Note: Verify correct IV concentration and rate of infusion to neonates, infants, children with physician.
- Test dose: May be given to assess unusual sensitivity to drug. Following administration, observe patient for at least 1 min for unexpected
deep anesthesia or respiratory depression.
PREPARE: Direct: Reconstitute each 500 mg of powder by adding at least 20 mL of sterile water for injection to yield a 2.5% solution
(25 mg/1 mL). Continuous: May be further diluted for infusion by adding 20 mL of reconstituted solution to at least 100 mL of NS or D5W. Prepare solution
freshly and use promptly. If a precipitate is present, discard solution. ??Unused portions should be discarded within 24 h.
ADMINISTER: Direct: Infuse each 25 mg over 1 min or more. Continuous: Titrate to achieve desired result.
INCOMPATIBILITIES Solution/additive: Dextrose Ringer's lactate, 10% dextrose, fructose 10%, lactated Ringer's injection, amikacin, calcium chloride, calcium gluconate, cephalothin, cephapirin, chloramphenicol, chlorpromazine, cimetidine, clindamycin, codeine phosphate, dimenhydrinate, diphenhydramine, doxapram, ephedrine, fibrinolysin, glycopyrrolate, heparin, hydromorphone, insulin, levorphanol, meperidine, metaraminol, methadone, methicillin, morphine, norepinephrine, penicillin G, prochlorperazine, promazine, promethazine, sodium bicarbonate, succinylcholine, tetracycline, vancomycin. Y-site: Alfentanil, ascorbic acid, atracurium, atropine, cisatracurium, diltiazem, dobutamine, dopamine, ephedrine, epinephrine, fenoldopam, furosemide, hydromorphone, labetalol, lidocaine, lorazepam, midazolam, morphine, nicardipine, norepinephrine, pancuronium, phenylephrine, succinylcholine, sufentanil, vecuronium.
- Consult physician if intraarterial injection or extravasation occurs. The extravasation site will require particular attention
to prevent arteritis, neuritis, and skin slough.
- An intraarterial injection usually causes extreme pain before patient loses consciousness.