Imipramine antidepressants: paroxysmal hypertension with the possibility of arrhythmia (inhibition of the entry of sympathomimetics into sympathetic fibres). Truth: The most important strategy nurses can use to avoid pain and complications is to ensure that the I.V. is patent, with a good blood return. You also should see no swelling or signs of vein irritation, such as redness and warmth. Administer the medication in the correct form and push it over the proper amount of time, as advised by the manufacturer. The I.V. catheter should be the appropriate size for the vessel. (See next Myth.)

Selective MAO-A inhibitors, Linezolid (by extrapolation from non-selective MAO inhibitors): Risk of aggravation of pressor action. Truth: The INS standards state that you shouldn’t transfer medication from one syringe to another. This practice can lead to a medication error or introduce bacteria into the syringe. In addition, a portion of the drug can be lost during transfer. Even a small loss can reduce the efficacy of a drug, especially with small-volume I.V. medications.Serotoninergic-adrenergic antidepressants: paroxysmal hypertension with the possibility of arrhythmia (inhibition of the entry of sympathomimetics into sympathetic fibres). Pallor, Coldness of the extremities. In high dosage or for patient's sensitive to adrenaline: hypertension (with risk of cerebral haemorrhage), vasoconstriction 1 Myth: A 10-mL syringe is required to administer I.V. push medications via a central line or peripherally inserted central catheter (PICC). Adrenaline 1mg/10ml (1:10,000) solution for injection in pre-filled syringe is not recommended for intramuscular use in acute anaphylaxis. For intramuscular administration, a 1mg/ml (1:1000) solution should be used

Intravenous adrenaline should only be used by those experienced in the use and titration of vasopressors in their normal clinical practice. Patients who are given IV adrenaline require continuous monitoring of ECG, pulse oximetry and frequent blood pressure measurements as a minimum. Many myths abound about I.V. push medications. To dispel these myths and outline evidence-based standards of practice, American Nurse Today interviewed Elizabeth Campbell, MSN, RN, CRNI, past president of the Infusion Nurses Society (INS) New England Chapter and a clinical scholar at Massachusetts General Hospital in Boston. Intravenous adrenaline should only be administered by those experienced in the use and titration of vasopressors in their normal clinical practice. A cookie set by YouTube to measure bandwidth that determines whether the user gets the new or old player interface.Prolonged use of adrenaline can result in severe metabolic acidosis because of elevated blood concentrations of lactic acid. Truth: The only time it’s acceptable not to label a syringe is if the medication is prepared at the bedside and administered right away. Otherwise, syringes should be labeled. That includes when preparing more than one medication at the bedside and when preparing any medication away from the bedside. The reason for these recommendations is that nurses often are interrupted during medication administration. If distracted even for a few moments, what was in the syringe and the dose may be forgotten. In addition, preparing more than one medication at the same time can lead to confusion about the contents of unlabeled syringes. Myth: It’s not necessary to label a syringe with medication that a nurse prepares if it will be administered right away. Adrenaline should be used with caution in patients with prostatic hyperplasia with urinary retention.

Myth: Diluting small-volume doses of medication, such as 0.5 mL, to ensure the patient gets the whole dose is a good idea. Truth: Unfortunately, many nurses erroneously believe this to be true. To ensure proper dosing, use a syringe that’s the appropriate size for the administration of I.V. push medications via a venous access device. A 10-mL syringe is needed only to assess the patency of the device, not for administering medications. Educational programs must stress using the right-size syringe for the job.

Myth: Using a 0.9% sodium chloride (saline) flush syringe to dilute I.V. push medications is acceptable. Note: Since the publication of this article, pharmacy experts have noted that there is not evidence to support needing to administer I.V. antibiotics one at a time. One pharmacist notes: “I do not want to discourage the practice of giving two antibiotics at the same time because in several instances it may be ideal (sepsis, extended infusion). Separating antibiotics also does not help differentiate which antibiotic caused the reaction. For instance, if cefepime is I.V. pushed at 09:00 and vancomycin started at 09:30 but patient develops a rash at 10:00, you would not be able to definitively conclude which antibiotic caused the reaction.

Truth: Nurses may see using sa line flush syringes as an easy way to dilute and administer medications. However, the Food and Drug Administration has approved them only for flushing venous access devices. Nurses should be aware that not all brands of saline flush syringes are labeled “for flush only.” However, using any saline flush syringe for dilution is unsafe. Frequency not known: pallor, coldness of the extremities. In high dosage or for patients sensitive to adrenaline: hypertension (with risk of cerebral haemorrhage), vasoconstriction (for example cutaneous, in the extremities or kidneys). In cardiac arrest following cardiac surgery, Adrenaline should be administered intravenously in doses of 0.5 ml or 1ml of 1:10,000 solution (50 or 100 micrograms) very cautiously and titrated to effect.

Records the default button state of the corresponding category & the status of CCPA. It works only in coordination with the primary cookie. Myth: Diluting I.V. push medications will reduce patient discomfort and vein irritation in peripheral I.V.s. Endotracheal use should only be considered as a last resort if no other route of administration is accessible, at a dose of 20 to 25 ml of the 1:10,000 solution (2 to 2.5 mg). In the treatment of anaphylaxis and in other patients with a spontaneous circulation, intravenous adrenaline can cause life-threatening hypertension, tachycardia, arrhythmias and myocardial ischaemia.