Acute Care1111Page

Floor Nurses’
1 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Bumetanide - Diuretic/Acute 0.5-2 mg 10 mg/day 0.25 mg/ml 2 mg over 2 Pain at injection Monitor labs; Multiple drug
(Bumex) Pulmonary Edema, over 1-2 minutes Site interactions; dizziness; N&V,
CHF, and Renal minutes hypotension, and decrease
disease calcium and K+

Chlorothiazide Sodium - Diuretic/Anti- 0.5 – 1 g 2 g/day 28 mg/ml Slow IVP Extravasation Monitor electrolytes, rash,
(Diuril) hypertensive agent MUST be hypotension
avoided. Do
NOT give SC or
IM

Cosyntropin (Cortrosyn) - Diagnostic Agent 1 mcg or 250 – 750 - Over 2 minutes Blood draws Hypertension, flushing.
250 mcg mcg must be at Peak cortisol concentration
specific times occurs 45-60 min after
indicated by MD administration
order. No
steroids or
spironolactone
day before or
day of test.

Dexamethasone Sodium - Antiemetic; Anti- 4 mg 10 mg 4 mg/ml Maximum rate: - Insomnia, nervousness,

Phosphate inflammatory Over 1 minute increased appetite, fluid
(Decadron) Slower if itching retention
Over 3-5 minutes

Dextrose 50% - Carbohydrate/ 25 gm - 25 gm/50ml 10 ml/min Phlebitis risk, Hyperglycemia, confusion

Symptomatic pain at injection
hyperglycemia site; Large bore
IV access

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 Acute Care2222Page
Floor Nurses’
2 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Diazepam - Benzodiazepine; 2-10mg/ 30 mg/8hrs 5 mg/ml 5 mg/minute Phlebitis risk, Bradycardia; tachycardia,
(Valium) Anti-anxiety, dose pain at injection drowsiness, hypotension,
Anticonvulsant, site hypoventilation
0.22 micron
filter required for
IVPB admin

Dihydroergotamine - Antimigraine Agent 0.3- 6 mg/week 1mg/ml Over 2-3minutes - HTN, Headache, dizziness, N/V
(D.H.E 45) 1mg/dose

Diphenhydramine HCL - Antihistamine; 12.5-50 mg 50 mg/dose 50 mg/ml 25 mg/minute Dilute to 25 mg/ Hypotension, tachycardia,
(Benadryl) Histamine 1 q 2-4H 400 mg/day ml in D5W or sedation, dizziness, insomnia
Antagonist NS

Dolasetron Mesylate - Antiemetic 12.5 mg 25 mg 12.5 mg/ 25 mg over 30 Caution in HTN, headache, urinary
(Anzemet) over 30 0.625 ml seconds patients at risk retention, tachycardia
seconds for prolonged
QT interval

Epinephrine - Anaphylaxis/ 0.3-0.5 mg - 1mg/ml 1mg/min Watch for Tachycardia, hypertension,

(Adrenaline Chloride) Sympathomimetic IM/SQ injection site nervousness, restlessness,
every 15- blanching/ headache, dizziness
Anaphylaxis Only 20 minutes Extravasation HR, BP
as needed Use 1:1000 in
anaphylaxis

Famotidine - Gastrointestinal; 20 mg q 40 mg 20 mg/5ml 20 mg over 2 - Headaches, dizziness, confusion,

(Pepcid) Histamine 2 12H minutes mental status changes
Antagonist

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 Acute Care3333Page
Floor Nurses’
3 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Flumazenil - Benzodiazepine 0.2 mg Give no 0.1mg/ml 0.2 mg over Use large vein Pt. may need additional doses in
(Rumazicon) Antagonist over 30 more than 15-30 seconds and free flowing case of re-sedation. Caution with
seconds 1 mg per IV to minimize seizure patient.
initial, can dose or pain
repeat with 3mg/hour
0.3mg

Furosemide - Loop Diuretic/ 20 - 40 mg 80 mg but 10 mg/ml 1-2 minutes - Hypotension, headache, and
(Lasix) Volume overload can vary (Consider IVPB dizziness
widely over 5-10
minutes)

Glucagon - Emergency treatment 0.5-1 mg/ - 1 mg/ml 1 mg/min May precipitate Unstable hypoglycemic diabetic
of symptomatic min with NS, K+ may not respond & will need IV
hypoglycemia (May be and Calcium; Dextrose instead;
repeated 1- Compatible N/V, hypokalemia in overdose,
2 times) with D5W urticaria, respiratory distress and
hypotension

Granisetron HCL 5HT3 Blocker 10 mcg/kg Undiluted over Headache, diarrhea,

(Kytril) Prevention of N/V given 30 30 seconds constipation, hypertension, fever
secondary to minutes
chemotherapy prior to
chemo

Haloperidol Lactate - Antipsychotic/ 2-5 mg Varies with 5 mg/ml 5 mg/min Start with lower Drowsiness, hypotension,
(Haldol) Agitation patient doses in geriatric Extrapyramidal effects,
patients bradycardia, tachycardia

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Floor Nurses’
4 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Heparin Bolus - Anti-coagulant Varies- 8,000 units Usual: Over 1 minute Antagonist is Bleeding, APTT, HCT, Hgb
(Heparin Drip 3,000- 10,000 Protamine Thrombocytopenia (HIT-
Protocol) -8,000 units/mL Heparin induced)
units

Heparin - Anti-coagulant 300 units - 100 units/ml - Antagonist is Bleeding, APTT, HCT, Hgb
(for flush of Central instilled Protamine Thrombocytopenia (HIT-
line catheter) into Central Heparin induced)
Catheter
Hydrocortisone - Anti-inflammatory 15-240 mg - 50 mg/ml Over 3-5 minutes - Insomnia, nervousness
Sodium Phosphate agent Corticosteroid BP
(Hydrocortone
Phosphate)

Hydrocortisone - Anti-inflammatory 15-240 mg 1 gm/24 - Over 1 minute Caution in Monitor electrolytes; May mask
Succinate (Solu- (IV given usually in hour elderly signs of infection
Cortef) emergency) May need to
taper therapy

Hydromorphone - Narcotic Analgesic 1-4 mg - 4 mg/ml Each 1 mg over Reversal agent – Palpitations, hypotension,
(Dilaudid) 2-3 minutes Naloxone dizziness, drowsiness, BP, RR
(Narcan)

Insulin (Regular only) - Pancreatic Hormone/ 5-10 units 10 units - 10 seconds Push for Monitor Finger Stick Blood
Hyperglycemia over 10 hyperkalemia Sugars
Push for seconds only; Only
hyperKalemia only Regular Insulin
can be given IV

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 Acute Care5555Page
Floor Nurses’
5 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Ketorolac - NSAID/Short-term 15- 30 mg 120 mg/day 30 mg/ml Over > 15 Requires renal Edema, drowsiness, headache
(Toradol) management of mod- IV q 6 Max. 5 seconds dose adjustment Avoid in patients with active or
severe pain hours days recent bleeds

Levothyroxine - Thyroid hormone 50-100mcg - 100 mcg/ml 100mcg/min -Prepare Symptoms of hyperthyroidism –
(Synthroid) immediately nervousness, tremor, headache,
(½ of oral before tachycardia, heat intolerance,
dose) administration, etc.
with 5ml Normal
saline.
-Do not mix with
any other IVF
-Do not further
dilute drug

Lorazepam - Benzodiazapine 2-4 mg 8 mg/12hrs 2 mg/ml 2 mg/minute Can easily cause Sedation, hypotension, dizziness,
(Ativan) diluted infiltration with headache, HR, BP, RR
with equal IVP,
volume of Consider IVPB
IVF over 5-10 min;
Reversal agent-
Flumazenil

Meperidine - Narcotic Analgesic 25-100 mg - 100 mg/ml Over 5 minutes Dilute to 10 mg/ Sedation, hypotension, dizziness,
(Demerol) q 2-4 hours ml with NS BR, RR
Reversal agent-
Naloxone
(Narcan)

Page 5 of 8
 Acute Care6666Page
Floor Nurses’
6 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Methylprednisolone - Anti-inflammatory 40-250 mg - 62.5 mg/ml 125 mg over 3-5 Only the Insomnia, nervousness
Sodium Succinate agent/ Adrenal minutes succinate form BP, Monitor Na+ and K+, FSBS
(Solu-Medrol) Corticosteroid Higher doses can be given IV;
give IVPB Rapid admin. Of
high doses can
cause circulatory
collapse

Metoclopramide - Cholinergic/ GI 5-10 mg 10 mg 5 mg/ml 10mg or fraction Too rapid rate Hypotension, SVT, sedation,
(Reglan) stimulant thereof over 2 may cause dizziness, rash, extrapyramidal
Antiemetic minutes intense anxiety effects treat with Benadryl:
>10 mg IVPB & restlessness Caution with hypertension
over 15 minutes

Morphine - Narcotic Analgesic 1-4 mg 8 mg 10 mg/ml 1 mg/min Reversal agent Sedation, dizziness, heart
– Naloxone palpitation, hypotension,
(Narcan) bradycardia, and respiratory
depression
BP, RR, Oxygen saturation

Muromonab-CD3 8E Immunosuppressive 5 mg 5 mg 1 mg/ml <1-2 minute Filter each dose Fever, chilling, dyspnea,
(Orthoclone, OKT3) Agent/ Rejection through a low wheezing, chest pain,
protein binding tachycardia, dizziness, shortness
0.22 micron of breath,
filter HR, BP, RR, Temperature

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Floor Nurses’
7 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Naloxone - Pure Opioid 0.1-0.8 mg 24 mg 1 mg/ml Administer a If patient does Tachycardia, narcotic withdraw,
(Narcan) Antagonist dilute solution of not arouse after hypertension, hypotension,
naloxone (0.4mg the initial anxiety, restlessness, Pulmonary
in 10 ml of saline) administration Edema, HR, BP, RR
IV, very slowly
(0.5ml over 2
of Naloxone
minutes) while (total dose of
you watch for the 0.8mg) begin
desired effect looking for
(titrate to effect). other causes of
The patient should sedation and
open his eyes respiratory
within one to two depression.
minutes. If not,
continue giving
naloxone at the
same rate up to 0.8
mg or 20 mls of
dilute solution.

Ondansetron (Zofran) - Antiemetic 1-4 mg 4 mg - 1-4 mg over 2-5 Incompatible Observe closely for respiratory
minutes with numerous distress; Ambulate Slowly
drugs
¾ 4 mg
consider
IVPB
over 15
minutes

Pantoprazole - Gastrointestinal; 40 mg 80 mg 4 mg/ml 40 mg over 2 Reconstitute Injection site reactions,

(Protonix) Proton pump minutes with 10ml, 0.9% headache, dyspepsia, and nausea
inhibitor Normal Saline

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 Acute Care8888Page
Floor Nurses’
8 of 8 Guide:
Intravenous Push (IVP) Drug List – Approved for RN Administration
University of Kentucky Chandler Medical Center
4/10/07

If medication is not approved for the IV push administration and alternative routes of administration are not available, approval for this individual situation must be
obtained through collaboration with pharmacy and the patient care manager

GENERIC NAME RESTRICTED THERAPEUTIC TYPICAL MAXIMUM MAXIMUM MAXIMUM RATE ADMINISTRATION ADVERSE EFFECTS/COMMENTS
(BRAND NAME(S)) AREA CATEGORY ADULT ADULT CONCENTRA OF CONSIDERATIONS MONITORING PARAMETERS
DOSE DOSE TION* ADMINISTRATION
**
Promethazine - Antiemetic/ 12.5-25 mg 50 mg 50 mg/ml IVP: 25 mg/min Monitor for Hypotension, tachycardia,
(Phenegran) IVP only Antihistamine infiltration dizziness, and drowsiness
with Central or IVPB: 20
PICC Line or IVPB minutes
over 20 mins
* Alter volume based upon dosage to be administered ** Alter duration based upon dose to be administered.

ƒ If the medication is not approved for IV push administration and alternative routes of administration are not available, approval for this
individual situation must be obtained through collaboration with pharmacy and the patient care manager

Updated: 04/10/07
Revised by: Christy Taylor, PharmD and Lori Proeschel, PharmD
Contact person for revisions: Kimberley Hite (khite2@uky.edu)

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