During reconstitution of a vial, use paraben free sterile water for injection. IV infusion concentration should not exceed 7 mg/ml. Rapid infusion may cause nephrotoxicity and infusion concentration beyond 7mg/ml may cause phlebitis or extravasation. Do not administer through intramuscular or subcutaneous route. After the infusion, maintain adequate hydration for first 2 hours to decrease the risk of nephrotoxicity.1-3 JL is receiving TPN for severe malnourishment. In addition to the TPN, lipids are injected. According to the Trissel IV compatibility database, acyclovir is not compatible with lipids or TPN. It causes precipitation.4 JL only has a single-lumen port for administration of the parenteral medication. She has to get TPN and IV acyclovir. IV acyclovir is not compatible therefore do not administer together. Turn off infusion pump. Stop TPN. Flush the line with 10 cc normal saline. Start IV acyclovir infusion over one hour. Flush the line again with saline and restart TPN. Repeat the procedure every 8
During reconstitution of a vial, use paraben free sterile water for injection. IV infusion concentration should not exceed 7 mg/ml. Rapid infusion may cause nephrotoxicity and infusion concentration beyond 7mg/ml may cause phlebitis or extravasation. Do not administer through intramuscular or subcutaneous route. After the infusion, maintain adequate hydration for first 2 hours to decrease the risk of nephrotoxicity.1-3 JL is receiving TPN for severe malnourishment. In addition to the TPN, lipids are injected. According to the Trissel IV compatibility database, acyclovir is not compatible with lipids or TPN. It causes precipitation.4 JL only has a single-lumen port for administration of the parenteral medication. She has to get TPN and IV acyclovir. IV acyclovir is not compatible therefore do not administer together. Turn off infusion pump. Stop TPN. Flush the line with 10 cc normal saline. Start IV acyclovir infusion over one hour. Flush the line again with saline and restart TPN. Repeat the procedure every 8