in NSGive at a maximum rate of 1mg/min.

Unlicensed route in the UK.

Ciclosporin Volumatic2 - 5 mg/kg

Range = 60 - 700mg

Each 50mg must be diluted with 20-100ml NS or D5W

(variable dilutions between 0.5 - 2.5 mg/ml)

MUST calculate mg/ml in bag in order to programme pump.

Fastest rate = 5 mg/kg over 2 hours

Infusion must be completed within 6 hours

Ciprofloxacin Volumatic 200 or 400mg Use undiluted (2mg/ml)Infuse at 400 mg/hr:

200mg over 30 mins or 400mg over 60 mins

Clarithromycin Volumatic 250mg or 500mg

Dilute 250mg with 125mls (draw out of 250ml bag) or

500mg with 250ml NS or D5W (2 mg/ml)

For fluid restricted patients, dilute to 5mg/ml

Administer over 60 minutes via a large peripheral vein (250 or 500 mg/hr)

. For 5 mg/ml concentration only

administer via CVC







Clindamycin Syringe 300, 600 or 900mg

Dilute to 50ml with NS or D5W Choose from three set dilutions;

300mg in 50ml = 6 mg/ml 600mg in 50ml = 12 mg/ml 900mg in 50ml = 18 mg/ml

Infuse 50ml over 30 minutes (100 ml/hr)

Clindamycin Volumatic 600, 900mg or 1200mg Dilute all doses to 100ml with NS or D5W

600mg: Infuse over 30 minutes

(20 mg/min) .

900mg: Infuse over 30 minutes (30 mg/min)

. 1200mg:

Infuse over 60 minutes (30 mg/min)

Clonazepam Volumatic1, 2 or 3mg

repeated if necessaryDilute all doses in 250ml NS or D5W

Give all doses over 1 - 2 hours (250 or 125 ml/hr)

BUT no longer than 2 hours. IV is potentially hazardous especially

if prolonged.

Clonazepam CVC Syringe1, 2 or 3mg

repeated if necessary

Dilute dose in 50ml NS or D5W Choose from three set dilutions:

1mg in 50ml = 0.02 mg/ml 2mg in 50ml = 0.04 mg/ml 3mg in 50ml = 0.06 mg/ml

For fluid restricted patients

Give all doses over 1 - 2 hours BUT no longer than 2 hours

(25 - 50 ml/hr) IV is potentially hazardous especially

if prolonged.

Note: There is 1 Volumat and 1 Injectomat entry for Clindamycin

Note: There is 1 Volumat and 1 Injectomat entry for Clonazepam







Clonidine Bolus Syringe 10 - 50 micrograms

Dilute dose (max 50 microgram) to 20ml with NS or D5W

(Variable dilutions between 0.5 - 2.5 microgram/ml)

Infuse over 10-15 minutes (120 - 80 ml/hr)

Clonidine High Dose SyringeDefault: 5mcg/kg/hr Max: 25mcg/kg/hr

Use four amps of 150mcg/ml and dilute to 30ml with NS or D5W to make a

20mcg/ml syringe

High dose. Use only on instruction of a Consultant

Clonidine Infusion SyringeDefault: 0.25mcg/kg/hr

Max: 2mcg/kg/hr

Use five amps of 150mcg/ml and dilute to 50ml with NS or D5W to make a 15

mcg/ml syringe

Co-Amoxiclav Syringe 600mg or 1200mg

Dilute dose to 20ml with WFI Choose from two set dilutions: 600mg in 20ml = 30 mg/ml 1200mg in 20ml = 60 mg/ml

Administer within 20 minutes of preparation.

Infuse 20ml over 5 minutes (240 ml/hr)

Note: There are 3 Injectomat entries for Clonidine







Colistin (colistimethate sodium)

Syringe 0.5 - 2 million units

Dilute all doses to 50ml NS or WFI: 0.5 million units in 50ml = 10 kU/ml 1 million units in 50ml = 20 kU/ml 2 million units in 50ml = 40 kU/ml

Use uncommon drugs pump 1000 units = 1 kU

1000 kU = 1 million unit Give over 30 minutes

(100ml/hr)

Colistin-MDR LOAD

(for Multi-Drug Resistant G-ve infections)

Volumatic

Only on advice of consultant microbiologist/haematologist

Loading dose: 9 million unitsDilute to 100ml with NS

9 million units over 2 hours (50ml/hr)

. 9 million units = 9000 kU

Colistin-MDR Maintenance

(for Multi-Drug Resistant G-ve infections)

Volumatic

Only on advice of consultant microbiologist/haematologist

Maintenance dose: 3 million unitsDilute to 100ml with NS

3 million units over 15 mins (400ml/hr)

Initiate maintenance dose 8 hours after starting the loading dose

3 Million units = 3000 kU

Note: There are 1 Injectomat and 2 Volumat entries for Colistin







Co-Trimoxazole Prophylaxis

Volumatic 480 or 960mg

Each 5mls contains 480mg of drug Dilute with NS or D5W as follows:

480mg to 125ml (3.84 mg/ml) (need to ADD volume to a 100ml bag)

960mg to 250ml (3.84 mg/ml)

For prophylactic doses only. Infuse dose over 1-2 hours

(125 ml/hr)

Co-Trimoxazole Peripheral

VolumaticEach dose is usually 30mg/kg.

Dilution range = 1.9 - 3.84 mg/ml

Each 5mls contains 480mg of drug. Dilute as below with NS or D5W:

Up to 480mg to 125ml (need to ADD volume to a 100ml bag)

481 - 960mg to 250ml; 961 - 1920mg to 500ml;

1921 - 3840mg to 1000ml

MUST calculate mg/ml in bag in order to programme pump. Infuse over 2 hours

(15 mg/kg/hr) Note: for doses above 3840mg, need

to infuse 2 bags consecutively.

Co-trimoxazole Fluid Restricted

VolumaticEach dose is usually 30 mg/kg.

Dilution range = 3.84 - 6.4 mg/ml

Dilute with D5W only Dilute each 480mg with at least 75ml of

D5W (max = 6.4 mg/ml) e.g. 384 - 640mg to 100ml 640 - 960mg to 150ml 960 - 1600mg to 250ml

1600 - 2400mg to 375ml 1920 - 3200mg to 500ml 3200 - 4800mg to 750ml 4800 - 6400mg to 1,000ml

CVC preferred Must calculate mg/ml in bag in order to programme pump. Administer over

60 minutes (max 30 mg/kg/hr)

Co-Trimoxazole CVC SyringeEach dose is usually 30mg/kg.

Default = 15mg/kg/hr Max = 20mg/kg/hr

Use undiluted = 96mg/ml

CVC only in fluid restricted patients. Treatment dose only. For prophylactic doses, cannot give via this route: use

volumetric. Give each dose over 90-120mins.

Note: There are 3 Volumat and 1 Injectomat entries for Co-trimoxazole







Cyclizine Syringe 50mg Dilute to 5-10ml with WFI or D5W to give

a dilution of 5-10mg/ml.

Administer over 10 minutes (5 mg/min)

Max rate over 5 minutes (10 mg/min)

Ensure line is flushed with 5-10ml NS or D5W

Administer within 30mins. Check for precipitation prior to administration. Discard if

cloudiness in solution.

Dalfopristin/ quinupristin

See Synercid®

Dalteparin 250ml Volumat 1000 - 5000units Dilute dose to 250ml D5W or NS

Use Uncommon Volumat PumpInfuse over 3 hours

(unlicensed preparation)

Give via CVC only

Dalteparin 500ml Volumat 5001 - 10,000units Dilute dose to 500ml D5W or NS

Use Uncommon Volumat PumpInfuse over 5 hours

(unlicensed preparation)

Give via CVC only

Note: pump locks out at 9999 units. Use this value for 10,000 unit dosing

Note: There are 2 Volumat entries for Dalteparin







Danaparoid Load Syringe

< 55kg: 1,500 units (75 units/ml)

55-90kg: 2,250 units (112.5 units/ml)

> 90kg: 3,750 units (187.5 units/ml)

Dilute all doses to 20ml NS or D5W.

Use Uncommon drugs pump Prophylaxis of thromboembolism in patients with acute HIT and isolated

thrombocytopeniaGive all doses over 5 minutes (240

ml/hr)

Danaparoid SyringeDefault: 200 units/hr Soft Min: 100 units/hr Soft max: 400 units/hr

Draw up 3000units (4 ampoules/2.4ml) and make up to a

total volume of 30ml to produce 100units/ml.

Use uncommon drugs pumpInitiate at 400 units/hr for 2 hours,

then 300 units / hr for 2 hours followed by a maintenance of 200

units/hr

If soft max exceeded, re-confirm dose with doctor

Daptomycin Syringe4-6 mg/kg (actual weight)

Range = 120 - 840mgDilute dose to 20ml NS

Use uncommon pumpUse a Central Venous Catheter or a large peripheral vein. Extreme pH -

avoid extravasation. Infuse over 30 minutes

(40 ml/hr)

Note: There are 2 Injectomat entries for Danaparoid







Desmopressin Bolus DDVAP

Syringe

0.5 - 4 microgramsDilute required dose to 20ml with NS.

Use DDVAP Brand only

Infuse 20ml over 3-5 minutes(240-400ml/hr)

Desmopressin IVI Syringe

For haemophillia, Von willebrands disease and fibrinolytic response

testing 0.3 or 0.4 mcg/kgRange = 9 - 50 micrograms

Dilute required dose to 50ml with NS. Infuse 50ml over 30 minutes

(0.6mcg/kg/hr)

Dexamethasone Syringe 0.5 - 24mg Dilute all doses to 20ml with NS or D5WAdminister 20ml over 5 minutes

(240 ml/hr)

Dexmedetomidine (Dexdor™)

SyringeDefault: 0.7mcg/kg/hr

Soft min: 0.2 mcg/kg/hrMax: 1.4mcg/kg/hr

Dilute a 2ml (100mcg/ml) ampoule to 50mls NS or D5W or Hartmanns

(4mcg/ml)

Dexmedetomidine (Dexdor™)

VolumaticDefault: 0.7mcg/kg/hr

Soft min: 0.2 mcg/kg/hrMax: 1.4mcg/kg/hr

Dilute with NS, D5W or Hartmanns: 4ml vial to 96ml (4mcg/ml)

10ml vial to 240ml (4mcg/ml)Each vial = 100mcg/ml

Remove:4ml from a 100ml bag and

add 4ml of drug10mls from a 250ml bag and

add 10ml of drug

Note: There is 1 Injectomat and 1 Volumat entry for Dexmedetomidine

Note: There are 2 Injectomat entries for Desmopressin







Dextrose 10% VolumaticFlow rate set at 50 ml/hr

Max: 150 ml/hr 10% = 100 mg/ml

Dextrose 20% VolumaticFlow rate set at 50 ml/hr

Max:150 ml/hr 20% = 200 mg/ml

CVC preferred If not via large bore preipheral vein.

Dextrose 50% CVC(Theatre only)

SyringeFlow rate set at 5 ml/hr

Max:20 ml/hr 50% = 500 mg/ml

Used in peri-operative cardiac surgical patients

CVC only

Dextrose 50% CVC VolumaticFlow rate set at 20 ml/hr

Max:100 ml/hr 50% = 500 mg/ml CVC only

Dextrose 50% with Insulin(Hyperkalaemia)

Syringe

To treat hyperkalaemia only

50ml Dextrose 50% with 10 units of soluble Human Insulin

Pump set in units/ml

0.2 units/ml

Infuse over 30 minutes (20 units/hr) as per Grey Book instructions

Check blood glucose hourly

Diamorphine Bolus Syringe 2.5 or 5mg

Dilute to 20ml with D5W or NS Choose from two set dilutions; 2.5mg in 20ml = 125 mcg/ml 5mg in 20ml = 250 mcg/ml

Use uncommon drugs pump. Administer over 5 - 10 minutes

(0.25 - 0.5 mg/min)

Note: There is 1 Volumat and 2 Syringe entry for Dextrose 50%







Diazepam or Diazepam emulsion

SyringeDefault: 1mg/min

Max rate: 5mg/minUse ready diluted 10mg in 2ml

(5 mg/ml)

MUST flush line with D5W before and after administration. Caution - risk of

thrombophlebitis with solution- emulsion preferable.

Diclofenac 24hr (Volterol®)

VolumaticLoad: 12.5mg (17ml) over 30mins (1800s)

Range = 25 - 150 mg/24hr

75mg to 100ml with NS Voltarol brand:

Add 0.5ml sodium bicarbonate 8.4% to a 100ml bag to buffer the solution. Draw

desired volume for the syringe.

For "problematic" pyrexia (consistently>38oC) e.g. brain injury

(any cause) and vasopressor resistance.

Dose escalation / reduction every 6 hours

. Usual doses:

25mg/24hr (1.4 ml/hr) 50mg/24hr (2.8 ml/hr)

75mg/24hr (4.2 ml/hr) or 150mg/24hr (8.3 ml/hr)

. Escalation if temp consistently >38oC

and reduction if temp consistently <37.2oC

Cessation of therapy when temp <38oC for 12 hours on 25mg/24hrs.

Diclofenac Bolus (Voltarol®)

Volumatic 50mg or 75mgAdd 0.5ml of 8.4% Sodium Bicarbonate

injection to 100ml NS or D5W as a buffer before adding diclofenac

Rate set at 150 mg/hr 50mg = 20 minutes 75mg = 30 minutes

Licensed for a max of 2 days

Note: There are 2 Volumat entries for Diclofenac







DigiFab 20ml

(for up to 5 vials)Syringe

20mg - 3200mg Dosing dependant on number of digoxin tablets ingested or known digoxin levels.

Maximum 5 vials (200mg) via this entry

Reconstitute according to manufacturer’s instructions

Dilute to final volume of 20ml with NS

Use uncommon drugs pump

Maximum rate over 30 minutes(= 40ml/hr). Reduce rate if required

Use within 4 hours of reconstitution.

Hand bolus if cardiac arrest is imminent - doctor only

DigiFab 60ml

(for 6 – 15 vials)Syringe

20mg - 3200mg Dosing dependant on number of digoxin tablets ingested or known digoxin levels.

Only 6 to 15 vials (max 600mg) via this entry

Reconstitute according to manufacturer’s instructions

Dilute to final volume of 60ml with NS

Use uncommon drugs pump

Maximum rate over 30 minutes(= 120ml/hr). Reduce rate if required

Use within 4 hours of reconstitution.

Hand bolus if cardiac arrest is imminent - doctor only

Digoxin Syringe 50 - 500 micrograms Dilute dose to 20ml with NS or D5W.

Infusion rate set to administer dose over 30 minutes

(40 ml/hr) Use this for all doses i.e load and

maintenance

Disopyramide Syringe

Load = 2 mg/kg (max 150mg) over 5 mins (300s)

Default = 100mg given under direct supervision of a doctor

Then infusion if necessary 0.4mg/kg/hr Max 300mg in the first hour

then 800mg daily

Use undiluted - use up to ten ampoules 50mg/5ml (10mg/ml). Dilute if necessary

with NS or D5WUse uncommon drugs pump

Note: There are 2 Injectomat entries for DigiFab







Dobutamine Syringe 5 - 20 mcg/kg/min

Dilute with D5W or NS Choose from two set dilutions:

250mg/20ml to 50ml = 5 mg/ml 500mg/40ml to 50mls = 10 mg/ml

If peripheral route used, MUST be via a large vein.

CVC only = 10mg/ml

Dopamine CVC SyringeDose: 1.5 - 7.5 mcg/kg/min

Default:Start at 2.5 mcg/kg/min and titrate to response

Dilute 200mg in 50ml (4 mg/ml) with D5W or NS

Via CVC only Do not exceed 7.5 mcg/kg/min (soft max) without Doctors authorisation

Dopamine Peripheral Volumatic Dose: 1.5 - 7.5mcg/kg/min

Default = Start at 2.5 mcg/kg/min and titrate to response

Dilute 400mg in 250ml (1.6mg/ml) with D5W or NS

Administer via a large vein Do not exceed 7.5 mcg/kg/min

(soft max) without Doctors authorisation

Dopexamine Syringe 0.25 - 2 mcg/kg/min.Dilute 25mg in 50ml (0.5mg/ml) with

D5W or NS

Rate = 0.25 - 2 mcg/kg/min Do not exceed 1 mcg/kg/min

(soft max limit) without Doctors authorisation.

If peripheral route used, MUST be via a large vein.

Doxapram VolumaticInitial Dose = 5 mg/min and decrease to

maximum of 3 mg/min Ready diluted 1000mg in 500ml

Note: There are is 1 Injectomat and 1 Volumat entry for Dopamine







Ephedrine SyringeDefault: 0.6 mg/min

Max: 1.7 mg/min

One ampoule is 30mg/ml Dilute to 10ml with NS or D5W

(3 mg/ml)

Use uncommon drugs pump. Administer 3-5mg over

3 - 5 minutes (0.6 - 1.7 mg/min)

Ensure line is primed. Observe response and repeat as required. May

be repeated (max 30mg).

Epoprostenol (prostacyclin) Flolan® CVVH/CVVHDF

Syringe5 - 20 nanograms/kg/min into the blood

dialyser

Reconstitute using the diluent provided to give a concentrate of 10,000

nanograms/ml (10 mcg/ml)

. Withdraw 25mls into 50ml syringe

and dilute to 50ml with NS (5 mcg/ml)

. or use undiluted (10 mcg/ml)

. (stable for 12 hours at room

temperature)

Use uncommon drugs pump During CVVH/CVVHDF to protect filter in patients with low platelet count or

heparin intolerance .

Attach a 5 micron filter supplied between the syringe and

administration line .

Keep concentrate in fridge to be used within 24 hours

(use IV label to sign, time and date vial)

Epoprostenol (prostacyclin) Flolan® PAH via NEBULISER

Syringe

NOT FOR INTRAVENOUS ADMINISTRATION - VIA NEBULISER

ONLY Default: 2 nanograms/kg/min Max: 20 nanograms/kg/min

Reconstitute using the diluent provided to give a concentrate of 10,000

nanograms/ml (10 mcg/ml)

. Use undiluted (10 mcg/ml). Draw 50ml

(500 mcg) into a 50ml syringe .

(stable for 12 hours at room temperature)

NOT FOR INTRAVENOUS ADMINISTRATION - VIA NEBULISER

ONLY For pulmonary arterial hypertension

according to local protocol

Ertapenem Syringe 500mg or 1000mg Dilute 500mg or 1g to 50ml with NS

Infuse over 30 minutes (100ml/hr)

Observe patient initially for anaphylaxis

Note: There are 2 Injectomat entries for Epoprostenol only ONE is for IV use







Erythromycin 250mg Syringe 250mg used as a prokinetic

Reconstitute each 1g vial with 20ml WFI (50 mg/ml)

Draw out 5ml (250mg) and dilute to 50ml NS (5 mg/ml)

Administer over 30-60 minutes (250-500 mg/hr)

One vial will keep for 24 hours in the refrigerator. Please mark time and

date on vial

Erythromycin CVC Syringe 250 or 500mg used as a prokinetic

Reconstitute each 1g vial with 20ml WFI (50 mg/ml). Draw out dose (5ml =

250mg, 10ml = 500mg) and dilute to 10 mg/ml with NS

Via CVC only Infuse 250mg over 1 hour and

500mg over 2 hours (250 mg/hr)

Fluid restricted patients only Cardiac monitoring recommended

(extension of QR interval)

Erythromycin Volumatic 500mg or 1000mg

Reconstitute each 1g vial with 20ml WFI (50 mg/ml). Draw out dose (500mg =

10ml; 1000mg = 20ml) and further dilute with NS

Choose from two set dilutions: 500mg to 100ml (5 mg/ml) 1000mg to 250ml (4 mg/ml)

Infuse 500mg over 30-60 minutes (16.7 - 8.3 mg/min)

Infuse 1000mg over 60 minutes (16.7 mg/min)

Note: There are 1 Volumat and 2 Injectomat entries for Erythromycin







Esmolol Volumatic

Loading dose: 500mcg/kg over one minute

Maintenance: Default:50 - 200 mcg/kg/min

Re-Load Dose: 500 mcg/kg over one minute

Use 2500mg /10ml ampoule and dilute to 250ml NS or D5W

Use Loading dose to infuse 500 mcg/kg over 1 min

To re-load, need to turn off pump then use loading dose function to give

500 mcg/kg over 1 minGive all loading doses under direct

supervision of a doctor

CVC preferred

Take care with loading doses to ensure pump set correctly

Ethambutol Volumatic15 mg/kg

Range = 450 - 2000mg Dilute all doses to 500ml NS or D5W

Use uncommon Volumat pump Administer over 2 hours

(250 ml/hr) Only for MYAMBUTOL® brand

Fentanyl Syringe

Load: 25-100mcg over 1-2 mins then start infusion

at 100 mcg/hour .

Infusion: Max: 400 mcg/hour

. Programmed bolus:

25-50 mcg over 30s to 1 min

Use undiluted (50 mcg/ml)







Flecainide Load / First Hour

Syringe

Load: 2mg/kg (max 150mg) then First Hour Infusion:

1.5 mg/kg given over 60 minutes May be followed by a maintenance infusion

see 'Flecainide 24 hour'

Use undiluted 150mg/15ml (10mg/ml) .

Draw up Total Dose (both load and first hour dose) into a 50ml syringe

. Example calculation:

For an 80kg patient. Load = 2 mg/kg (max 150mg) + first hour (80mg x 1.5

mg/kg = 120mg) Total Dose = 150mg + 120mg = 270mg

= 27 ml

Use uncommon drugs pump Loading Dose: Use loading dose function on pump to administer

loading dose (max 150mg) over 10 mins (600s) or 30 mins (1800s)

. First Hour Infusion: Administer

over 60 mins (1.5 mg/kg/hr)

. Maintenance Infusion:

See 'Flecainide 24 hour' NB max cumulative dose in 24hr = 600mg IV

treatment usually restricted to 24 hours

Flecainide 24 hour Volumatic

Given after loading dose and First Hour (see above)

Start maintenance infusion 100 - 250 mcg/kg/hour

Dilute 150 - 600mg to 500ml with D5W

Use uncommon Volumat pump. NB: Max cumulative dose in 24 hours is

600mg (including load and First Hour) IV treatment usually restricted to 24

hours only

Note: There is 1 Volumat and 1 Injectomat entry for Flecainide







Flucloxacillin Syringe 250mg, 500mg, 1000mg or 2000mg

250mg, 500mg or 1000mg dose: Dilute dose to 20ml with WFI: 250mg in 20ml = 12.5 mg/ml 500mg in 20ml = 25 mg/ml 1000mg in 20ml = 50 mg/ml

For 2000mg dose: Dilute 2g up to 40ml with WFI

(50 mg/ml)

2g runs over 10 minutes (240 ml/hr)

all other doses run over 5 minutes (240 ml/hr)

Fluconazole Volumatic 50 - 400mgUse ready diluted preparation

200mg/100ml (2mg/ml)

NB: May not need to administer entire bottle. Therefore, must calculate VTBI to deliver the correct dose for patient

weight. Flow rate set at 10-20 mg/min

i.e. each 100mg over 5-10 mins

Flucytosine Volumatic Dose = 25 - 50 mg/kgProvided ready-diluted as 2.5g in 250ml

(10 mg/ml)

NB: May not need to administer entire bag. Therefore, must calculate VTBI to deliver the correct dose for

patient weight. Rate: 50 - 100 mg/kg/hr to

administer dose over at least 30 minutes

NB. The infusion duration must be balanced with the fluid requirements of the patient and large volumes may

need to be infused over longer periods







Fluids Volumatic

Flow rate set at 80 ml/hrMax: 1500 ml/hr

Programmed bolus set at 500-1000ml given over 20 - 40mins

(1000 - 1500 ml/hr)

Use for: Dextrose 5%,

Dextrose 4%/Sodium chloride 0.18%, Dextrose 5%/Sodium chloride 0.45%, Dextrose 5%/Sodium chloride 0.9%,

Hartmanns, Sodium Chloride 0.9%,

Volplex For programmed bolus, dextrose-

containing fluids NOT recommended. Cannot set flowrate related to weight -

MUST verify that flow rate appropriate for age and weight

Flumazenil SyringeDefault: 100 mcg/hr

Max: 400 mcg/hrDilute 500mcg to 50ml with NS or D5W

(10 mcg/ml)

Flush SyringeUse compatible flush

Range = 1 - 1200 ml/hrTypically NS or D5W. Administer flush (in ml/hr) at same

rate as previously administered drug

Flush VolumaticUse compatible flush

Range = 1 - 1500 ml/hrTypically NS or D5W. Administer flush (in ml/hr) at same

rate as previously administered drug

Folinic acid (calcium Folinate)

Syringe 15 - 30mg Dilute to 20ml with NS or D5WUse uncommon drugs pump. .


Note: There is 1 Volumat and 1 Injectomat entry for 'Flush'







Foscarnet Volumatic6 - 120 mg/kg

Range = 180mg - 12gDiluted to 12 mg/ml by Pharmacy

Technical Services

Infuse over at least 60 minutes. The maximum rate is

1 mg/kg/min NB. Because of wide dose variation

caution programming pump and ensure infusion runs over at least 60

mins Ensure adequate hydration

Foscarnet 24hr CVC Volumatic 45-120 mg/kg/24hrs

Use undiluted. Prepared by Pharmacy Technical Services but can use from

original bottle (one per 24 hours) until request can be made from Technical

services. Note 6g/250ml or 12g/500ml =

24 mg/ml

Via CVC Only NB.

Ensure adequate hydration

Foscarnet CVC Volumatic6-120 mg/kg

Range = 180mg - 12g

Use undiluted. Prepared by Pharmacy Technical Services

Note 6g/250ml or 12g/500ml = 24 mg/ml

Via CVC Only Infuse over at least 60 minutes

The maximum rate is 1 mg/kg/min

NB. Because of wide dose variation caution programming pump and

ensure infusion runs over at least 60 minutes

Ensure adequate hydration

Fosfomycin (Fosfocina™)

Volumatic 1g, 2g or 4g

Reconstitute:1g vial with 10ml WFI

4g with 20ml WFI

Then dilute to 200ml D5W1g in 200ml (5mg/ml)2g in 200ml (10mg/ml)4g in 200ml (20mg/ml)

Use Uncommon Volumat Pump

Give over 60 minutes (200ml/hr)

2-4g 6 hourly in combination with other antibiotics

Note: There are 3 Volumat entries for Foscarnet







Fungizone® (amphotericin)

Volumatic 0.25 - 1 mg/kg over 2-4 hours

Use buffered D5W to dilute dose Add 1ml buffer to each 250ml D5W

before adding amphotericin; .

Doses up to 25mg in 250ml Doses of 26-50mg in 500ml

Doses of 51-100mg in 1000ml Dilution Range: 30 - 100 mcg/ml

. NB MUST calculate dilution in mcg/ml in

order to programme pump

Use uncommon Volumat pump NO TEST DOSE REQUIRED. Infuse dose over 2 - 4 hours

(0.13 - 0.5 mg/kg/hr)

Fungizone® CVC (amphotericin)

Volumatic 0.25 - 1 mg/kg over 2-4 hours

Add 1 ml buffer to each 250ml D5W before adding Amphotericin

Dilute to a concentration between 75 - 500 micrograms/ml using buffered

D5W

Fungizone® CVC (amphotericin)

Syringe

Usual dose range is 0.25 - 1mg/kg over 2-4 hours

Infusion: Default: 0.13mg/kg/hr Max: 0.5mg/kg/hr

Add 1 ml buffer to each 250ml D5W before adding amphotericin.

Dilute to a concentration between 15 - 500 micrograms/ml using buffered D5W

Furosemide Bolus (frusemide)

Syringe 20mg - 500mg

Doses 200mg or less: Dilute dose up to 20ml with NS

. Doses greater than 200mg: Use

undiluted (10 mg/ml)

For intermittent infusion Administer no faster than 240 mg/hr (4 mg/min)

Furosemide 24hr (frusemide)

Syringe 1 - 10 mg/hrChoose from two set dilutions: 50mg

to 50ml with NS (1mg/ml) Undiluted 10mg/ml

Use undiluted for fluid restriction

Note: There are 2 Volumat and 1 Injectomat entry for Fungizone

Note: There are 2 Injectomat entries for Furosemide

Use uncommon Volumat pump NO TEST DOSE REQUIRED







Ganciclovir Volumatic1.25-5 mg/kg

Range = 37.5 - 700mg Dose is diluted to 100ml NS by Pharmacy Technical Services (immunosuppressant)


Gentamicin < 120mg Syringe

Variable Dilution: Min = 2mg/ml Max = 6mg/ml

Default = 4 mg/ml

Dilute dose to 20ml with NS or D5W. Administer 20ml over 5 minutes

(240 ml/hr)

Gentamicin >120mg Syringe

Variable Dilution: Min = 2.4 mg/ml Max = 10 mg/ml

Default = 7 mg/ml

Dilute required dose to 50ml with NS

Give over 30 minutes (100 ml/hr)

Note: Dose should never go above 500mg

Glucagon Syinge

Load: Default: 2mg Max: 10mg

. Infusion:

50 mcg/kg/hr

Reconstitute vials with D5W not diluent provided. Use 25 vials to make a (0.5

mg/ml) 50ml syringe or 5 vials to make a (0.1 mg/ml) 50ml syringe

Use uncommon drugs pump For ß-blocker overdose

Note: There are 2 Injectomat entries for Gentamicin







Glyceryl Trinitrate (GTN)

Syringe

Default: 1 mg/hr and titrate according to response

Soft max: 12 mg/hr Max: 20 mg/hr

Programmed bolus: 2mg fast (60mg/hr)

Use ready diluted vials (1 mg/ml)

Nursing staff have the authority to exceed the soft limit but must inform

doctor due to possible GTN resistance. Review if still on infusion

after 48 hours. For high dose boluses in severe

decompensated heart failure: Repeat programme bolus every 3-5

mins. Max 20mg in 30mins

Heparin (unfractionated)

Syringe

MUST SEE GREY BOOK .

Load: 5000-9999 units then start infusion and

adjust according to APTT .

Soft max: 2500 units/hr IF EXCEEDED, must contact

haematologist on bleep 6068

Dilute 25,000 units (25kU) to 50ml with NS

(500 units/ml)

Omit loading dose if high risk of haemorrhage. Doses above 2500

units/hr, need haematology advice as possible heparin resistance.

Heparin HaemOnc (unfractionated)

Syringe 100 units/kg/24 hoursDilute 25,000 units (25kU) to 50ml with

NS (500 units/ml)

Use Uncommon Drugs Pump In haematology transplant patients only. Continued to day 21 post transplant.







Hydralazine Bolus Syringe 5 - 10mgDilute to 10ml with NS

(0.5 - 1 mg/ml)

Infuse over 5 to 20 minutes 5 minutes = 120 ml/hr 20 minutes = 30 ml/hr

The injection must be given immediately and any remainder

discarded

Hydralazine 24hr Syringe Initial Rate = 200-300 mcg/min Maintenance = 50 - 150 mcg/min

Dilute with NS to 1 mg/ml (e.g. 40mg in 40ml or 60mg in 60ml)

Soft Max = 150 mcg/min Max = 300 mcg/min

Hydrocortisone Infusion

Syringe Continuous Infusion: 10 mg/hr

Reconstitute according to manufacturer's instructions

Dilute 100mg to 50ml withNS or D5W (2 mg/ml)

Use hydrocortisone sodium succinate

Infusion used as a vasopressor sparing agent

Hydrocortisone Bolus Syringe 25, 50, 100 or 500mg

Reconstitute according to manufacturer's instructions then dilute to 20mls with NS or D5W Choose from four set dilutions:

25mg in 20ml = 1.25 mg/ml 50mg in 20ml = 2.5 mg/ml 100mg in 20ml = 5 mg/ml 500mg in 20ml = 25 mg/ml

Use hydrocortisone sodium succinate. Give over 5 minutes

(240 ml/hr)

Note: There are 2 Injectomat entries for Hydralazine

Note: There are 2 Injectomat entries for Hydrocortisone







Hyoscine Butyl Bromide (Buscopan®)

Syringe 20mg Dilute 20mg to 20ml with NS or D5W

(1 mg/ml)Administer 20mg over 5 minutes

(4 mg/min)

Hyoscine hydrobromide

Syringe 300 - 600mcg Dilute dose to 20mls with WFI

Use uncommon drugs pump .

Pump set at 240ml/hr to enable doses given over 5 minutes

For acute use only e.g. in severe nausea and vomiting. Monitor for

bradycardia

Ibandronate Bone Volumatic

Dose = 6mg .

Renal Dose: CrCl 30 - 50 ml/min = 4mg CrCl < 30 ml/min = 2mg

Dilute 6mg in 100ml (60 mcg/ml) NS or D5W infuse over 15 minutes

. Renal dose:

4mg (8 mcg/ml) or 2mg (4 mcg/ml)

to 500ml NS or D5W infuse over 75 minutes

For skeletal events. Rate for all doses = 400 ml/hr

Ibandronate Hypercalcaemia

VolumaticSet dilutions:

2mg, 4mg or 6mgDilute all doses to 500ml with NS or D5W


Note: There are 2 Volumat entries for Ibandronate







Iloprost Syringe 50 micrograms - vascular protocolDilute 50 mcg to 25ml with NS or D5W (2

mcg/ml)

Unlicensed medicine. See iloprost protocol on Trust intranet for

administration info. Infusion is limited to one six hour infusion per day. No

bolus. No continuous infusion.

Immunoglobulin, human

See Privigen®, Octagam® 5% or Vigam®

Infliximab Volumatic 3 - 7.5 mg/kg Dilute all doses to 250ml with NS.

Range: 90 - 1000 in 250ml

Use only an infusion set with an in-line, sterile, non-pyrogenic, low protein-binding filter (pore size 1.2

micrometer or less). Infuse over 2 hours

(120 ml/hr)

Insulin Syringe

Default: 2 units/hr

Soft min: 0.5 units/hr

Soft Max: 10 units/hr

Max: 20 units/hr

Programmed bolus:5 units over 3 - 5 mins

Dilute 50 units to 50ml with NS (1 unit/ml)

Soluble short acting insulin e.g. Actrapid

MUST monitor blood sugar regularly

Starting rate according to sliding scale / blood sugars.

Do not exceed soft max without Doctor's authorisation

Insulin (high dose) Volumatic

Default: 0.5 unit/kg/hr

Max: 10 unit/kg/hr

Load: 0.5 - 1 unit/kg units over 3 - 5 mins

Dilute 500 units to 500ml with NS (1 unit/ml)

For use in calcium channel blocker and beta blocker overdose only

MUST be accompanied with a glucose infusion

Note: There is 1 Injectomat and 1 Volumat entry for Insulin







Intralipid 20% Volumatic

Load with bolus: 1.5 ml/kg over 1 min then start infusion: 0.25 ml/kg/min. Repeat bolus

dose twice at 5 min intervals if adequate circulation has not been restored. Increase

infusion rate to 0.5 ml/kg/min after a further 5 min if circulation still not restored.

Note: Maximum possible pump flow rate is 1500 ml/hr (25 ml/min)

Use ready made bag 20%

For severe local anaesthetic toxicity. See association of anaesthetists protocol. Use programmed bolus

function to administer loading dose (1.5 ml/kg over 1 min) and

subsequent bolus doses. Must calculate ml/hr required as

pump set in ml/hr not ml/kg

Iron Sucrose (Venofer®)

Volumatic Dose: 100 or 200mg Dilute all doses to 100ml with NS Infuse at 400mg/hr

Isoniazid Syringe 200 - 900mg Dilute dose to 20ml with WFI Administer dose over 5 minutes

(240 ml/hr)







Isoprenaline SyringeLoad: 20-60mcg Default: 2mcg/min

Max: 20mcg/minDilute 2mg (base) (40mcg/ml) or 4mg (80mcg/ml) in 50ml D5W

Use uncommon drugs pump. CVC only

Cardiac arrthymias (emergency) = IV bolus (load) of 20-60mcg over 3-5mins then start an infusion initial

dose at 5mcg/min then adjust between 2-20mcg/min

Temporary measure until pacemaker therapy = 2-

10mcg/min Shock = 0.5-5mcg/min. Max 1 hour in septic shock.

Itraconazole Volumatic 200mg

Dilute ampoule with diluent provided (NS) 250mg in 75ml = 3.33 mg/ml

200mg dose = 60ml final solution .

IMPORTANT: follow instructions on package insert

CVC preferred .

Infuse 60ml only (= 200mg) over 60 minutes (60 ml/hr)

via 0.2 micron in-line filter Flush line before & after according to

manufacturers instructions

Ketamine Syringe

Load: Only give under Dr Supervision

0.5 - 2 mg/kg over 1 min

Continue infusion: 0.2 - 4 mg/kg/hour

Programmed bolus 0.5 - 1 mg/kg (FAST)

Dilute to 10 mg/ml or 25 mg/ml with D5W or NS (unlicensed practice)

Can use 50 mg/ml in fluid restricted patients only







Labetalol Bolus Syringe

50mg over at least one minute. If necessary, doses of 50mg may be repeated at five

minute intervals until a satisfactory response occurs. The total dose should not exceed

200mg.

Use undiluted (5 mg/ml) Must use 10ml syringe to ensure only

single dose per syringe


Maximum rate = over one minute (50 mg/min)

Labetalol Infusion Syringe

Loading dose: over 60 seconds

Default:5mg Max:10mg

. Infusion:

Default: 15 mg/hr Max: 180 mg/hr

Soft Min: 5 mg/hr Soft Max: 120 mg/hr

Give undiluted (5 mg/ml)

Administration rate varies according to indication. See SmPC on

www.medicines.org.uk for infoand confirm before exceeding soft max

limit. Blood pressure and pulse rate should be monitored throughout the

infusion.

Lacosamide Syringe 50, 100, 150 or 200mg Dilute all doses to 20mls NS or D5W. NOTE: For 200mg use undiluted (10

mg/ml)

Infuse over 15-60 minutes (80-20 ml/hr, respectively)

Levetiracetam Load Volumatic20-40 mg/kg

Range: 600 - 4800mgDilute dose to 250ml with NS or D5W

Infuse over 10 minutes (1500 ml/hr)

Levetiracetam Volumatic 250 - 1500mg Dilute dose to 100ml with NS or D5WInfuse over 15 minutes

(400 ml/hr)

Levofloxacin Volumatic 125mg - 500mg

Use undiluted bottles (5 mg/ml) 50ml contains 250mg 100ml contains 500mg

For 125mg dose set the VTBI to 25ml

Infuse at a maximum rate of 500 mg/hr

Give via CVC or large peripheral veinMonitor BP

Note: There are 2 Injectomat entries for Labetalol

Note: There are 2 Volumat entries for Levetiracetam







Levomepromazine Syringe 12.5 or 25mg

Dilute all doses to 20ml NS or D5W Two set dilutions:

12.5mg in 20ml = 0.63 mg/ml 25mg in 20ml = 1.25 mg/ml


Levosimendan Volumatic

Continuous Infusion: Start at 0.1 micrograms/kg/min and titrate

according to response (see comments). Loading Dose (usually omitted): 12-24 micrograms/kg over 10 minutes (600s)

Mix one vial of levosimendan (12.5mg) with 250ml D5W

Unlicensed medicine - see protocol. Infuse via independent lumen. Monitor BP & HR for 30mins

If infusion not tolerated reduce rate to 0.05 micrograms/kg/min

Lidocaine CVC (lignocaine)

SyringeLoading Dose: 50 - 100mg over 2 mins

(120s) immediately followed by Infusion: Maximum 4mg/minute

Use undiluted 2% to 50ml (20mg/ml)

Use uncommon drug pump Use loading dose function to infuse 50 - 100mg over 2 mins then set VTBI

for subsequent doses as per consultant direction only.

24 hours only

Lidocaine (lignocaine)

Volumatic

Loading Dose: 50 - 100mg over 2 mins (120s) immediately followed by:

Infusion: Maximum 4mg/minute for 30minutes then 3mg/minute for 2 hours,

then 2mg/minute for 2 hours then1 mg/minute

Reduce concentration further if infusion continues beyond 24 hours

Use ready diluted preparations: 0.1% in 500ml D5W (1mg/ml) or 0.2% in 500ml D5W (2mg/ml)

Use loading dose function to infuse 50 - 100mg over 2 mins then set VTBI

for subsequent doses:

For 0.1% Infusion:4 mg/min for 30min = 120ml3 mg/min for 2 hours =360ml2 mg/min for 2hrs = 240ml

then 1 mg/minute to continue

For 0.2% Infusion:4 mg/min for 30min = 60ml

3 mg/min for 2 hours = 180ml2 mg/min for 2hrs = 120ml

then 1 mg/minute to continue

Note: There is 1 Injectomat and 1 Volumat entry for Lidocaine







Liothyronine Syringe Usually 5 - 20 microgram bolusDilute dose up to 10mls with WFI (0.5 -

2microgram/ml)

Use uncommon drugs pumpGive over 5 minutes(1 - 4 microgram/min)

MUST flush line with 5 - 10ml NS.

Preferably via a CVC line

Linezolid Volumatic 600mg Use ready-made bag (600mg in 300ml)

Infuse over 30 - 120 minutes: 30 minutes = 1200 mg/hr 60 minutes = 600 mg/hr 120 minutes = 300 mg/hr

Lorazepam Syringe Dose: 0.5 - 4mg Dilute each 4mg/ml ampoule with 1ml NS

or WFI to make 2mg/ml Use a 5ml syringe

Store in a refrigerator Max time at room temperature = 30

minutes .

Administer over 2 - 5 minutes (max 2 mg/min)

Due to small volume, ensure line is flushed with NS







Magnesium Sulphate Bolus

Syringe 4mmol or 8mmol

Dilute to 20ml with NS or D5W Choose from two set dilutions:

4 mmol = 0.2 mmol/ml 8 mmol = 0.4 mmol/ml

Give over 5 minutes (240 ml/hr)

Magnesium Sulphate Infusion

SyringeDefault = 5 mmol/hr

Max = 10 mmol/hr (CVC only)

Peripheral: Dilute 20mmol to 50ml with NS or D5W

(0.4 mmol/ml) .

CVC only: Dilute 40mmol to 50ml with NS or D5W

(0.8 mmol/ml) Can also put 20mmol in 25 mls

4 mmol = 2ml of 50% (1g) 20 mmol = 10ml of 50% (5g)

. Peripheral route:

4 - 20 mmol over 4 hours (max 5 mmol/hr)

. CVC only:

Max 20mmol over 2 hours (10 mmol/hr)

Magnesium Sulphate 10% (eclampsia)

Syringe4000mg load then

1000 mg/hr for 24 - 48 hoursUse 10% solution undiluted

(100 mg/ml)

Use uncommon drugs pump Use loading dose setting on pump to

administer 4000mg load over 20 mins (1200s)

. Then administer infusion at

1000 mg/hr ECG monitoring mandatory

Magnesium Asthma Volumatic 8 mmol (2g) Dilute in 250ml NS

Infuse over 20 minutes (750ml/hr)For acute asthma

8mmol = 4ml of 50% Magnesium sulphate

Mannitol 20% Volumatic0.25 - 1 g/kg

repeated if necessary once or twice after 4 - 8 hours

20% = 200mg/ml

CVC preferred If not via large bore preipheral vein

Infuse over 20 minutes via an in-line filter

(2 -3 g/kg/hr)

Note: There are 3 Injectomat and 1 Volumat entries for Magnesium







Meropenem 500mg or 1g

Syringe 500mg or 1g

Dilute if necessary to 20ml with NS Choose from two set dilutions: 500mg in 20ml = 25 mg/ml 1000mg in 20ml = 50 mg/ml


Meropenem 2g Syringe 2gDilute 2g to 50ml with NS

(40 mg/ml)Infuse 2g over 15 minutes

(200 ml/hr)

Meropenem 4hr Syringe 500mg, 1g or 2g

Dilute all doses to 50ml with NS Choose from three set dilutions:

500mg = 10 mg/ml 1000mg = 20 mg/ml 2000mg = 40 mg/ml

For prolonged infusions Infuse 50mls over 4 hours

(12.5 ml/hr)

Metaraminol SyringeDefault: 1ml/hr

Maximum: 10ml/hrDilute 10mg to 20ml NS or D5W

Maximum 6 hour infusion. CVC preferred or via a large

peripheral vein due to low pH of preparation

Methylene Blue (Methylthioninium chloride)

Syringe

Loading & bolus dose: For methaemoglobinaemia, NO poisoning and

treatment of septic shock (for low SVR)

. 2mg/kg over 5 minutes

(300s) .

Intermittent infusion: 0.25 - 2 mg/kg/hr

Dilute 25ml (250mg) from an ampoule to 50ml with D5W

(5 mg/ml)

Use uncommon drugs pump For bolus dose ONLY, use loading dose function then stop infusion

Monitor: Methaemoglobinaemia (large doses).

Blue colour to urine and skin can hinder diagnosis of cyanosis. In veiw of potential for CNS toxicity avoid use in patients recently treated with SSRI

antidepressants

Note: There are 3 Injectomat entries for Meropenem







Methylprednisolone 10 - 250mg

Syringe 10 - 250mg Dilute required dose to 20ml with NS Administer 20ml over 5 minutes

(240 ml/hr)


Syringe 250 - 2000mg

Dilute doses between 250mg-1000mg to 20ml with NS or D5W

(12.5 - 50 mg/ml) .

Dilute doses between 1000-2000mg to 40ml with NS or D5W

(25 - 50 mg/ml)

Use methylprednisolone sodium succinate

For fluid restricted patients Administer 20ml over at least

30 minutes and 40ml over at least 60 minutes (40 ml/hr)


Volumatic 250 - 1000mg Dilute to 100ml with NS or D5W

Use methylprednisolone sodium succinate. Administer over


Methylprednisolone ARDS

Volumatic

Loading Dose: 1 mg/kg then

. Infusion:

0.125 - 1 mg/kg/24hr

Dilute to 250ml with NS or D5W Choose from three set dilutions: 40mg in

250ml 80mg in 250ml 500mg in 250ml

Use methylprednisolone sodium succinate. As per Miduri Trial

Loading Dose: Administer over 60 minutes (3599s)

Infusion: Day 1 - 14: 1 mg/kg/24hr

Day 15-21: 0.5 mg/kg/24hr Day 22-25: 0.25 mg/kg/24hr Day 26-28: 0.125 mg/kg/24hr

If patient extubates between day 1-14 advance to day 15 of therapy

Note: There are 3 Volumat and 3 Injectomat entries for Methylprednisolone (continued on next page)







Methylprednisolone Neuro LOADING DOSE(on pump as Methylpred Load)

volumatic 900 - 4,200mg Reconsitute vials and dilute to 250ml NS

(3.6mg/ml - 16.8mg/ml)

Use Uncommon Drugs PumpUse methylprednisolone sodium

succinate. Remove fluid from infusion bag if necessary

Loading dose 30mg/kg over 15 minsFor acute spinal cord injury

Methylprednisolone Neuro

Syringe 5.4mg/kg/hour

Dilute 3000mg to 60ml with NS (50mg/ml)

Use Uncommon Drugs PumpWait 45 mins after the loading

dose before starting the infusionUse methylprednisolone sodium

succinateFor acute spinal cord injury. Usually

for 24 hours only

Metronidazole Volumatic 500mgSupplied ready diluted

500mg in 100ml Infuse over 20 minutes

(25 mg/min)

Metoclopramide Syringe 10mgDilute 10mg to 20ml with NS

(0.5 mg/ml)

May be given as a hand bolus over 2 mins. Dilute to 10ml NS.

Use only 20ml syringes. Administer 10mg over 5 minutes

(2 mg/min)

Metoprolol Syringe5mg

Repeated after 5mins if necessary to total dose of 10 - 15mg

Dilute 5mg to 20ml with NS or D5W (0.25 mg/ml)

Inject slowly at 1 - 2 mg/min .

Use only a 20ml syringe to ensure only single dose administered

Metoprolol 24hr SyringeDefault = 0.5mg/hr

Max = 5mg/hr Dilute 20mg in 50ml NS or D5W

Use uncommon drugs pump. Titrate dose to a target heart rate. IV indication only as transition onto oral

therapy.







Midazolam Syringe

Load: adminstered over 60s

Default = 1mg Max = 3mg

. Infusion:

Default = 2 mg/hr Max = 14 mg/hr

. Programmed bolus = 1mg (FAST)

Further dilute TEN x 10mg/2ml ampoules to 50ml with NS or D5W to give

100mg/50ml (2 mg/ml)

Only 10mg/2ml ampoules to be kept in the CD cupboard

Milrinone Syringe

100-600 nanograms/kg/min (max = 900 nanograms/kg/min)

. Load:

(if necessary) 50 mcg/kg over 20 minutes

(1200s) .

Starting Dose: 300 nanograms/kg/min and titrate to response

Dilute a 10mg ampoule to 50ml with NS or D5W to produce a 0.2 mg/ml solution

(= 200 mcg/ml)

Do not exceed soft max limit (600 nanograms/kg/min) without Doctors

authorisation

Morphine Syringe

1-12 mg/hour .

Start at 5 mg/hour and titrate to response .

Use programmed bolus of 1mg-2mg (FAST).

Usually prefilled syringes of 50mg in 50ml NS

(1 mg/ml)







Mycophenolate Mofetil Volumatic 1000mg

Add 1000mg (two vials) to 140ml D5W (6 mg/ml)

Total VTBI = 170ml .

Consult product literature for full reconstitution advice

www.medicines.org.uk

CVC only unless directed by senior physician

. Wear gloves & eye protection Wash

off any spills immediately .

Infuse over 2 hours (500 mg/hr)

Naloxone Infusion (opioid overdose)

Syringe60% of initial bolus dose per hour (see BNF)

(NB bolus doses given by hand)

Dilute 4mg to 20ml with NS or D5W (0.2 mg/ml)

Use uncommon drugs pump. Start infusion at 60% of initial IV injection

dose per hour (default rate = 240 micrograms/hr)

and review(max 2000 micrograms/hr)

Natalizumab Volumatic 300mg Dilute in 100ml NSInfuse over 1 hour. Observe for

hypersensitivity reactions both during and for 1 hour after infusion

Neostigmine Volumatic 0.4 - 0.8 mg/hr for 24 hours Dilute two 2.5mg/ml ampoules to 50ml

NS bag (0.1 mg/ml)

Unlicensed 4-8 ml/hr

Nimodipine Syringe 1 - 2 mg/hour

Use ready diluted 0.02% (0.2 mg/ml) 10mg/50ml bottle

. Draw contents into a 50ml syringe and

use giving set provided by manufacturer

Must administer via CVC with NS or D5W running at 40 ml/hr

Nitroprusside See Sodium Nitroprusside







Noradrenaline (Norepinephrine)

Syringe

4mg, 8mg or 12mg

Default: 0.1mcg/kg/minSoft Max: 0.5mcg/kg/min

Max: 1.5mcg/kg/min

Dilute to 50ml with D5W or NS Choose from four set dilutions:

4mg in 50ml (0.08mg/ml) 8mg in 50ml(0.16mg/ml) 12mg in 50ml(0.24mg/ml)

Via CVC only .

Start at 0.1mcg/kg/min and titrate to response

. Nurse authorised to exceed soft maximum limit. Ensure doctor is informed and documented action.

Octagam® (Immunoglobulin, human 10%)

Volumatic

Dose 0.2 - 2 g/kg (see SmPC)Vial sizes = 5g or 10g

For SmPC go to www.medicines.org.uk

Use ready diluted 10% = 100 mg/ml

Use uncommon Volumat pump Give according to SGH Protocol using administration chart provided starting

at 60 mg/kg/hr

Must enter the weight used to calculate dose to programme pump. This may not be the patients actual

weight.

Pharmacist to verify weight and dose calculations before programming

pump. Patients must be monitored during

and for 20mins after end of administration (60mins post infusion

monitoring at first dose)

Octaplex Syringe

INR ≤ 4 = 20 units/kgINR > 4 = 30 units/kg

Please round the dose to the nearest vial size (nearest 500 units)

Maximum of 3000 units per single dose (120mL reconstituted solution)

Reconstitute according to the instructions in the package insert.

This makes a 25 unit/ml solution. Do not dilute further

For doses with a volume greater than 1500 units (60ml), use two syringes

Read Protocol before administrationStart infusion at 1ml/min

(60ml/hour)Increase to maximum 3ml/min

(180ml/hour)In life threatening situations, on the

advice of Haematology SpR or consultant, the rate may be increased to 10ml/min (600ml/hr). Document in

the notes







Omeprazole Bolus Syringe 20 or 40mg

Reconstitute vial and dilute to 50ml with D5W or NS

Choose from two set dilutions: 40mg/50ml = 0.8 mg/ml 20mg/50ml = 0.4 mg/ml


Omeprazole 72hr Volumatic80mg

Omeprazole High Dose Infusion

See Trust Protocol. .

Dilute with NS: 80mg to 200ml or 40mg to 100ml

(0.4 mg/ml)

As per Trust High Dose Protocol. Administer 80mg over the first hour

(use loading dose function 80mg over 3599 seconds) and then 8 mg/hr

thereafter .

A new bag will need to be made up every 10 hours

Omeprazole Fluid Restriction (72hr)

Volumatic80mg

Omeprazole High Dose Infusion

For Fluid Restriction: Dilute each 80mg to 100ml

(or 40mg to 100ml) with NS and infuse as per Trust protocol

As per Trust High Dose Protocol. Administer 80mg over the first hour

(use loading dose function 80mg over 3599 seconds) and then 8 mg/hr

thereafter .

A new bag will need to be made up every 10 hours

Note: There are 2 Volumat and 1 Injectomat entry for Omeprazole

Syringe 50 mcg/hrOctreotide Use uncommon drugs pump Bleeding oesophageal varices

500 mcg to 50ml with NS (10 mcg/ml)







Ondansetron <65yrs Syringe 4mg or 8mgDilute with NS or D5W:

4mg to 20ml (0.2mg/ml) 8mg to 20ml (0.4mg/ml)


Ondansetron >65yrs

(for patients 65 years old or older)

Syringe 4mg or 8mgDilute with NS or D5W:

4mg to 50ml (0.08mg/ml)8mg to 50ml (0.16mg/ml)

For patients 65 years old or over Administer 50ml over

15 minutes (200ml/hr)

Oxycodone Syringe 2 - 10mg Dilute dose to 20ml in NS or D5WUse uncommon drugs pump.

Administer over at least 5 minutes (240 ml/hr)

Note: There are 2 Injectomat entries for Ondsansetron







Oxytocin Induction (10 units)

Syringe10 units

As per delivery suite protocol (Section 8 Induction and Augmentation of Labour)

Dilute 10 units to 50ml with NS. Dilution 0.2 units/ml

Use uncommon drugs pump Pump cannot be programmed in milli

Units (mU). Set dose in ml/hr

Default rate:0.6 ml/hr (2 mU/min)

Registrar to approve rates above soft max limit of 6 ml/hr

(20 mU/min) Max rate 9.6 ml/hr = (32 mU/min)

Oxytocin PPH (40 units)

Volumatic 40 units Dilute 40 units to 500ml with NSInfuse 500ml over 4 - 6 hours

(10 - 6.7 units/hr)

Oxytocin PPH CVC (40units)

Syringe Maximum 10 units /hour Dilute to 1 unit/ml in NS

Use Uncommon Pump. Unlicensed preparation. Monitor for cloudiness in preparation. Discard

every 24 hours.

Pabrinex® See Vitamins B & C (Pabrinex®)

Note: There are 2 Injectomat and 1 Volumat entries for Oxytocin




http://stginet/Units and Departments/Maternity/Guidelines/Maternity Guideline Manual.pdf�




Pamidronate Disodium Volumatic 15, 30, 60 or 90mg

Dilute with NS or D5W Choose from four set dilutions:

. 15mg in 250ml (0.06 mg/ml) 30mg in 250ml (0.12 mg/ml) 60mg in 250ml (0.24 mg/ml) 90mg in 500ml (0.18 mg/ml)

Infuse over at least 60 minutes (two hours for 90mg doses)

(250 ml/hr) .

Infuse via a large vein

Pamidronate Disodium (renal impairment)

Volumatic 15, 30, 60 or 90mg

Dilute with NS to max 0.24 mg/ml Choose from six set dilutions:

. 15mg in 100ml = 0.15 mg/ml 30mg in 250ml = 0.12 mg/ml 30mg in 125ml = 0.24 mg/ml 60mg in 250ml = 0.24 mg/ml 90mg in 375ml = 0.24 mg/ml 90mg in 500ml = 0.18 mg/ml

NB. Must calculate bag concentration in mg/ml in order to programme

pump .

Use in moderate renal impairment only (CrCl 30-60 ml/min)

. Administer no faster than

20 mg/hr

Paracetamol Pt>50kg VolumaticFor patients OVER 50kg

1000mg

Use undiluted (10 mg/ml)

Infuse 100ml (1g) undiluted over 15 minutes (400 ml/hr)

Paracetamol Pt <50kg Volumatic

For patients 50kg or LESS

Single dose 15mg/kg

Maximum Daily Dose 60mg/kg/day

Use undiluted 10mg/ml

Calculate total volume required to give prescribed dose.

Must set volume to be infused (VTBI) to ensure correct dose given

or withdraw any solution in excess of the dosage

requirements.

Administer 15mg/kg over 15 minutes at rate

of 60 mg/kg/hr.

Note: There are 2 Volumat entries for Paracetamol

Note: There are 2 Volumat entries for Pamidronate







Pentamidine Volumatic4 mg/kg

Range = 120 - 400mgDilute required dose to 100ml with NS or

D5W


. Patient must be supine during

administration. Take baseline and regular BP during administration.

Wear mask and gloves.

Pethidine Syringe 25, 50, 75 or 100mg bolus Dilute to 20mls with NS, WFI or D5W Use uncommon drugs pump

Give over at least 5 minutes (240 ml/hr)

Phenobarbital Phenobarbitone

Syringe

10 - 15 mg/kg normally given in divided doses of 200mg.

Repeat every 5 mins to max 10 - 15 mg/kg

(as per Trust Grey Book)

Dilute each 200 mg/ml ampoule with 10ml WFI

(20 mg/ml)

Via CVC preferable Infuse 200mg over 2 minutes

(100 mg/min)

Phenylephrine Volumatic 30 - 180 micrograms/min Dilute 10mg to 500ml with NS or D5W

Initial Infusion: Up to 180 micrograms/min


reduced according to response to 30 - 60 micrograms/min







Phenytoin Load (Diluted)

Volumatic 500 - 1500mg Dilute in 250ml NS

Must see Critical Care Guidelines. Infuse via a 0.2 micron Braun sterifix

filter (supplied by pharmacy). The rate of administration should not

exceed 50 mg/min (default = 25 mg/min). Therefore

each 500mg should go in over 10 - 20 minutes. Flush line well with NS

before and after administration.

Phenytoin Load (Undiluted)

Syringe500 - 1500mg

Must see Critical Care Phenytoin Guidelines.Use undiluted (50 mg/ml)

The rate of administration should not exceed 50 mg/min

. Therefore each 500mg should go in

over 10 - 20 minutes .

Flush line well with NS before and after administration

Phenytoin Maintenance

SyringeVariable between 100 - 500mg

Must see Critical Care Phenytoin Guidelines.Dilute required dose to 50ml with NS

(2 - 10 mg/ml)


via a 0.2 micron Braun sterifix filter (supplied by pharmacy)

. Flush line well with NS before and

after administration. Default Rate = 25 mg/min

Max Rate = 50 mg/min

Note: There is 1 Volumat and 2 Injectomat entries for Phenytoin




http://stginet/Units and Departments/Transformation/docs/IV Pumps/Phenytoin.doc�




Phosphate (Glycophos®)

Volumatic 20 or 40 mmolDilute each 20 mmol to 250ml or 40mmol

to 500ml with NS or D5W (0.08 mmol/ml)

Infuse over 6-8 hours .

20 mmol Prescribed: 6hr = 3.3 mmol/hr 8hr = 2.5 mmol/hr

If patient is hypocalcaemic infuse over 12hr (1.7 mmol/hr)

. 40 mmol Prescribed:

6hr = 6.7 mmol/hr 8hr = 5 mmol/hr

If patient is hypocalcaemic infuse over 12hr (3.3 mmol/hr)

Phosphate with potassium (Addiphos®)

See 'Addiphos®'

Phytomenadione (Konakion MM®)

Syringe see 'Vitamin K'







Potassium CVC Syringe5 - 40 mmol/hr

Start at 10 - 20mmol/hr1 mmol/ml prefilled syringe

Via CVC onlyCan set volume to be infused (VTBI) via Volume/time mode (V/T) in pump

menu

Must monitor potassium levels

For rates above soft max (20 mmol/hr) confirm prescribers

instructions

Potassium (K+)20mmol/1L Fluid

VolumaticDefault 2.5 mmol KCl/hr

Max: 10mmol KCl/hr

Use for: Dextrose 5% + 20mmol KCl,

Sodium Chloride 0.9% + 20mmol KCl

Infuse over 1-8 hours (max rate = 20 mmol/hr)

Must monitor potasssium levels

Potassium (K+)40mmol/1L Fluid

VolumaticDefault 5 mmol KCl/hr Max: 10mmol KCl/hr

Use for: Dextrose 5% + 40mmol KCl,

Sodium Chloride 0.9% + 40mmol KCl

Infuse over 2-8 hours (max rate = 20 mmol/hr)

Must monitor potasssium levels

Privigen® (Immunoglobulin, human 10%)

Volumatic

Dose 0.2 - 2 g/kg (see SmPC)Vial sizes = 5g, or 10g

For SmPC see www.medicines.org.uk

Use ready diluted 10% = 100 mg/ml

Use uncommon Volumat pump Give according to SGH Protocol

using administration chart provided starting at

30 mg/kg/hr

Must enter the weight used to calculate dose to programme pump. This may not be the patients actual

weight.


pump.

Patients must be monitored during and for 20mins after end of

administration (60mins post infusion monitoring at first dose)

Note: There are 2 Volumat and 1 Injectomat entry for Potassium







Procainamide VolumaticLoad: 500-600mg over 25-30mins

Maintenance:120mg-360mg/hrDilute 1g to 250ml D5W

Acute control of tacharrhythmia: hand bolus (over 1-2 mins) 100mg

and repeat every 5 mins. Not more 500-600mg is usually

required. Use continuous infusion for

suppression of chronic arrhythmias.

Prochlorperazine SyringeMaximum IV dose = 12.5mg (unlicensed). Doctor must be present when administered

Dilute to 10ml with NS (1.25mg/ml)

Administer over 10 minutes (1.25mg/min)

(max = 6.25mg/min) Ensure line is flushed with NS

. May cause venospasm or postural hypotension. Monitor BP and HR. Extravasation will cause tissue

damage

Promethazine SyringeDefault: 120 ml/hr

Max: 200 ml/hrDilute each 25mg (1ml) with 9ml WFI

(2.5 mg/ml)

Each 25mg is administered via slow injection over 3 minutes

(200 ml/hr) or 5 minutes (120 ml/hr)







Syringe

Loading Dose: 100 - 200mg over 2 minutes

Maintenance Infusion: Default: 100 mg/hr

Max: 600 mg/hr Soft max: 400 mg/hr Programmed bolus:

30 - 50mg fast (200 - 720 ml/hr)

Use ready diluted preparation 1% = 10mg/ml

Volumatic


Maintenance Infusion: Default: 100 mg/hr

Max: 600 mg/hr Soft max: 400 mg/hr Programmed bolus:

30 - 50mg fast (200 - 720 ml/hr)


Propofol 1% Theatre Syringe


Maintenance Infusion: Default: 100 mg/hr Max: 2000 mg/hr

Programmed bolus: 30 - 50mg fast

(200 - 720 ml/hr)


Change syringe and giving set every 6 hours.

.

Propofol 2% Volumatic

No loading dose Maintenance Infusion:

Default: 400 mg/hr Max: 600 mg/hr

Programmed bolus: 30 - 50mg fast

(200 - 360 ml/hr)

Use ready diluted preparation 2% = 20 mg/ml

Change the bottle and giving set every 12 hours.

Nursing staff authorised to exceed soft max dose of 400mg/hr but must obtain consent from a consultant and

document in notes .

Use 2% propofol on Consultant order only

Propofol 1%

Syringe: change syringe and giving set every 6 hours.

Volumat: chnage bottle and giving set every 12 hours.

Nursing staff authorised to exceed soft max dose of 400mg/hr but must obtain consent from a consultant and

document in notes .

Note: There are 2 Volumat and 2 Injectomat entries for Propofol







Protamine ITU SyringeDefault = 2.5 mg/min

Max = 5 mg/min

Dilute to 20ml with NS Choose from two set dilutions: 25mg to 20ml = 1.25 mg/ml 50mg to 20ml = 2.5 mg/ml

Use uncommon pump

Infuse the required dose over 5 -20 minutes at a max rate of 5 mg/min (default = 2.5 mg/min)

Protamine Theatre CVC

SyringeDefault = 50 mg/min

Max = 50 mg/min Undiluted = 10mg/ml

Infuse the required dose over10 minutes at a rate of 50 mg/min

Unlicensed rate: Used in Cardiac Theatres

CVC ONLY

Quinine (Load) VolumaticLOAD ONLY

20 mg/kg (max 1400mg) Range = 600 - 1400mg

Dilute required dose (max 1.4g) to 500ml with D5W

Infuse 500ml over 4 hours (125 ml/hr)

. Monitor blood glucose 4 hourly and

ECG prior and during (QTc prolongation)

Quinine 250mls Volumatic10mg/kg

Range = 300 - 700mg Dilute required dose (max 700mg) to

250ml with D5W

For fluid restricted patients .




Quinine 500mls Volumatic10mg/kg

Range = 300 - 700mg Dilute required dose (max 700mg) to

500ml with D5W




Note: There are 3 Volumat entries for Quinine







Ranitidine Syringe 50mgDilute 50mg to 20ml with NS or D5W

(2.5 mg/ml)

May be given undiluted as a hand bolus over 2 mins.

Caution: bradycardia if given too quickly.

Infuse 20ml over 5 minutes (10 mg/min)

Rasburicase Syringe 200 mcg/kg Dilute all doses to 50ml NS (variable dilution between

120 - 560 mcg/ml)


Remifentanil SyringeDefault: 0.05 mcg/kg/minSoft Max: 0.75mcg/kg/min

Max: 2mcg/kg/min

Reconstitute according to manufacturer's instructions and dilute to 50ml with NS or

D5W:1mg to 50ml (20 mcg/ml)5mg to 50ml (100 mcg/ml)







Rifampicin 100ml Volumatic300, 450mg or 600mg

Use 100ml for fluid restricted patients

Dilute to 100ml with D5W Choose from three set dilutions:

300mg in 100ml 450mg in 100ml 600mg in 100ml


preferably via CVC or a large peripheral vein as extravasation will

cause tissue damage Must complete infusion in 30 minutes.

Rifampicin 500ml Volumatic 300mg, 450mg or 600mg

Dilute to 500ml with D5W Choose from three set dilutions: 300mg in 500ml 450mg in 500ml 600mg in 500ml

Administer 500ml over 2 hours (250 ml/hr) or 3 hours (167 ml/hr)

via a large peripheral vein Total time from preparation to completion of infusion must not

exceed 3 hours

Salbutamol (Asthma)

Syringe

Load: 250mcg over 5 minutes (300s)

Maintenance Infusion: 5 mcg/min

then 3 - 20 mcg/min

Dilute 5mg or 10mg to 50ml with NS or D5W

(0.2 or 0.1 mg/ml, respectively)

For continuous infusion infuse at a rate of 3 - 20 mcg/min.

Salbutamol Bolus (Asthma)

Syringe250mcg

repeated if necessaryDilute 250mcg to 20ml with WFI

(12.5 mcg/ml)Administer over 5 minutes

(240 ml/hr)

Salbutamol (Asthma)

Volumatic

Load: 250mcg over 5 minutes (300s)

Maintenance Infusion: 5 mcg/min

then 3 - 20 mcg/min

Dilute 5mg to 500ml with NS or D5WFor continuous infusion infuse at a

rate of 3 - 20 mcg/min.

Sodium Bicarbonate 1.4%

Volumatic As per Grey Book 1.4% (= 83.3 mmol in 500ml) Infuse at a max rate of 500 ml/hr

Note: There is 1 Volumat and 2 Injectomat entries for Salbutamol

Note: There are 2 Volumat entries for Rifampicin







Sodium Bicarbonate 8.4%

Volumatic Usual max dose = 100ml of 8.4% 8.4% (= 200 mmol in 200ml)Hypertonic - CVC preferred

Infuse at a max rate of 200 ml/hr

Sodium Chloride 0.45%, Glucose 5%, and Potassium chloride 0.15% (10mmol in 500ml)(On pump as 0.45%S 5%G

0.15%K)

VRIII protocol Fluids – fixed rate

Volumatic

See Variable Rate Insulin Infusion Protocol

Rate: 85 ml/hr

Ready prepared bags (500ml)

Use Uncommon volumat Pump

Fixed rate infusion only to be used for Variable rate insulin intravenous

infusion policy

Sodium Chloride 0.45%, Glucose 5%, and Potassium chloride 0.3% (20mmol in 500ml)(On pump as 0.45%S 5%G 0.3%K)

VRIII protocol Fluids – fixed rate

Volumatic

See Variable Rate Insulin Infusion Protocol

Rate: 85 ml/hr

Ready prepared bags (500ml)

Use Uncommon volumat Pump

Fixed rate infusion only to be used for Variable rate insulin intravenous

infusion policy

Sodium Chloride 0.45%

VolumaticFlow rate set at 80 ml/hr

Max: 500 ml/hr

Cannot set flowrate related to weight - MUST verify that flow rate appropriate for

age and weight

Sodium Chloride 1.8% VolumaticFlow rate set at 80 ml/hr

Max: 200 ml/hr

Cannot set flowrate related to weight - MUST verify that flow rate appropriate for

age and weight.

CVC preferred If not via large bore preipheral vein







Sodium Chloride 5% CVC(On pump as SodiumChloride 5%)

Volumatic 1 - 2 ml/kg NaCl 5% = Na 50 mg/ml Maximum 100ml/hr

Sodium Nitroprusside Syringe0.5 - 8 mcg/kg/min Titrate to response

Reconstitute with 2ml D5W provided then further dilute with D5W to 50ml

(1 mg/ml) and give via CVC.

Via CVC only .

Protect giving set and syringe from light

. Do not exceed soft max limits

(4 mcg/kg/min) without Doctors authorisation

Sodium Valproate Load

Syringe30 mg/kg

Range = 900 - 4200mg

Dilute to 50ml with NS or D5W Variable dilution between 18 - 84 mg/ml


Max = 5 minutes (600 ml/hr)

Sodium Valproate Syringe Range = 300 - 1200mgDilute to 20ml with NS or D5W

Variable dilution between 15 - 60 mg/ml

Administer 20ml over at least 5 minutes (240 ml/hr)

Solivito-N Volumatic 1 vialReconstitute one vial and dilute to 250ml

D5WUse Uncommon Volumat Pump Infuse

over 4 hours (62.5ml/hr)

Note: There are 2 Injectomat entries for Sodium valproate







Streptokinase (for temporary wires)

Syringe 750,000 unitsDilute 750,000 units to 50ml with NS

(15 kU/ml)

Use uncommon drugs pump .

1000 units = 1 kU .

For temporary pacing wires and clots around wires

. Infuse 750,000 units over 48 hours

(15.6 kU/h)

Synercid® (Dalfopristin/quinupristin)

Volumatic7.5 mg/kg every 8 hours Range = 225 - 1050mg

Dilute to 250ml D5W

Peripheral route for use in emergencies only

CVC preferred .

Administer over 1 hour (250 ml/hr)

Synercid® CVC (Dalfopristin/quinupristin)

Volumatic7.5 mg/kg every 8 hours Range = 225 - 1050mg

Dilute to 100mls with D5W

Must go via CVC .

Administer over 1 hour (100 ml/hr)

Tacrolimus Syringe

Renal Transplant dose 50-100 mcg/kg (max 5mg)

infused over 24 hours Range = 0.2 - 5mg

Dilute required dose to 50ml with NS or D5W

(4-100 mcg/ml)

Use uncommon drugs pump. Infuse 50ml over 24 hours

(2.1 ml/hr) .

Max 7 days

Note: There are 2 Volumat entries for Synercid







Tazocin® 4 hr (Piperacillin with tazobactam)

Syringe 2.25 or 4.5g

Dilute to 50ml with NS Choose from two set dilutions:

2.25g in 50ml = 45 mg/ml 4.5g in 50ml = 90 mg/ml

Prolonged infusions: Administer 50ml over 4 hours

(12.5 ml/hr)

Tazocin® Bolus (Piperacillin with tazobactam)

Syringe 2.25 or 4.5g

Dilute dose to 25ml with NS Choose from two set dilutions:

2.25g in 25ml = 90 mg/ml 4.5g in 25ml = 180 mg/ml

Intermittent Infusion: Administer 25ml over 5 minutes

(300 ml/hr)

Teicoplanin Syringe 200 to 1000mg Dilute all doses to 20ml with NS or D5WAdminister over 5 minutes

(240 ml/hr)

Terbutaline (bronchodilation)

Volumatic 1.5 - 5 mcg/min for 8 - 10 hours Dilute 2.5mg to 500ml with NS or D5W

Start infusion rate at 1.5 mcg/min (max = 5 mcg/min)

1.5 mcg/min = 90 mcg/hr 5 mcg/min = 300 mcg/hr

Terlipressin Syringe 1mg or 2mgUse undiluted i.e. either 1mg in 5ml or

2mg in 10ml (0.2 mg/ml)

Administer 1mg over 5 minutes and 2mg over 10 minutes

(0.2 mg/min) .

Ensure line is flushed with NS

Terlipressin 24h Syringe

Loading Dose: 1.3 mcg/kg

. Continuous Infusion: 0.65 - 2.6 mcg/kg/hr

Dilute 2mg to 50ml with NS (40 mcg/ml)

Loading Dose: 1.3 mcg/kg over 1- 3 mins

(60 - 180s) .

Infusion: Default: 1.3 mcg/kg/h

Max: 2.6 mcg/kg/hr

Note: There are 2 Injectomat entries for Tazocin

Note: There are 2 Injectomat entries for Terlipressin







Thiopental (Thiopentone Sodium)

Syringe

Load: 2 - 5 mg/kg over 2mins (120s)

. Maintenance dose:

1-12 mg/kg/hour .

Programmed bolus: 1-2 mg/kg given fast

Reconstitute 3 x 500mg with 20ml WFI each and draw total volume (60ml) into a

50ml syringe (25 mg/ml)

. Via CVC only

Reconstitute 5 x 500mg vials with 10ml each of WFI and draw total volume

(50ml) into a 50ml syringe (50 mg/ml)

Preferably via CVC but 50 mg/ml MUST be via CVC

Replace syringe every 7 hours

Tigecycline Volumatic 25mg, 50mg or 100mg

Dilute to 100ml with NS or D5W Choose from three set dilutions:

25mg in 100ml 50mg in 100ml 100mg in 100ml


Timentin (Ticarcillin 3g & Clavulanic acid 200mg)

Volumatic 3.2gReconstitute according to manufacturer's

instructions then dilute in 100ml D5W

Use Uncommon Volumat Pump

Infuse over 30mins ( 220ml/hr)

Tirofiban Volumatic

Load: 12 mcg/kg over 30mins (1800s)

then continue with .

Maintenance Infusion: 100 nanograms/kg/min

for at least 48 hrs (max 108 hrs) Dose may be reduced in renal impairment

Add one vial (12.5mg in 50ml) to 200ml NS or D5W

(12.5mg/250ml)

Use only AGGRASTAT®* (250 micrograms/mL) concentrate for

solution for infusion .

Use Loading Dose Function to infuse at 400 nanograms/kg/min for 30 mins

(12 mcg/kg over 1800s)







TPN(Parenteral Nutrition) Volumatic

Always infuse at prescribed rate

Default rate 60 ml/hrMaximum rate 210 ml/hr

Prepared by pharmacy technical services

Cannot set flow rate related to weight - MUST verify that flow rate appropriate for

age and weight

Requires a dedicated line for TPN. No other drugs or infusions to be given

through TPN designated line.See guidelines for parental nutrition.

Extravasation: May cause tissue damage.

Tranexamic AcidSyringe

Load: 500-1000mgContinuous Infusion: 500 -1000mg/hr

Use undiluted 100mg/mlFor trauma and cardiac surgery

guidelines

Tranexamic Acid (bolus)

Syringe

For Bolus Doses:Typically 500mg or 1000mg

Lower doses may be used in renal impairment

Dilute required dose to 20ml with NS. Variable dilution between

7.5 - 50 mg/ml

Administer each 500mg over 5 minutes

(100 mg/min)

Note: There are 2 Injectomat entries for Tranexamic acid







Vancomycin 1g CVC Volumatic1000mg only

Use to administer intermittent doses or the loading dose for 24hr regimen

Must use standard dilutions Add 1000mg (20ml) to a 100ml bag of

NS to give: 1000mg in 120ml = 8.3 mg/ml


Vancomycin 24 hr CVC Volumatic

Following loading dose (see above) infuse 500mg - 6000mg over 24 hours as a

continuous infusion as per Critical Care Vancomycin Guidelines.

Must use standard dilutions Add 1000mg (20ml) to a 100ml bag of

NS or D5W to give: 1000mg in 120ml = 8.3 mg/ml

For doses above 1000mg in 24 hours, set rate as per protocol and increase the FREQUENCY of bag changes. E.g. 3000mg in 24 hours requires bag to

be changed 3 times.

Vancomycin Peripheral Volumatic500mg, 750mg, 1 gram, 1.25 gram or 1.5

gram

Dilute with NS or D5W: 500mg to 250ml (2 mg/ml) 750mg to 250ml (3 mg/ml) 1gram to 250ml (4 mg/ml)

1.25 grams to 250ml (5 mg/ml)1.5 grams to 250ml (6mg/ml)

Infuse at maximum rate of 10mg/minute

Infuse every 500mg over 60 minutes

(8.3 mg/minute)

Use this entry for Vancomycin 24 hr Load

USE A LARGE PERIPHERAL VEIN FOR DOSES >1G

Vancomycin 24 hr Volumatic

Following loading dose (see above) infuse 500mg - 6000mg over 24 hours as a

continuous infusion as per Critical Care Vancomycin Guidelines.

Must use standard dilution Add 1000mg (20ml) to a 250ml bag of

NS or D5W to give: 1000mg in 270ml = 3.7 mg/ml

For doses above 1000mg in 24 hours, set rate as per protocol and increase the FREQUENCY of bag changes. E.g. 3000mg in 24 hours requires bag to

be changed 3 times.

Vasopressin Syringe

Default: 0.6 units/hr Max: 4 units/hr

Soft Min: 0.5 units/hr Soft Max: 3 units/hr

Dilute with D5W or NS to 1 unit/ml

Argipressin. Kept in fridge. Nurse authorised to exceed soft maximum limit. Ensure doctor is informed and

action documented.

Note: There are 4 Volumat entries for Vancomycin







Vecuronium (Norcuron ®)

Syringe

Load: 80-100 mcg/kg over 1 min


0.8 to 1.4 mcg/kg/min titrated according to response

. Programmed bolus: 50-100mcg/kg (FAST)

Reconstitute with 5ml WFI (diluent provided) and dilute to 1mg/ml with WFI,

NS or D5W

Vigam® (Immunoglobulin, human 5%)

Volumatic0.5 - 2 g/kg

Vial sizes = 2.5g, 5g, or 10gUse ready diluted (5% = 50 mg/ml)

Give according to SGH Protocol using administration chart provided starting

at 30 mg/kg/hr

Must enter the weight used to calculate dose to programme pump to

max 75kg. This may not be the patient’s actual weight.


pump. Where weight used for dosing is > 75kg enter 75kg onto pump

Patients must be monitored during and for 20mins after end of

administration (60mins post infusion monitoring at first dose)

Vitamins B & C (Pabrinex®)

Volumatic 1, 2 or 3 ampoule pairsDilute required number of ampoule pairs

to 50 - 100ml with NS or D5W

Infuse 50ml over 15 minutes or 100ml over 30 minutes

(200 ml/hr)







Vitamin K (Konakion MM®)

SyringeUse for phytomenadione (Konakion MM®)

only Range = 1 - 10mg

Dilute to 20ml with D5W (0.05 - 0.5 mg/ml)


Vitlipid Adult Volumatic 1 ampouleDilute ONE ampoule to 100ml Intralipid

20% via a 5 micron filter. Keep bag protected from light

Use Uncommon Volumat Pump Infuse over 4 hours (25ml/hr)

Voriconazole (100ml)

Volumatic Range = 90 - 500mgDilute required dose to 100ml with NS or D5W (must use 250ml for doses greater

than 500mg - see below)

Infuse required dose over 2 hours

(50 ml/hr)

Voriconazole (250ml)

Volumatic Range = 90 - 600mgDilute required dose to 250ml with NS or

D5WInfuse required dose over 2 hours

(125 ml/hr)

Zoledronic acid Volumatic 3 - 5mg depending on indicationDilute all doses to 100ml with NS or D5W

or use ready-diluted solution (5mg in 100ml) if indicated

Aclasta® brand is ready diluted. Infuse 100ml over 15 minutes

(400 ml/hr)

Note: There are 2 Volumat entries for Voriconazole




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