Adverse reactions : תופעות לוואי

Adverse Reactions
General
Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia.
Nausea, fever, and flushing of the skin have occurred.
If an adverse reaction does occur, the infusions should be discontinued, the patient evaluated, appropriate therapeutic countermeasures instituted, and the remainder of the fluid saved for examination if deemed necessary.

For Lactated Ringer’s Solution
Allergic reactions or anaphylactoid symptoms such as localized or generalized urticaria and pruritis; periorbital, facial, and/or laryngeal edema; coughing, sneezing, and/or difficulty with breathing have been reported during administration of Lactated Ringer’s Injection. The reporting frequency of these signs and symptoms is higher in women during pregnancy.

IV INJECTIONS IN PLASTIC BAGS   21 11. 2007, RH
Precautions
General
Do not administer unless the solution is clear and the seal is intact.
Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during prolonged parenteral therapy, or whenever the condition of the patient warrants such evaluation.
Caution should be exercised in the administration of parenteral fluids, especially those containing dextrose, sodium ions, to patients receiving corticosteroids or corticotropin.
Caution should be exercised in the administration of these injections to the very young and to elderly patients.
Administer so that extravasation does not occur. If thrombosis occurs during administration, stop injection and correct.
For Solutions Containing Dextrose
Solutions containing dextrose should be used with caution in patients with overt or subclinical diabetes mellitus, or carbohydrate intolerance.
Hyperglycemia and glycosuria may be functions of rate of administration or metabolic insufficiency. To minimize these conditions, slow the infusion rate, monitor blood and urine glucose; if necessary, administer insulin.
Vitamin B-complex deficiency may occur with dextrose administration.

Dosage and Administration
Note: Do not administer unless solution is clear and seal is intact.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Use of a final filter is recommended during administration of all parenteral solutions, where possible.

The dosage is usually dependent upon the age, weight and clinical condition of the patient, as well as laboratory determinations. All injections in plastic bags are intended for intravenous administration using sterile equipment. It is recommended that intravenous administration apparatus be replaced at least once every 24 hours.
Additives may be incompatible Complete information is not available. Those additives known to be incompatible should not be used. A pharmacist should be consulted, if available. If, in the informed judgment of the physician, it is deemed advisable to introduce additives, aseptic technique should be used. Thorough mixing should be performed when additives have been introduced. Solutions containing additives must not be stored.

Directions for Use of Plastic Bags
Warning : Do not use plastic bags in series connections. Such use could result in air embolism due to residual air being drawn from the primary bag before administration of the fluid from the secondary bag is completed.

To Open
Do not remove units from overwrap until ready for use. Use all units promptly when pouch is opened.
The overwrap is a moisture barrier. The inner bag maintains the sterility of the product.
IV INJECTIONS IN PLASTIC BAGS   21 11. 2007, RH


Tear pouch down side at slit and remove solution bag. Check for minute leaks by squeezing inner bag firmly. If leaks are found, discard solution as sterility may be impaired. If supplemental medication is desired, follow directions below before preparing for administration.


Preparation for Administration
1. Suspend bag from eyelet support.
2. Remove plastic protector from outlet port at bottom of bag.
3. Attach administration set. Refer to complete directions accompanying set.


To Add Medication Before Solution Administration
Warning: Additives may be incompatible.
1. Prepare medication site.
2. Using syringe with 19-22 gauge needle, puncture medication port and inject.
3. Mix solution and medication thoroughly. For high density medication such as potassium chloride, squeeze ports while ports are upright and mix thoroughly.


To Add Medication During Solution Administration
1. Close clamp on the set.
2. Prepare medication site.
3. Using syringe with 19-22 gauge needle, puncture resealable medication port and inject.
4. Remove bag from IV pole and/or turn to an upright position.
5. Evacuate both ports by squeezing them while bag is in the upright position.
6. Mix solution and medication thoroughly.
7. Return bag to in use position and continue administration.