Learn about support programs for your patients, including co-pay assistance. Reported infusion reactions have usually been mild or moderate in severity. Signs and symptoms may include transient increases in blood pressure, feeling hot, tachycardia, dyspnea, headache, and muscular pain. Infusion reactions may occur during an infusion or within 1. Monitor patients with IBD for flare of disease. Hyperglycemic events should be managed with medications for glycemic control, if necessary.
Dosing Flashcard For dosing calculations for patients weighing 50 kg to kg lbs to lbs , download the dosing flashcard. Preparation and administration overview. Dilute Dilute the required volume of reconstituted solution based on the dose in an IV infusion bag containing 0. Infuse Infuse for the appropriate duration. First things first. Each carton contains a single-dose vial with mg of teprotumumab antibody. An in-line filter with a 0. As always, remember to use aseptic technique. Make sure the stream of diluent is not directed onto the cake of lyophilized powder.
Do not shake. Now, you will have a volume of Before moving on, visually inspect the solution. Select an intravenous infusion bag containing 0. The volume in the infusion bag should remain constant. Use a sterile syringe and needle to remove the volume of saline equal to the amount of the reconstituted solution to be placed into the bag.
Discard the saline withdrawn. Mix the diluted solution by gentle inversion. Discard vials and all unused contents. If not administered immediately, protect from light. If refrigerated, allow the diluted solution to reach room temperature prior to infusion. If not well tolerated, the minimum infusion time should remain at 90 minutes.
When the infusion is complete, discard items. Infusion Guide For complete instructions, including information about infusion reactions, download the Infusion Guide. Infusion Checklist For a step-by-step checklist, download the Infusion Checklist. This highlights the importance of ascertaining the factors behind medication errors, and potential solutions to these errors. Medication errors are most frequently due to the wrong dose, omitted or delayed medication or the wrong medication being administered NPSA, a.
The most frequently cited error resulting in the wrong dose being administered stems from calculation errors. However, these can have different contributing factors. Evidence suggests that most medication errors are caused by health professionals:.
These errors can be the result of health professionals not having the right know-ledge or skills, or a result of other factors, such as distractions or stress. Medication errors have been identified across acute, community, general practice, learning disability and mental health clinical areas, making key calculation skills applicable to all nurses National Reporting and Learning System, Evidence indicates that awareness of potential risks in certain procedures can help nurses to anticipate errors and be more vigilant in preventing them Vincent, More recent thinking on medication errors emphasises the need not just to prevent an error in the calculation, but to prevent any error from reaching the patient Vincent, To calculate and administer the correct dose of a medicine to a patient, nurses need to understand the different measurements used for drug dosages in healthcare and be able to convert between different units of measurement.
Drugs are generally measured according to either:. A number of medication errors have been made through not converting between different units of measurement correctly, resulting in doses of 10 or times of those prescribed NPSA, b.
For example, there have been a number of fatalities through not understanding how to measure insulin units, mistakenly measuring this in millilitres and administering large doses of insulin NPSA, Box 1. The main weight measurements that nurses must be familiar with, and confident converting between, are grams, milligrams, micrograms and nanograms.
The relationship between each of these measurements is a factor of 1, Fig 1 , so conversions require nurses to multiply or divide dosages by 1, The prescribed dose is always converted to the units of the available drug dose, so that it is easier to compare the prescription with how the medicines is labelled.
For example, if the prescription given for benzylpenicillin is 1. To convert 1. It is important that conversions are checked carefully, through repeating the calculation or asking a colleague if unsure.
Once the conversion has been checked, the prescribed dose can be compared with the available dose to calculate how much of the medicine to administer. For solid oral doses such as tablets or capsules, this type of calculation is usually quite straightforward, as the prescribed dose can be divided by the available drug dose to work out how many tablets to give. For example, if the prescription is for 30mg prednisolone, and the available tablets are 5mg, then the number of tablets to administer would be six.
You can check this by adding up the dosage of each tablet and making sure the total is 30mg. When the medicine is a solution of a specific strength, calculations can become more complicated. You will need to work out what volume needs to be administered to give the prescribed dose.
So if mg amoxicillin is prescribed, the amount of suspension to administer would be two x mg, which would be 10ml. Nurses use different methods to calculate the volume of solutions or number of ampoules to administer, depending on several factors, and do not necessarily stick to one method Wright, The most important thing is finding a method that you feel comfortable and confident with. Although there is some criticism of this method Wright, it can be a useful tool if you are tired, stuck or need to check a calculation.
More experienced and confident nurses seem to work easily in this way, but those who are less confident with numbers may find the formula safer. Whatever method you use it is important to be able to explain your methods and how you arrived at an answer so you can participate in double-checking calculations with colleagues.
Checking must involve each nurse doing the calculation independently, then checking the answer together. There is some evidence that double-checking can increase the risk of error, as each nurse relies on the other to pick up any error Alsulami et al, This is why it is important that each nurse does the calculation independently before comparing.
Once the calculated answer is agreed; it is important to relate this back to clinical practice, to ensure that the calculated answer makes logical sense from your clinical and medicine knowledge. This particular calculation would be considered to be a high-risk calculation because it has multiple stages in which errors can be introduced, and because of the small dosage involved and the conversion required between different units of measurement NPSA, b.
Such calculations must be checked carefully with a second nurse to reduce the risk of error. Medications can also be prescribed in doses that need to be administered continuously for a specified period of time. An infusion is therefore administered at a flow rate that will give the required dosage per hour or minute for the patient. Generally, clinical areas will have standardised infusion strengths that are always used for specific medications, with the rate varied according to the prescribed dose for that patient.
This can be done in stages:. There are formulas that can help with these calculations to reduce the number of steps needed in converting dosages into the volume required per hour Fig 3.
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