Table of Content

Acetyl cysteine 3 Aztreonam 9 Cisatracurium 12 Ephedrine 17

Acyclovir 3 Baclofen 9 Clindamycin 13 Epinephrine 17

Adenosine 4 Benztropine 9 Cloxacillin/Floclox 13 Erythromycin 17

Albumin 4 Calcium Chloride 10% 9 Colistimethate 13 Erythropoietin 17

Alprostadil 4 Calcium Gluconate 10% 10 Dantrolene 13 Esmolol 18

Alteplase 5 Carnitine 10 Deferoxamine 14 Fat Emulsion 18

Amikacin 6 Caspofungin 10 Desmopressin 14 Fentanyl 18

Aminophylline 6 Cefepime 10 Dexamethasone 14 Fluconazole 18

Amiodarone 6 Cefotaxime 11 Dexmedetomidine 15 Flumazenil 19

Amoxicillin 7 Ceftazidime 11 Dextrose 5%-250% 15 Furosemide 19

Amphotericin B 7 Ceftizoxime 11 Diazepam 15 Gentamycin 19

Ampicillin 7 Ceftriaxone 11 Digoxine 16 Glucagon 19

Atracurium 8 Cefuroxime 12 Diltiazem 16 Glycopyrolate 20

Atropine Sulfate 8 Chlorpheniramine 12 Dobutamine 16 Granisetron 20

Azithromycin 8 Ciprofloxacin 12 Dopamine 16 Haloperidol 20

Page1
Heparin 20 Mannitol 20% 25 Oxycodone 30 Sodium Bicarbonate 35

Hydralazine 21 Meropenem 25 Oxytocin 30 Sodium Chloride 35

Hydrocortisone 21 Methylene Blue 22 Papaverine 31 Sodium Nitroprusside 35

Hyoscine N Butylbromide21 Methylergometrin 25 Paracetamol 31 Succinylcholine 36

Imipenem + Cilastatin 22 Methylprednisolone 26 Phenobarbital 31 Thiamine HCl 36

Immunoglobulin-G 22 Metoclopramide 26 Phenylephrine 31 Thiopental 36

Infliximab 22 Metronidazole 26 Phenytoin 32 Tigecycline 36

Iron Sucrose (Ferosac) 22 Morphine Sulfate 27 Piperacillin/Tazocin 32 Trace elements 37

Isoproterenol 23 Nalaxone 27 Potassium Chloride 33 Tramadol 37

Ketamine 23 Neostigmine 28 Potassium Phosphate 33 Tranexamic 37

Labetalol 23 Nimodipine 28 Prochlorperazine 33 Valproate Sodium 33

Levofloxacin 23 Nitroglycerine 28 Promethazine 33 Vancomycin 38

Lidocaine 2% 24 Norepinephrine 29 Propofol 33 Verapamil 38

Linezolid 24 Ocreotide 29 Protamine Sulfate 34 Vit K1 phytonamide 38

Lorazepam 22 Omeprazole 29 Ranitidine 34 Zoledronic Acid 38

Magnesium Sulfate 24 Ondansetron 30 Rituximab 34

Page2
 Pharmacy Services – IV Admixture Room
*** Medications highlighted in purple are approved to be administered by nursing staff via IV Push ***

INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES

IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations

Acetyl cysteine Loading: 150 mg/kg Loading: 150

in 250 ml D5W mg/kg in D5W
Initial maintenance: 250 ml over 60
Oral Route preferred. 50 mg/kg in 500 ml mins followed by
IV Push/ IM/ SC Not recommended D5W 50 mg/kg in 500
2nd maintenance: ml D5W over 4
100mg/kg in 1000ml hours then
D5W 100mg/kg in 1
liter over 16
hours or longer
Acyclovir IV Push/ IM/ SC Not recommended Dilute every 500 mg
(Zovirax) in 100 ml D5W or
NS to infuse for 1 N/A Do not refrigerate.
hour. If dose > 700
mg dilute in 250ml
D5W.

Page3
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion Comments/
Medication Special
Preparation Where it can be Preparation Where it can be Preparation Where it can be Considerations
given given given

RAPID IV
PUSH preferred Max 3 mg/mL.
IM/SC:Not Rate Adult: 140
mcg/kg/min over 6 Physician must be
recommended
min infusion present when
6mg in 1-2 secs.
Critical Care Critical Care administered in In-
Adenosine Max adult single
Areas, ED, OT, Pediatric: < 50kg Areas, ED, OT, N/A Patient wards
dose: 12 mg. RR RR
Infant- child: if 0.05-0.1mg/kg Max
single dose 0.3 Code Blue equipment
odes is less than
mg/kg or 12mg must be on standby
0.2 ml (600mcg)
dilute to 1-2 ml
NS

20%: max 1 ml/min

Albumin 20% Discard after 4 hours
Pediatrics or Adult All Nursing Units N/A
undiluted IV Push/ IM/ SC Not recommended from spiking
Over 1 to 4 hours.

Dilute 500mcg in
25 or 250ml
D5W/NS

Start at 0.05- 24hrs refrigerated

0.1mcg/kg/min.
All Nursing
Alprostadil IV Push/ IM/ SC Not recommended NA When therapeutic
response is
Units Any Dextrose –
achieved, reduce Saline solution
rate in increments
to the lowest dose
that maintains the
response

Page2
 IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion Comments/
Medication Special
Preparation Where it can be Preparation Where it can be Preparation Where it can be Considerations
given given given

Weight above 67kg

Infuse 15mg over 1-2 Do NOT use in-line
mins, then 50mg over filter
30 mins. Infuse
remaining 35mg over Reconstitute solution
the next hour in provided diluent
Myocardial
Critical Care Critical Care
Infarction
Areas, ED Areas, ED Infusion stable for
Weight 67kg or less 8hrs refrigerated
Infuse 15mg over 1-2
mins, then 0.75mg/kg
over 30 mins. Infuse
remaining 0.5mg/kg
over the next hour
Alteplase NA

Give 10% of 0.9/kg

Acute Ischemic Critical Care dose over 1min then Critical Care
Stroke Areas, ED give remainder dose Areas, ED
over 60mins

Acute
Critical Care Give 100mg over Critical Care
Pulmonary
Areas, ED 2hours Areas, ED
Embolism

Pediatrics with
Give at a rate of 0.1-
Systemic PICU
0.6mg/kg/hr
PICU
thrombosis

Page2
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Dilute in 100 to
7 days refrigerated
IV Push/ SC Not recommended 200ml of All Nursing
Amikacin N/A or 24 hours at room
IM at large muscle Dextrose/Saline to Units
temperature.
infuse for 30-60 mins

24 hours
refrigerated.
1) Aminophylline
Adult: 0.25-2.0
Slow I V push 100mg = 85mg
mg/kg/hour
≤25 mg/min Theophylline
All Nursing All Nursing
Aminophylline IM/SC: Not 2) Acephylline
Units N/A Pediatrics: 1yr- Units
recommended (Etaphylline)
16 yrs old 0.5-
100mg = 64mg
0.8 mg/kg/hour
Theophylline
=75mg
Aminophylline

Stability:
IM/SC: Not
24 hours
recommended Critical Care
900 mg in 500 refrigerated
Critical Care Bolus 150mg over 10 Areas, ED,
ml D5W at 1
IV Push- 300 mg Areas, ED, Other minutes Other
Amiodarone mg/min x 6 Stability in PVC
over 1 min for Nursing Units Nursing Units
hours then bag-2 hours only
VF/VT arrest with Physician with
0.5mg/ min
flush with 10 ml present Physician
maintenance Dose for neonates/
NS present
children are not
established.

Page6
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion Comments/
Medication Special
Preparation Where it can be Preparation Where it can be Preparation Where it can be
given given given
Considerations

Dilute every 600 mg

in 50 ml Normal
Stable for 8 hours
Saline only to run for All Nursing
Amoxicillin refrigerated; 4 hours
IV Push/ IM/ SC Not recommended 30 minutes. Units N/A
at room temperature
1200 mg in 100ml
for 1 hour.

50 mg in 50 ml
D5W infuse
Amphotericin-B All Nursing Use micron filter
over 1-2 hours
Liposome IV Push/ IM/ SC Not recommended N/A
Units Avoid using saline
Max:
2.5mg/kg/hour

IV Push 3-5 min

if between 125 to
500 mg , max 100 1 gm in 50 ml NS or Stable for 24 hours
mg/min. All Nursing 2 gm in 100ml to All Nursing refrigerated
Ampicillin
IM: dose in 3-5 Units infuse minimally Units N/A NS preferred
mL, painful over 30 mins. D5W (4 hrs. stability)
SC-not
recommended

Page3
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Special
Preparation Where it can be Preparation Where it can be Preparation Where it can be Considerations
given given given

Rapid IV Push, 11-13 Stable for 24 hours

10 mg/mL or less
undiluted mcg/kg/min refrigerated
Critical Care Standard Critical Care Critical Care
Atracurium IM / SC :Not Dose for Dilute with any
Areas, ED, OT concentration 10 Areas, ED, OT Areas, ED, OT
Recommended Pediatrics may dextrose saline
mg/ml
be higher solution

IV PUSH: 0.1 Maybe given via

mg/ml or ETT followed by 10
undiluted. 0.5- ml NS and ambubag
1mg every 3-5min All Nursing
Atropine sulfate Physician must be
not to exceed Units N/A
0.04mg/kg. N/A present when
SC/IM- administered in In-
Undiluted Patient wards

Dilute with any

Dose in 250 ml D5W All Nursing
Azithromycin IV Push/ IM/ SC Not recommended dextrose saline
to run for 1-2 hours Units N/A solution

Page8
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations
Each gram in 50 ml Dilute with any
D5W over 60 All Nursing
Aztreonam N/A Dextrose saline
IV Push/ IM/ SC Not recommended minutes Units
solution
IM: undiluted
IV PUSH: rarely
Benztropine 1-2 mg over 1-2 Adult Nursing N/A IM administration
N/A
(Cogentin) minutes Units preferred over IV
SC: Not
recommended
For Intrathecal
(Epidural)
injection
For Intrathecal (Epidural)
All Nursing
Baclofen Test Dose: For Intrathecal (Epidural) injection injection
Units
Screening dose of
50mcg/ml over at
least 1min

IV PUSH: 500 Extravasation risk.

mg-1000mg over Requires central line
Critical Care Critical Care
1 minute unless emergency
Areas, ED, OT, Areas, ED, OT,
Cardiac arrest: 500mg- 1000mg in
Calcium Chloride other nursing other nursing N/A
1g or prescribed 50 ml D5W or NS With physician
10% units with units with
dose over 10-20 over 15-30 minutes. present
Physician Physician
sec.
present present
IM/SC: Not Do not exceed
recommended 200mg/min

Page9
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations
IV PUSH: 1gm Critical Care 1-2 gm in 50-100 ml Critical Care Extravasation Risk.
slow IV PUSH Areas, ED, OT, over 30-60 mins. Areas, ED, OT, Prefer central line.
Calcium Gluconate atleast over 2-5 other nursing other nursing
Any dextrose- Saline
mins NA solution.
10% units with units with Be careful when mix
IM/ SC: Not Physician Physician
recommended with phosphate-
present present containing Solution.

IV Push: Dilute with any

Dilute with 25ml
Carnitine 50mg/kg over 2- All Nursing All Nursing dextrose- Saline
D5W/NS at NA
L-Carnitine 3mins every 3- Units Units Ringer’s Lactate
4mg/kg/hr
4hrs solution

48 hours refrigerated
50-70 mg in 250 ml diluted vial with water
is stable for 24 hours
Caspofungin IV Push/ IM/ SC Not recommended NS over 1 hour up to nn sruN ll
NA refrigerated
(Cancidas) 100 ml for fluid sl nN NS or RL only.
restricted patients. Do not use Dextrose
Solution

Dilute each gm in
100 ml NS or 50 ml Dilute with any
IV Push/ IM/ SC Not recommended All Nursing
Cefepime for fluid restricted NA dextrose- Saline
Units
patient over solution
minimum of 30 mins.

P a g e 11
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Medication Comments/
Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations
IV PUSH: 500
mg in 10 ml NS Dilute each gm in
over 3-5 minutes 100 ml NS or 50 ml Dilute with any
IM: Deep muscle All Nursing All Nursing
Cefotaxime for fluid restricted dextrose- Saline
200- 300mg Units Units N/A
patient over solution
SC: Not minimum of 30 mins.
recommended
IV PUSH: 500
Dilute each gm in
mg in 10 ml NS
100 ml NS or 50 ml Dilute with any
over 3-5 minutes All Nursing All Nursing
Ceftazidime for fluid restricted N/A dextrose- Saline
IM/ SC: Not Units Units
patient over solution
recommended
minimum of 30 mins
IV PUSH: over
Dilute each gm in
3-5 min
100 ml NS or 50 ml Dilute with any
IM: deep muscle All Nursing All Nursing
Ceftizoxime for fluid restricted dextrose- Saline
SC: Not Units Units N/A
patient over solution
recommended
minimum of 30 mins

Dilute each gm in
IV PUSH: over
100 ml NS or 50 ml Dilute with any
3-5 min All Nursing All Nursing
Ceftriaxone for fluid restricted dextrose- Saline
IM/ SC: Not Units Units N/A
patient over solution
recommended
minimum of 30 mins.

P a g e 11
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations
Dilute each 750 mg
IV PUSH: 550
in 100 ml NS or 50
mg in 8.3 ml NS Dilute with any
All Nursing ml for fluid restricted All Nursing
Cefuroxime over 3-5 minutes. N/A dextrose- Saline
Units patient over Units
IM/ SC: Not solution
minimum of 30mins
recommended

IM / SC :
injection over 1
min.
Chlorpheniramine All Nursing
IV PUSH: only in N/A N/A
Units
severe allergies,
and should be
given slowly over
at least 1 min.
200 mg in 100 ml
IV Push/ IM/ SC Not recommended 400 mg in 200 ml All Nursing
Ciprofloxacin N/A Prefer Central Line
D5W over 60 Units
minutes

IV PUSH: 0.15- For 7 days

0.2 mg/kg over 5-10 100mg/250 ml refrigerated
Cisatracurium secs.
Critical Care Critical Care
D5W/ NS at 1-5 (Protected from light)
(Nimbex) IM/ SC: Not Areas, OT N/A Areas
mcg/kg/min Mechanical
recommended Ventilator required

P a g e 12
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations
IV PUSH/SC: 300-900 mg in 100
not recommended ml D5W/ NS over 30
Dilute with any
IM: dose greater All Nursing min All Nursing
Clindamycin N/A dextrose- Saline
than 600 mg must Units Units
solution
be over 2 sites for
adult
IV PUSH: conc. D5W preferred for
Dilute 500 mg in dilution.
100mg/mL SWI,
100 ml D5W or 50 For 7 days refrigerated
Cloxacillin Or dose over 10 min All Nursing All Nursing
ml for fluid restricted N/A (with D5W)
Flucloxacillin Units Units For 24 hours
patient over
IM: painful dose refrigerated
minimum of 30 mins
in 3-5 mL (with NS)
IV Push: Dose in Dilute dose with
20ml SWI in 25-100ml
D5W/NS May be administered
5mins
in a standard
Colistimethate
Give 1/2 of total nebulizing apparatus
Colomycin® Aerosol: dissolve All Nursing
All Nursing daily dose as IV or with an IPPB
2 MU= 160 mg of in 1-2ml NS NA Units
Units Push over device
colistimethate = 60 mg
5mins. The
Colistin base Adult: 25-50mg
remaining 1/2 to Discard unused
2-3 times daily
be given after portions after 24hrs
Pedia: 2-15mg
1hr to run over
2-4 times daily
23hrs
IV Push: 1mg/kg Reconstitute 20mg Do NOT use glass
rapid IV push, with 60ml SWI. containers.
Dantrolene repeated as Extravasation risk.
Surgical Units Surgical Units N/A
necessary up to Prophylactic dose: Incompatible with
10mg/kg 2.5mg/kg over 1hr D5W, NS or
(Emergency dose) bacteriostatic water
P a g e 13
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medication Preparation Where it can be Preparation Where it can be Preparation Where it can be Special
given given given Considerations
IV Push Not
Recommended
IM
Reconstitute 500mg
(recommended for
Deferoxamine All Nursing in 2ml sterile water, All Nursing
all patient not in Stable for 24hrs at
Desferrioxamine Units except then add to 250ml Units except NA
shock) : use 500 room temperature.
Desferal NICU D5W at 15mg/kg/hr NICU
mg/2 mL SWI
every 8hrs
Intraperitoneal:
5 mg/kg added to
final daily dialysis

IV Push 2-4mcg Dilute with NS only.

All Nursing 0.3mcg/kg in 50ml All Nursing
Desmopressin undiluted over
Units except NS over 15-30mins Units except NA
Desmopressin acetate 1min for Diabetes Max infusion not
NICU for bleeding NICU
Insipidus more than 20mg/min

IV Push: over 1-
5mins without Give dose in volume
3mg /kg to dilute
dilution if dose is All Nursing of normal saline to All Nursing All Nursing Stable for 7 days
Dexamethasone every 4mg in
less than 10mg Units 0.4mg/ml over 30 to Units Units refrigerated
1ml NS over 24h
60mins
IM: 4mg/ml

P a g e 12
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Dilute 200 mcg
in 48 mL NS
Max infusion period
Critical Care
NA 1mcg/kg over 10 is 24 hrs.
Dexmedetomidine IV Push/ IM/ SC Not recommended Areas
minutes,
followed by NS Preferred
infusion of 0.2-
0.7 mcg/kg/hr
Adult: Max 5- Large vein preferred
IV Push: 25gm of 6mg/kg/min
All Nursing All Nursing
Dextrose 25-50% 50% each 3ml NA Dilute with any
Units Units
over 1min Pedia: Max 5-17 dextrose- Saline
mg/kg/min solution
IV Push: Give May be given via
dose undiluted at ET tube
Diazepam All Nursing NA NA
a rate of 5mg over
Units
1min NS Only
Add dose to 100-
Only Voltaren
Add dose to 100- 500ml NS/D5W
brand approved for
IV Push/SC: Not 500ml NS/D5W with with 0.5ml
IV infusion.
Recommended All Nursing 0.5ml Sodium All Nursing Sodium All Nursing
Diclofenac (Voltaren) Units except bicarbonate 8.4% Units except bicarbonate 8.4% Units except
Add 0.5ml Sodium
IM: 25mg/ml NICU NICU NICU
bicarbonate 8.4% to
undiluted To be given over 5mg/hr up to
diluent as buffering
30mins maximum daily
agent
dose of 150mg

P a g e 12
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push: 0.125- Cardiac monitoring
0.5mg over 5min preferred

IM/SC: Not Critical Care Slow IV Push Preferred Slow IV Push Preferred Physician must be
Digoxin
recommended Areas, ED, OT present when
administered in In-
Patient wards
Cardiac monitoring
IV Push: Dilute 250mg in
preferred
Dilute with D5W,
0.25mg/kg over 500ml D5W or
Critical Care NS, SWI
2mins Critical Care 125mg in 100ml
Diltiazem NA Areas, ED, Physician must be
May repeat with Areas, ED, OT D5W
OT present when
0.35mg.kg in
administered in In-
15mins at 5-15mg/hr
Patient wards
Dilute 250mg in May be used by
AT LEAST Stress labs
Critical Care,
50ml D5W Only stable drips for
Dobutamine NA NA Areas, ED,
step-down units
OT
At 2-20 5% Dextrose-saline
mcg/kg/min solution only

Dilute 200mg in Central line

AT LEAST preferred except for
Critical Care
50ml D5W emergencies
Dopamine NA NA Areas, ED,
OT
At 2-20 5% Dextrose-saline
mcg/kg/min solution only

P a g e 16
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Central line
IV Push: 1mg
required except for
every 3-5mins in Dilute 2mg in
emergency
cardiac arrest 250ml D5W
Epinephrine Critical Care NA Critical Care
Adrenaline Areas, ED, OT Areas, ED, May be given via
At 0.01-0.05
OT ET tube
mcg/kg/min
D5W preferred
IV Push:
5-25mg, each All Nursing Do not administer
Ephedrine 10mg over 1min Units except NA NA unless solution is
NICU clear
IM: Undiluted

Infusion stable for

24hr refrigerated,
Dilute 1gm in 250ml 8hrs in room
Erythromycin All Nursing
IV Push / SC / IM not recommended NS to be given over NA temperature
Lactobionate Units
1hr
Compatible with NS
only
IV route preferred
IV Push: 1-3min
in Dialysis patients,
into venous line at
Otherwise,
end of dialysis, All Nursing
Erythropoietin NA NA Subcutaneous
undiluted Units
preferred
SC: undiluted
Compatible with NS
only
P a g e 13
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
2500mg in Extravasation risk
IV Push: Critical Care
250ml D5W
0.5mg/kg over 1 Critical Care NA Areas, ED,
Esmolol Dilute with any
min Areas, ED, OT OT
At 25-300 dextrose- Saline
mcg/kg/min solution
Infant: max
0.75ml/kg/h
Pedia: max See TPN policy
IV Push / IM / SC Not All Nursing
Fat Emulsion 20% 1.25/ml/kg/h NA
Recommended Units
Adult: max Avoid with RL
1.25ml/kg/h not to
exceed 50ml/h
For pain
management,
IV Push: monitor chest wall
Dilute 2500mcg
25-100mcg over rigidity – can cause
Critical Care Critical Care in 50ml D5W Critical Care
Fentanyl citrate 3-5mins Per PCA orders apnea and rest
Areas, ED, OT Areas Areas
At 50-250mcg/hr
Dilute with any
dextrose- Saline
solution

2mg/ml (100ml) vial All Nursing Do not use if cloudy

Fluconazole IV Push / SC / IM not recommended NA
to run at 200mg/hr Units or precipitated

P a g e 18
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Large vein preferred
IV Push: 0.2mg
Critical Care NA NA
over 15secs. May
Flumazenil Areas, Dilute with any
repeat every 1min
Endoscopy, OT dextrose- Saline
for a total of 1mg
solution

Slow IV Push: Use cautiously for

Dilute 40mg in
over 2-5 min patient with renal
40ml NS
All Nursing impairment
Dilute 40mg in 40ml All Nursing All Nursing
Furosemide IM: Undiluted Units except
NS Units 10-80mg/hr for Units
NICU Dilute with any
titration every
SC: Not dextrose- Saline
3-6hrs
recommended solution
<100mg in 50ml in For neonatal dosing,
30min see newborn
>200mg in 100ml guidelines
All Nursing
Gentamycin IV Push / IM / SC not recommended >300mg in 150ml NA
Units
over 1hr Dilute with any
500mg in 250ml over dextrose- Saline
2hrs solution
Dilute 10mg in
IV Push: 3-5mg
100ml NS at
0.07mg/kg/hr
For treatment of Dilute with any
All Nursing NA All Nursing
Glucagon beta blocker dextrose- Saline
Units For beta- Units
excess: solution
blockade:
50-150mcg/kg
1-15mg/hr to
over 1min
max of 16mg/hr

P a g e 19
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push: 200mcg
per 1ml or
neostigmine over Dilute with any
1-2mins Critical Care NA NA
Glycopyrolate dextrose- Saline
Areas, OT, ED
solution
IM: Undiluted
200mcg
Stable for 7 days
refrigerated
Dilute 1mg in 20ml
All Nursing
Granisetron IV Push / IM / SC not recommended NS and to be given NA
Units Dilute with any
over 5-10mins
dextrose- Saline
solution
Monitor for ECG
IV Push: 0.5 –
Changes (May
10mg at 5mg/min
prolong QT
to be diluted with Critical Care
Haloperidol NA NA interval)
SWI or D5W Areas, ED, OT
Dilute with D5W
IM: Undiluted
only
IV Push: To be
given over at least
Dilute
1min
25000units in
All Nursing All Nursing See KHUH Heparin
Heparin NA 250ml NS at rate
SC: 5000units/ml Units Units Guidelines
as ordered per
protocol
IM: Not
recommended

P a g e 21
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Central line
Dilute 20mg in
preferred
IV Push: 10- 200ml NS or RL
40mg over 1min Obs and Gyne NA Obs and Gyne
Hydralazine See KHUH
Areas Loading doe of Areas
OB/Gyne protocol
IM: Not preferred 0.1mg/kg then at
a rate of
Monitor BP
IV Push: 25-
200mg over 30-
Dilute 100mg in
60secs All Nursing All Nursing
Hydrocortisone 100ml NS and to be NA
Units Units
given over 30mins
SC: Not
recommended

Hyoscine-N-
Dilute 20mg in 50ml All Nursing
Butylbromide or
IV Push / IM / SC not recommended NS at a rate of Units except NA
Scopolamine-N-
1ml/min NICU
Butylbromide Br

Dilute each 500ml in

50-100ml NS and to All Nursing
Imipenem + Cilastatin IV Push / SC not recommended NA
be given over 30 to Units
60mins

P a g e 21
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations

Dilution and All Nursing Monitor for

Immunoglobulin-G Units NA
IV Push / SC not recommended compatibility based anaphylaxis, BP,
IgG (IV)
on Manufacturer HR and temperature

Reconstitute each
vial with 10ml SWFI
gently, let sit for
Adult Nursing
5mins. Must be given in a
Infliximab IV Push / IM / SC not recommended Units except NA
set with in-line filter
Obs and Gyne
Dilute in 250ml
NSand to be given
over 2hrs.

IV Push: Over
Dilute 50units in
15-30secs
All Nursing 50ml NS and All Nursing Kindly see KHUH
Insulin (Regular) NA
Units titrate according Units guidelines
SC/IM: Given
to protocol
undiluted

Too rapid
IV Push: 100mg Dilute 200mg in administration may
All Nursing All Nursing
Iron Sucrose (Ferosac) over 3-5mins with 100ml NS to be given NA cause hypotension
Units Units
extreme caution over 15mins or symptoms of
overdose

P a g e 22
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Dilute 1mg in
IV Push: Dilute
Adult Nursing NA 250ml D5W and Adult Central line for
Isoproterenol 200mcg in 10ml
Units titrate at 2- Nursing Units continuous infusion
NS.
20mcg/min

Dilute 500mg in
Critical Care Critical Care Not compatible with
IV Push: 250ml D5W
Ketamine Areas except Areas except NA barbiturates or
0.5mg/kg/min
NIC, OT NIC, OT benzodiazepines
At 1-7 mcg/kg/min

IV Push:
20mg initial dose
Dilute 300mg in Adult
followed by 40- Adult Nursing
240ml D5W Nursing
Labetalol 80mg. Each 20mg Units/ Obs and NA
Units/ Obs
to be given over Gyne
At 2-8mg/min and Gyne
2mins.
Max 300mg

500mg to be given
over 60mins Do not administer
All Nursing
Levofloxacin IV Push / IM / SC not recommended NA with cations
Units
750mg to be given (Ca, Mg, etc.)
over 90mins

P a g e 23
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push:
1-1.5mg/kg load Dilute 2gm in
(rate of 250ml D5W Critical Care
Critical Care NA Areas, ED, May be given via
Lidocaine 2% 50mg/min).
Areas, ED, OT OT ET tube
Repeat dose 0.5- Titrate at
0.75mg/kg. 1-4mg/min
Max of 3mg/kg
Ready-to-use
infusion bags
All Nursing Do not mix with
Linezolid IV Push / IM / SC not recommended NA
Units other medications
To be given over 30-
120mins
Check BP and
IV Push: Dilute 100mg in SPO2 30mins after
0.5-10mg dilute 100ml NS Critical Care IV push dose.
Critical Care
Lorazepam with NS (1mg/ml) NA Areas, OT, Reasses fall risk.
Areas, OT, ED
and give each Max dose of ED
2mg over 2-5mins 8mg/hr Can cause
nephrotoxicity

IV Push: Over Dilute 1-4gm in

Monitor BP, RR,
2mins. 100ml NS
SPO2 every 5mins
Max 150mg/min
All Nursing All Nursing during loading dose.
Magnesium Sulfate 1gm in 30min NA
Units Units
1-2gm in 10ml 2gm in 60min
Strict Intake and
push (Cardiac 3gm in 2hrs
Output
arrest) 4gm in 3hrs

P a g e 22
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Inspect for crystals
prior to
administration.
IV Push: Adult and
Undiluted solution All Nursing Re-dissolve by
Mannitol 20% 0.25-2gm/kg over Pediatric NA
given over 30-90mins Units warming solution
5-10mins Nursing Units
In line filter
required

Dilute with 100ml

NS for every 500mg All Nursing
Meropenem IV Push / IM / SC not recommended NA
and infuse over 30 to Units
60mins

IV Push: Over 5-
10mins Ensure patient is not
All Nursing
hypoglycemic.
Methylene Blue Units except IV Push preferred IV Push preferred
IM: 1ml(10mg) Consider giving
NICU
into gluteus D5W if necessary
maximus

IV Push: Over at IV route reserved

least 60 seconds for life-threatening
Dilute dose to 50ml situations.
Methylergometrine
IM: 0.2mg Obs-Gyne NS and give over Obs-Gyne NA
Methergine
undiluted. Repeat 5mins Monitor blood
every 2-4hrs pressure very
IM route preferred closely

P a g e 22
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Reconstitute in
provided diluent.
Dilute 500mg in
200ml NS and to be Only SUCCINATE
All Nursing
Methylprednisolone IV Push / SC not recommended given for at least NA formulation can be
Units
30mins. given IV

Doses above 500mg

over at least 60mins
IV Push: Given
Dilute dose in at
over 2min
All Nursing Dilute dose in at least All Nursing least 50ml NS All Nursing
Metoclopramide Units except 50ml NS and infuse Units except and infuse at a Units except
Doses above
NICU for at least 15mins NICU rate of 0.5- NICU
10mg to be given
1.2mg/kg/hr
as infusion

Avoid using
Pre-diluted solution
All Nursing equipment
Metronidazole IV Push / IM / SC not recommended to be given over 30- NA
Units containing
60mins
aluminum

P a g e 26
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Dilute 25mg in
50ml D5W and
Critical Care
IV Push: 0.5-2mg Critical Care start at 1mg/hr. For conscious
Midazolam NA Areas, ED,
over 2mins Areas, ED, OT sedation
OT
Max dose per
physician's order

IV Push: Dilute
10mg in 10ml NS
and give 2-5mg
over 3-5mins Dilute 100mg in
Max 20mg/4hrs 100ml NS and
See Patient Monitor for
All Nursing All Nursing start at 1mg/hr All Nursing
Morphine Sulphate Controlled Analgesia respiratory
If ventilated: 5- Units Units Units
protocol depression
10mg max of Max dose per
200mg in 24hrs physician's order

IM: Give
undiluted

Dilute 4mg in
Continuous infusion
IV Push: 0.4-2mg 100ml NS
used for long-acting
each 0.4mg over
All Nursing All Nursing opioid overdose
Naloxone 15secs NA Start at 0.2-
Units Units
0.4mg/hr and
May be given via
IV push preferred titrate to patient
ET tube
response

P a g e 23
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push: 0.5mg-
Neostigmine NA NA
2mg over 1min

Dispensed in syringe.

Initial dose of 1mg/hr Nimotopp solution

for the first 2hrs. must not be added
Co-infuse with to any PVC bag or
Adult Nursing
Nimodipine D5W/NS at 20ml/hr NA bottle
IV Push / IM / SC not recommended Units except
via 3-way stop cock
Obs and Gyne
Use special tubing
Max of 2mg/hr with provided by
co-infuse rate of manufacturer
40mg/hr

Dilute 10-40mg
in 100ml NS
Use non-PVC
(glass container)
plastic or glass
bottle
Start at a rate of
Adult
Nitroglycerine IV Push / IM / SC not recommended NA 10mcg/min,
Nursing Units Tolerance may
increase by
develop if
10mcg every
administered over
5mins
24hrs
Max dose
400mcg/min

P a g e 28
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations

Dilute 4mg in
250ml D5W or
16mg in 500ml
D5W
Critical Care Central line only
Norepinephrine IV Push / IM / SC not recommended NA Areas, ED,
Adult: 0.01-3
OT Not stable in NS
mcg/kg/min

Pedia: 0.05-2
mcg/kg/min

Dilute 500mcg in
IV Push: 50-
Ocreotide Adult Nursing 500ml NS Adult
100mcg over NA NS preferred
Sandostatin Units Nursing Units
3min
At 20-50mcg/hr

IV Push: Over 3-
Dilute 80mg in
5mins
All Nursing 100ml NS All Nursing
Omeprazole NA NS only
Units Units
IM/SC: Not
At 8mg/hr
recommended

P a g e 29
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push: 4mg
dose over 2-5mins
Adult Nursing Dilute 32mg in 50ml Adult Nursing Monitor QTc for
Ondansetron NA
Units and give over 15mins Units ongoing treatment
IM/SC: Not
recommended

Dilute 20units in
1L NS/LR/D5W
with fetal demise
See Oxytocin
IV Push:
infusion protocol
Emergencies only, Dilute 30units in
Oxytocin maximum dose 2 Obs and Gyne NA 500ml for Obs and Gyne
1000milliUnits =
units administered induction
1unit
by physician
Titrate rate at
0.5-10
milliUnits/min

IV Bolus: Dilute
10mg in 10ml
D5W/NS and
Oxycodone administer a bolus NA NA
dose of 1 to 10mg
slowly over 1-
2mins.

P a g e 31
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push: Slow IV
push 30mg/2min
Adult Nursing
Papaverine NA NA
Units
To be given by
physician only

Prepared solution to All Nursing

Paracetamol IV Push / IM / SC not recommended NA
be given over 15mins Units

IV Push: 100-
320mg each 60mg
All Nursing
over 1min
Phenobarbital Sodium Units NA NA
Slow IV push
preferred

Dilute 20-40mg
IV Push: 0.2- in 250ml
All Nursing All Nursing Extravasation risk,
0.5mg over D5W/NS
Phenylephrine Units except NA Units except Central line
30secs every
NICU NICU preferred
15mins At 0.1-0.5
mcg/kg/min

P a g e 31
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Loading dose: Give in a line with
Dilute 500mg in NS only or flush
IV Push: 100ml NS over with 10ml NS
Maintenance 20mins before and after.
All Nursing
Phenytoin Sodium dose: 50-100mg All Nursing units NA Large bore IV
Maintenance dose: Units
each 25-50mg preferred.
over 1-2mins Dilute 50-100mg in
50-100ml NS over Stable only for 3hrs
20min at room temp.
Dilute 2.25mg in
50ml NS
Piperacillin/
IV Push / IM / SC not recommended All Nursing
Tazobactam NA
Dilute 3.375 and Units
Tazocin
higher doses in
100ml over 30mins

The maximum adult

dose must not
Peripheral line:
Central line: exceed 200mEq
Dilute 60mEq in
Dilute 20mEq in /24hrs
1L NS
100ml NS
At rate not more
At rate not more than All Nursing All Nursing Maximum pedia
Potassium Chloride IV Push / IM / SC not recommended than 10mEq/hr
20mEq/hr Units Units dose must not
exceed
Pedia: Not more
Pedia: Not more than 2mEq/kg/24hrs
than
1mEq/kg/hr
0.5mEq/kg/hr
Infusion pump
required

P a g e 32
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Maximum rate of
Peripheral
administration is
Central Line: Line:
7.5mmol as
Potassium Phosphate Dilute 15mmol in All Nursing Dilute 27mmol All Nursing
IV Push / IM / SC not recommended Phosphate per hour
as Phosphate 100ml NS over Units in 1L NS at a Units
2hours rate of
Infusion pump
3-4mmol/hr
required
IV Push: 5mg/ml
Observe for 30mins
over 1-5mins
after administration
Dilute 10mg in 50ml
Adult Nursing Adult Nursing
Prochlorperazine IM: 5mg/ml, NS at a rate of NA
Units Units The maximum daily
upper outer 5mg/min
IV dose should not
buttock
exceed 40 mg
IM route preferred
IM: Deeply into a
Extravasation risk
large muscle
All Nursing Dilute 12.5-25mg in All Nursing
IM route preferred
Promethazine Units except 50ml D5W over Units except NA Rapid rate may
NICU 15min NICU cause fall in blood
IV/SC: Not
pressure
recommended

IV Push: Dilute 1000mg

20-40mg IV push in 100ml D5W Critical Care
Critical Care Tubing change
Propofol NA Areas, ED,
Areas, ED, OT every 12hrs
IM/SC: Not At 10-50 OT
recommended mcg/kg/min

P a g e 33
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Dilute 50-100mg in 1mg Protamine
IV Push: Slow IV 50ml D5W over 20- neutralizes 1mg
All Nursing All Nursing
push, not to 30mins Enoxaparin and
Protamine Sulfate Units except Units except NA
exceed 50mg in 100units dalteparin/
NICU NICU
10mins Slow IV Push tinzaparin or
Preferred heparin
Continuous infusion
only recommended
IV Push: Dilute Total daily dose
Dilute 50mg in 50- for Zollinger-
50mg in 18ml NS All Nursing All Nursing or 150mg in All Nursing
Ranitidine 100ml D5W/NS over Ellison patients.
and to be given Units Units 250ml D5W/NS Units
15mins Needs monitoring
over 5mins at 1-2.5mg/kg/hr
of gastric acid
output
Dilute 50mg in
IV Push: 0.6-1.2
50ml D5W/NS
mg/kg over 5mins Critical Care
Critical Care
Rocuronium NA Areas, ED,
Areas, ED, OT Titrate at a rate
SC/IM: Not OT
of 8-12
recommended
mcg/kg/min
Dilute 500mg in 200-
450ml D5W/NS
Do not shake
Rituximab Start 50mg/hr if there Adult Nursing
IV Push / IM / SC not recommended NA solution after
(Mabthera) is no reaction, Units
preparation
increase the rate
50mg every 30mins
to max of 400mg/hr
P a g e 32
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Not to exceed
150mEq/1000ml
IV Push: 0.5-
D5W/NS to be
1mEq/kg over 1-
given over 8- Incompatible with
Sodium Bicarbonate 3mins for cardiac
All Nursing 12hrs All Nursing RL, dopamine,
8.4% (1mEq/ml) arrest NA
Units Units dobutamine,
Remove 150ml epinephrine
Max conc <2yrs
from bag before
old: 0.5mEq/ml
adding
bicarbonate

To infuse at a rate of Does not need a

25-50ml/hr central line
Sodium Chloride 3% All Nursing
IV Push / IM / SC not recommended NA
(500ml) Units
Not to exceed Tubings change
100ml/hr in adults every 48hrs

Each 50mg must

be reconstituted
Protect from light
in 2-3ml
immediately after
D5W/SWI and
mixing.
diluted in
Adult
Sodium Nitroprusside IV Push / IM / SC not recommended NA minimum of
Nursing Units Monitor blood
250ml D5W/NS
pressure
continuously while
Titrate at a rate
on medication
of 0.3-10
mcg/kg/min

P a g e 32
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
IV Push:
Physician must be
0.3-1.1mg/kg over
Dilute 100mg in present and
30secs
50ml D5W/NS Critical Care ventilator on
Succinylcholine Critical Care
NA Areas, ED, standby
(Suxamethonium) IM: When IV Areas, ED, OT
Titrate at 10- OT
route not feasible,
100mcg/kg/min Attach patient to
high into deltoid
cardiac monitor
muscle

Dilute dose in 25-

IV Push: Slow IV Adult Nursing Adult Nursing
Thiamine HCl 100ml D5W/NS over NA
over 5mins Units Units
30-120mins

Reconstitute each
vial with 5ml
D5W/NS then dilute All Nursing Initial dose of
Tigecycline IV Push / IM / SC not recommended in 100ml D5W/NS Units except NA 100mg followed by
Obs and Gyne 50mg every 12hrs
To be given over 30-
60mins

IV Push: Dilute Dilute 1000mg

Dilute 500mg in 150-
500mg in 10-25ml in 50ml Critical Care
Critical Care 250ml D5W/NS to Critical Care
Thiopental D5W/NS and D5W/NS Areas, ED,
Areas, ED, OT be given over 15- Areas, ED, OT
given over 3- (central line OT
30mins
5mins only)

P a g e 36
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations

Add dose to suitable All Nursing

Trace Elements Incorporated in TPN for NICU
IV Push / IM / SC not recommended volume and infuse Units except
(Pediatrics or Adult) patients
over at least 2hours NICU

IV Push:
Dilute dose to
Undiluted over 2- All Nursing All Nursing
suitable volume
Tramadol 3mins Units except NA Units except
and titrate the
NICU NICU
rate
IM: Undiluted
Administer in
IV Push: Max plastic syringe
dose of Dilute 500mg in
All Nursing All Nursing
100mg/min 50ml D5W/NS and Prepare at the same
Tranexamic acid Units except Units except NA
transfuse over 5- time the solution is
NICU NICU
SC/IM: Not 30mins to be used. Stable
recommended for 2hrs refrigerated

Dilute 400mg in
50ml D5W/NS and
give over 60mins Adult Nursing
Valproate Sodium IV Push / IM / SC not recommended NA
Units
Max infusion of
20mg/min

P a g e 33
 INTRAVENOUS MEDICATION ADMINISTRATION GUIDELINES
IV PUSH / IM/ SC Intermittent Infusion Continuous Infusion
Comments/
Medications Where it can be Where it can be Where it can be Special
Preparation Preparation Preparation
given given given Considerations
Reconstitute each
500mg with 10ml
SWFI
All Nursing
Vancomycin IV Push / IM / SC not recommended Dilute 1g in 200ml NA
Units
D5W/NS
>1.25g in 250ml
>1.5g in 500ml
IV Push: 2.5- Cardiac monitoring
10mg over 2-
Critical Care
Verapamil 3mins Slow60mins
IV Push Preferred NA Monitor for
Areas, ED, OT Infuse over
Max dose prolonged PR
5mg/min interval

IV Push: 1mg
over 1min or Dilute 10mg in 50ml
Vit K 1 All Nursing All Nursing
longer with D5W/NS to be given NA
Phytonadione Units Units
extreme caution over 30mins
(Emergency only)

Prediluted 100ml Flush IV line with

Zoledronic acid Adult Nursing
IV Push / IM / SC not recommended over at least 15mins NA 10ml NS after
Zoledronate Units
or longer infusion

P a g e 38
Note:
 Medication highlighted in purple are approved to be administered via IVPUSH by nursing staff.
 Clear order and special instructions must be obtained from the prescribing physician before preparing and
administering medications especially in vulnerable populations and patients with co-morbidities. (e.g. neonates,
pediatric, pregnant and lactating mothers, multi-organ compromised, renal failure etc.)
 Contact clinical pharmacist in case of any doubt for clarifications.
 If a certain medication is ordered to be administered as IV push and is not included on the list above, clinical
pharmacist must be contacted.
 ALWAYS ENSURE PATENCY OF IV LINES PRIOR TO ADMINISTERING IV PUSH.

P a g e 39