McGill University Health Center Pediatric Drug Infusion Preparation Chart

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1 McGill University Health Center Pediatric Drug Preparation Chart Tableau de préparation d infusion en Pédiatrie au Centre Universitaire de Santé McGill The purpose of the current chart is to: 1. Establish standard fixed drug s for commonly d drug infusions 2. Provide rs with summary pertinent to prescribing and of drug infusions. It is not the intention of this chart to provide comprehensive on specific drug indication, dosage and administration. Please consult appropriate references and institutional drug administration protocols if available. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. Legends and abbreviations: "PVC": Polyvinyl Chloride "DKA": Diabetic ketoacidosis All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 1 of 10

2 L objectif du tableau est de : McGill University Health Center Pediatric Drug Preparation Chart Tableau de préparation d infusion en Pédiatrie au Centre Universitaire de Santé McGill 1. Établir des s standardisées des médicaments en infusion continue couramment utilisées au sein de notre institution. 2. Fournir des s sommaires aux usagers pertinentes aux prescriptions, ainsi qu aux préparations des médicaments en infusion continue. Cet outil de travail ne vise pas à fournir de l complète sur l indication, le dosage ni l administration des médicaments. Pour cela, il est nécessaire de consulter les références appropriées et les protocoles institutionnels pour de l plus exhaustive. Dans tous les cas, la du médicament choisie doit correspondre à une des s indiquées dans ce tableau. Les catégories de poids indiquées dans ce tableau sont à titre indicatives. Si une situation clinique l exige, une autre que celle correspondant à la catégorie du poids du patient peut être utilisée de façon exceptionnelle. Toutes les préparations sont considérées stable 24 heures à la température pièce, à moins qu un astérisque (*) soit indiqué, alors de l additionnelle est fournie. Légende et abréviations: "PVC": Polychlorure de vinyle "DKA": Acidocétose diabétique All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 2 of 10

3 Alprostadil 500 mcg/ml Alteplase Reconstitute with SWI to Aminophylline 2 Amiodarone 50 mg/ml Bumetanide 0. cyclosporine 50 mg/ml Desmopressin 4 mcg/ml Dexmedetomidi ne 100 mcg/ml Diltiazem 40mL, ALL 2 mcg/ml 100 mcg = 0.2 ml With 49.8 ml of diluent for ALL Fluid Restriction ALL 10 mcg/ ml 500 mcg = 1 ml With 49 ml of diluent for No dilution required ALL 2 mg/ml 100 mg = 4 ml With 46 ml of diluent for ALL 2 mg/ml 500 mg = 10 ml With 240 ml of diluent for Total volume of 250 ml ALL 0. 4 mg = 8 ml With 32 ml of diluent for Total volume of 40 ml ALL 0. Use prefilled bag prepared by pharmacy and follow instructions on pharmacy label ALL 0.02 mcg/ml 1 mcg = 0.25 ml With ml of diluent for ALL 4 mcg/ml 200 mcg = 2 ml With 48 ml of diluent for ALL 50 mg = 10 ml With 40 ml of diluent for 40 mcg = 0.08 ml With ml of diluent for 200 mcg = 0.4 ml With 19.6 ml of diluent for, D10W, 1/2NS D5W Use empty non PVC bag 2 mg = 4 ml With 16 ml of diluent for Protect from light Use empty non PVC bag Hazardous agent NS All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 3 of 10

4 DOBUTamine 12. DOPamine 3.2 mg/ml EPINEPHrine 0.1mg/mL (1: ) NICU ONLY (1: 1 000) Others 40mL, 0.8 mg/ml 40 mg = 3.2 ml With 46.8 ml of diluent for 5 kg to kg 1.6 mg/ml 80 mg = 6.4 ml With 43.6 ml of diluent for 25 kg or more 3.2 mg/ml 160 mg = 12.8 ml With 37.2 ml of diluent for 0.8 mg/ml 40 mg = 12.5 ml With 37.5 ml of diluent for 5 kg to kg 1.6 mg/ml 80 mg = 25 ml With 25 ml of diluent for 25 kg or more 3.2 mg/ml No dilution required 10 mcg/ml Using (1:1 000) commercial : 0.5 mg = 0.5 ml With 49.5 ml of diluent for 5 kg to kg 25 mcg/ml Using (1:1 000) commercial : 1.25 mg = 1.25 ml With ml of diluent for 25 kg or more 60 mcg/ml Using (1:1 000) commercial : 3 mg = 3 ml With 47 ml of diluent for 16 mg = 1.28 ml With ml of diluent for 16 mg = 5 ml With 15 ml of diluent for 32 mg = 10 ml With 10 ml of diluent for Using 0. (1:10 000) commercial : 0.2 mg = 2 ml With 18 ml of diluent for Using 0. (1:10 000) commercial : 0.5 mg = 5 ml With 15 ml of diluent for Using 0. (1:10 000) commercial : 1.2 mg = 12 ml With 8 ml of diluent for, D10W, 1/2NS, D10W, D10W All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 4 of 10

5 Epoprostenol Reconstitute vial to 100 mcg/ml with manufacturer provided diluent only Esmolol FentaNYL 50 mcg/ml Furosemide Heparin 100 unit/ml Insulin (Regular) 100 unit/ml DKA ONLY 40mL, 3 mcg/ml 150 mcg = 1.5 ml of reconstituted With 48.5 ml of diluent for 5 kg to kg 5 mcg/ml 250 mcg = 2.5 ml of reconstituted With 47.5 ml of diluent for 25kg or more 10 mcg/ml 500 mcg = 5 ml of reconstituted With 45 ml of diluent for ALL equal to 2.49 kg 12.5 mcg/ml 625 mcg = 12.5 ml With 37.5 ml of diluent for No dilution required 2.5kg or more 50 mcg/ml No dilution required ALL 40 mg = 4 ml With 36 ml of diluent for Total volume of 40 ml ALL 100 units/ml ALL 0.1 unit/ml SEE DKA PROTOCOL No dilution required 60 mcg = 0.6 ml of reconstituted With 19.4 ml of diluent for 250 mcg = 5 ml With 15 ml of diluent for 20 mg = 2 ml With 18 ml of diluent for Use manufacturer provided diluent ONLY, D10W Keep cold with icepack during administration Protect from light All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 5 of 10

6 Insulin (Regular) 100 unit/ml NONDKA INDICATIONS Isoproterenol 200 mcg/ml Ketamine Labetalol Lidocaine 20 mg/ml equal to 0.99 kg 40mL, 0.04 unit/ml 2 unit = 0.02 ml With ml of diluent for 1 kg to 4.99 kg 0.1 unit/ml 5 unit = 0.05 ml With ml of diluent for 5 kg or more 0.5 unit/ml 25 unit = 0.25 ml With ml of diluent for 20 mcg/ml mcg = 5 ml With 45 ml of diluent for 5 kg or more 60 mcg/ml mcg = 15 ml With 35 ml of diluent for ALL 2 mg/ml 100 mg = 10 ml With 40 ml of diluent for ALL 2 mg/ml 100 mg = 20 ml With 30 ml of diluent for ALLFluid Restriction ALL 8 mg/ml 400 mg = 20 ml With 30 ml of diluent for No dilution required 400 mcg = 2 ml With 18 ml of diluent for, D10W 40 mg = 8 ml With 12 ml of diluent for All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 6 of 10

7 Midazolam Milrinone Morphine Naloxone 0.4 mg/ml Nitroglycerin 40mL, 50 mg = 10 ml With 40 ml of diluent for 5 kg to kg 2 mg/ml 100 mg = 20 ml With 30 ml of diluent for 25 kg or more No dilution required 125 mcg/ml 6.25 mg = 6.25 ml With ml of diluent for 5 kg to kg 250 mcg/ml 12.5 mg = 12.5 ml With 37.5 ml of diluent for 25 kg or more 500 mcg/ml 25 mg = 25 ml With 25 ml of diluent for 100 mcg/ml 5 mg = 0.5 ml With 49.5 ml of diluent for 5 kg to kg 250 mcg/ml 12.5 mg = 1.25 ml With ml of diluent for 25 kg or more 1000 mcg/ml 50 mg = 5 ml With 45 ml of diluent for ALL mg = 6.25 ml With ml of diluent for Total volume of 250 ml ALL 0.4 mg/ml 100 mg = 20 ml With 230 ml of diluent for Total volume of 250 ml 20 mg = 4 ml With 16 ml of diluent for 2.5 mg = 2.5 ml With 17.5 ml of diluent for 2 mg = 0.2 ml With 19.8 ml of diluent for, 1/2NS, 1/2 NS, D10W, 1/2NS, 1/2NS Use empty non PVC bag All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 7 of 10

8 Nitroprusside 2 Norepinephrine Octreotide 500 mcg/ml *Pantoprazole Reconstitute with 10 ml of NS to 4 mg/ml 40mL, 0.2 mg/ml 10 mg = 0.4 ml With 49.6 ml of diluent for 5 kg to kg mg = 1 ml With 49 ml of diluent for 25 kg or more 50 mg = 2 ml With 48 ml of diluent for 10 mcg/ml 0.5 mg = 0.5 ml With 49.5 ml of diluent for 5 kg to kg 25 mcg/ml 1.25 mg = 1.25 ml With ml of diluent for 25 kg or more 60 mcg/ml 3 mg = 3 ml With 47 ml of diluent for 4 mg = 0.16 ml With ml of diluent for 0.2 mg = 0.2 ml With 19.8 ml of diluent for 10 mcg/ml 200 mcg = 0.4 ml With 19.6 ml of diluent for 5 kg or more 20 mcg/ml mcg = 2 ml With 48 ml of diluent for ALL 0.4 mg/ml 20 mg = 5 ml of reconstituted With 45 ml of diluent for ALLFluid Restriction 0.8 mg/ml 40 mg = 10 ml of reconstituted With 40 ml of diluent for 400 mcg = 0.8 ml With 19.2 ml of diluent for 8 mg = 2 ml of reconstituted With 18 ml of diluent for D5W NS NS, D5W * Stability varies from 12h24h depending on commercial brand d please contact pharmacy for more details All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 8 of 10

9 PHENobartital 30 mg/ml (NICU ONLY) 120 mg/ml (Others) Phenylephrine Procainamide 100 mg/ml *Propofol Remifentanil Rocuronium Salbutamol 40mL, ALL Using 120 mg/ml commercial : 500 mg = 4.17 ml With ml of diluent for 10 mcg/ml 0.5 mg = 0.05 ml With ml of diluent for 5 kg to kg 25 mcg/ml 1.25 mg = 0.13 ml With ml of diluent for 25 kg or more 60 mcg/ml 3 mg = 0.3 ml With 49.7 ml of diluent for ALL 4 mg/ml 200 mg = 2 ml With 48 ml of diluent for, D10W 0.2 mg = 0.02 ml With ml of diluent for, D10W, 1/2NS All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 9 of 10 NS ALL No dilution required * Stable for 12 hours if infusing directly from original container * Stable for 6 hours if transferred from the original container OR ONLY 10 mcg/ml OR ONLY 20 mcg/ml 5 kg or more ALL 2 mg/ml 100 mg = 10 ml With 40 ml of diluent for ALL mg = 25 ml With 25 ml of diluent for

10 SUFentanil 50 mcg/ml Tacrolimus Tranexamic acid 100 mg/ml Vasopressin 20 units/ml Diabetes Insipidus Vasopressin 20 units/ml Shock, GI hemorrhage equal to kg 40mL, 25 mcg/ml mcg = 25 ml With 25 ml of diluent for 25 kg or more 50 mcg/ml No dilution required OR ONLYALL 2 mcg/ml 5 kg to kg mg/ml mg/ml Use prefilled bag prepared by pharmacy and follow instructions on pharmacy label 25 kg or more 0.02 mg/ml ALL 2 mg/ml 100 mg = 1 ml With 49 ml of diluent for OR ONLY 50 mg/ml equal to kg OR ONLY 100 mg/ml 25 kg or more ALL 0.04 unit/ml 2 unit = 0.1 ml With 49.9 ml of diluent for 0.2 unit/ml 10 unit = 0.5 ml With 49.5 ml of diluent for 5 kg or more 1 unit/ml 50 unit = 2.5 ml With 47.5 ml of diluent for 500 mcg = 10 ml With 10 ml of diluent for Use empty non PVC bag Hazardous agent 40 mg = 0.4 ml With 19.6 ml of diluent for 4 unit = 0.2 ml With 19.8 ml of diluent for All infusion s are stable for 24 hours at room temperature except those marked with an asterisk (*) where additional will be provided. If clinical consideration warrants, a different drug than the one corresponding to the patient's weight category may be d as an exception. However, all drug infusions in our institution must be prepared in Approved by PMAP on ; Approved by P&T on V. 08/10/2015 Page 10 of 10

3. This solution retains potency for 2 8 hours at room temperature after reconstitution.

1 CHAPTER 10 Reconstitution of Powdered Drugs Problems 10.1 (page 124) 1. The drug should be stored at or below 86 F (30 C). 2. This drug is administered IM or IV. 3. This solution retains potency for