Title: Re: Dilantin
Nancy, you are not alone as I have also seen this problem for many years.

Back in the 1980's, there was a perception going around that there was some issues of compatibility between silicone and drugs like dilantin. I do remember this in the instructions for only one product, but I have never seen any real evidence to support this idea. However, the occlusions do happen.

Dilantin is a drug that is not compatible with any other drug according to its literature. Are you giving dilantin undiluted by slow IV push or are you giving it diluted? Have your pharmacy check the latest compatibility information on dilution. Dilution requires careful attention to the concentration and length of time it has been diluted. This method is not recommended by the drug manufacturer but it is used. So your problem could be related to the method of infusion.

There could also be issues with other drugs that were not adequately flushed from the line. Remember the literature says it is not compatible with any other drug and it may precipitate due to a change in the pH. So I would use require a dual lumen and use one lumen only for dilantin and nothing else.

Of course the best thing would be to get your pharmacy and doctors to switch to fosphenytoin and these issues go away. Lynn

At 5:26 PM -0800 2/3/06, Nancy Sullivan wrote:
I know you ladies and gentlmen have probably discussed this many times, but I'm new to these message baords and have a  questions.
 
My hospital has a policy that states: "DO NOT INFUSE DILANTIN THRU PICC LINES." I have been working at this hospital for 3 years and it does seem like every time a nurse puts dilantin into a picc--occlusion and loss of the line.  I have been told that it is a flushing problem and lack of education. We use groshong  and per q cath piccs. SO PLEASE EDUCATE ME IN THIS MATTER, BECAUSE I WOULD LOVE TO EDUCATE THE REST OF THE STAFF.
Thanks in advance
Nancy Sullivan RN
 
                       

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-- 
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861



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