For research results that do not fit these conventional guidelines, the research results are designated as Uncertain or Variable. "_5ZIkcu 3 o(|pM,d7Ut_8=zjgRgQ:m ns{k&h{ pADpD.Ak,{i-D%6B_sX?\L1yy.z"$ oJ {4a:\y"9Hl/lDj:}zyGDMVZJ^ j&27. From the IV medication syringe 2.5 mL was transferred into the 5-mL syringe containing 2.5 mL of lipid emulsion. In chart view, you can filter the table to display just the Y site results. To add drugs to be compared, the user only has to . %PDF-1.5 % 2. {W } 6AEMJ0MzJ@Rb:`1"8]"nhHJ83]DbFXHZtLQ65+:v5 IzB&fFWN`SgJpRz4ObQL W`&T\R VR. Klin Padiatr; 219(1): 37-43, 7 Gikic M, Di Paolo ER, Pannatier A, Cotting J. You can either click on the X in the top right or press the Close button to return to the previous screen. Conversely, for a drug molecule which can lose a proton or hydrogen ion (a Lowry-Bronsted acid - usually a weak organic acid), ionisation is achieved by formulation in a high pH solution, usually as a sodium or potassium salt (for example, benzylpenicillin sodium). Trissel LA. Hawthorn, Vic. Fortunately, King Guide, the oldest continuously published reference on parenteral drug stability and compatibility, is designed to provide practitioners with the timely information they need in this era of drug shortages. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. To view all solution and drug compatibility results for a single drug, enter the IV Drug and Click "View Compatibility". Trusted clinical technology and evidence-based solutions that drive effective decision-making and outcomes across healthcare. medication compatibility chart I.v. User Interface: Upon launching the app, the user is brought to a simple to use screen where there is an alphabetical list of IV medications. 3 Emami S, Hamishehkar H, Mahmoodpoor A, Mashayekhi S, Asgharian P. (2012) Errors of oral medication administration in a patient with enteral feeding tube. Reasonable care is taken to provide accurate information at the time of creation. Select a second drug the same way (limited to 2 drugs) 3. Y-SITE COMPATIBILITY & pH MONITORING, ADVERSE EFFECTS & COMMENTS Acetylcysteine Infusion for liver failure 15mg/kg loading dose then 7.5mg/kg over 24 hours for 5 days pH: 7 adjusted with sodium hydroxide. Compatibility analyses can also be viewed in a list display, where results are shown in pairs. Y-Site, Syringe, and other sets/container specific information. For this reason, the decision to mix any two injection solutions whether in a syringe, in an infusion bag or at a Y-site should be based on a reliable reference. Iran J Pharm Res; 14(suppl); 87-93. http://www.ncbi.nlm.nih.gov/pubmed/17937330, drugs and inappropriate IV solutions as diluent, two drugs (drug-drug incompatibility) when they are, drugs and adjuvants (preservative, buffer, stabilizer, solvent). 1. "d @7. 1: Main causes of incompatibilities in standard IV therapy. Incompatibility can involve precipitation, ionic reactions, evolution of gas and denaturation of biological molecules. Adverse effects of drug incompatibilities extend periods of patients hospitalization and the total costs for hospitals. We also added new stability information to the monographs for DIGOXIN, HYDROMORPHONE HYDROCHLORIDE, MORPHINE HYDROCHLORIDE, SODIUM CHLORIDE, and VANCOMYCIN HYDROCHLORIDE. Drugs administered to patients receiving PN should be given through a separate IV site or catheter lumen. J Basic Clin Pharm; 5(2): 49-53, 5 Westbrook JI, Rob MI, Woods A, Parry D. (2011) Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. Alfentanil. Our solutions for regulated financial departments and institutions help customers meet their obligations to external regulators. ">(f`TagTq`OrNh,Zv@nVG @X5 t"6lBT10 4! Each sample was prepared in duplicate and performed at room temperature. 9814 0 obj <>stream This is because of higher mutual drug concentrations and potentially greater pH changes in the more concentrated solution. ">"b@-Hx\,.262OqaDdH\m>cn!Bmn La/))Z.$+HS'xtI9,y[}rRWLStG\_ #x#x4yF8MT{E)S %PDF-1.6 % Over 600 IV drugs with at-a-glance view of compatibility in 12 fluids. Click "Get Compatibility" once both drugs are selected PEPID's IV Compatibility tool is included in any every clinical decision support suite Protecting your client's UCC position when insolvency or bankruptcy looms, The Corporate Transparency Act's impact on law firms, Pillar 2 challenges: International Law, EU Law, Dispute Management & Tax Incentives, What legal professionals using AI can learn from the media industry, Legal Leaders Exchange: Matter intake supports more effective legal ops, Different types of liens provide creditors with different rights, Infographic: Advanced technology + human intelligence = legal bill review nirvana, Advanced Practice Nurses and Physician Assistants, Defense Health Agency Training & Support Portal, Veterans Affairs Training & Support Portal, Linking to Other Content from a Drug Monograph, Viewing Content Within Collapsible Sections. New compatibility information was added to the existing drug monograph for AMPHOTERICIN B, BUMETANIDE, FOSFOMYCIN DISODIUM, PLAZOMICIN, SCOPOLAMINE HYDROBROMIDE, and IMIPENEM, CILASTATIN AND RELEBACTAM with 28 other drugs. For a drug molecule which acts as a proton acceptor (a Lowry-Bronsted base), ionisation is achieved by formulation in a low pH solution usually as a hydrochloride or hydrogen sulfate salt (for example, amiodarone hydrochloride or adrenaline acid tartrate). The selected drug(s) and solution(s) will populate the Selected Items in the left pane. saline IV Soln: dex/Na/K IV soln < 1 unit/mL heparin PN (NO heparin) PN (with heparin) intralipids (fats) alprostadil (PGE1) amiodarone: calcium CHLORIDE calcium GLUCONATE: Visit our global site, or select a location. Better business continuity for Nelnet now! Fig. 4: Color coding and drug separation to prevent drug incompatibilities through a clear indication of the drug. A separate license is required for each facility location and we offer discounts for multiple licenses. Cs = Compatible Only if Drugs mixed in NS CD = Compatible Only if Drugs mixed in Dextrose C* =Conc./Time dependent, CALL PHARMACY dextrose IV soln. sweating. The most prominent example of a pH-related reduction in solubility is dilution of phenytoin sodium injection. administration of intravenous (IV) medication to neonates. Incompatibility between two intravenous (IV) bolus drugs constituted 68.8% with pantoprazole and ondansetron (85.4%) being the most frequent combination. We start 2023 with the following list of 603 injectable drugs currently found in the King Guide to Parenteral Admixtures Loose-Leaf, and Internet Editions. z Z}\3n g[z@@(~B7n$kR2bY8q+':ntv&=~UT}qog&p&G5mZ92}u`0eLQ'HY_4U)J#Zh} kY2m} vu&YoYjFxOK8b=fE&WJbJ" (A blank space indicates no available data.) The mixing of drug salts of calcium, and to a lesser extent magnesium, with phosphates, carbonates, bicarbonates, tartrates or sulfates should also be avoided. With this app you will have access to the largest, most comprehensive IV compatibility resource which: Includes drug-solution compatibility results as well as drug-drug compatibility results when creating an admixture or administering via Y-Site. 20 years of helping Australians make better decisions about medicines, medical tests and other health technologies. David McAuley, Pharm.D. Use reference materials to find incompatibility, compatibility, and storage information. Read in online version de INTRAVENOUS COMPATIBILITY CHART - Drug Information For The .. Download page 1-6 in FlipHTML5. When in contact with other fluids it precipitates as well. This table was compiled for the convenience of . Iv Medication Solution Compatibility Chart For Nurses [zpnxwkyzq94v] Iv Medication Solution Compatibility Chart For Nurses Uploaded by: run.rebel.run April 2020 PDF Bookmark Download This document was uploaded by user and they confirmed that they have the permission to share it. IV medication must be cleared by flushing at the same rate of administration to avoid the . (2014) A clinical study on drug-related problems associated with intravenous drug administration. A change in visible or electronically (even if not visible) particulates, haziness, or turbidity, frank precipitation, color or gas evolution occurred. 3: Compatibility check using available literature, databases, services and information material. wy D63Hr=bW.X=3$o]$fr5\F0#7B/Le!xtPqBllZ'dgc~vA1+ Search fields self-populate with brand and generic drug names as you type, and compatibility results are instantly generated as you build your drug list. 1. With no software to install and no updates to apply practitioners are assured of having the latest and most up-to-date information available. Some incompatibilities are eminently predictable from simple chemical knowledge, but most compatibilities and incompatibilities are not so easily predicted. IBM Micromedex IV Compatibility (Mobile) IBM Micromedex Mobile IBM Micromedex Neofax (Mobile) IBM Micromedex Neofax and Pediatrics IBM Micromedex Pediatrics (Mobile) IBM Micromedex RED BOOK IBM Micromedex UltiMedex Clinical Knowledge Hours of Operation Micromedex Support is available 24/7. Use the free Micromedex IV Compatibility app. dry mouth , chest pain or pressure, pain spreading to the jaw or shoulder , nausea, and. qR` $m^0n`2A{q0&l'lo}E5|mOA LU $s@_w ?bz8y LX&qCRKuzDr~tM,3'#5 =&8 5aWFxx[~6Du2bxdE@$FU$!Dc- J Res Pharm Pract; (1): 37-40, 4 Vijayakumar A, Sharon EV, Teena J, Nobil S, Nazeer I. It is used to reduce mild to moderate pain, inflammation and has some ability to reduce fever. The cost can be calculated using the average daily costof the expected clinical treatment. Apply judgment in using these results. This application provides the healthcare profession with a method of quickly checking the compatibility of any two of the following intravenous drugs at the Y-site: Acetylcysteine. Key points The table provides a guide to medication compatibility via Y-site within the NICU. We streamline legal and regulatory research, analysis, and workflows to drive value to organizations, ensuring more transparent, just and safe societies. You can also check the IV compatibility of a single drug. When both compatible and incompatible study results are available for the same drug pair. Incompatibility is an undesirable reaction that occurs between the drug and the solution, container or another drug. Intensive Care Med; 25(4): 353-9, 9 Vogel Kahmann I, Brki R, et al. Incompatibility problems are more likely to arise when small concentrated volumes are mixed in a syringe rather than in the larger volume of an infusion bag. Each monograph reports the routes, dosages, temperatures, and containers used to determine compatibility and stability from fully referenced peer-reviewed primary sources. You can't just ignore the problem and hope the wound heals itself. Amiodarone (Cordarone) IV Infusion IV Infusion IV Infusion: A-fib rate control only . Consistently checking alternative modes of administration and/or using multi-lumen catheters. Incompatibility between two intravenous (IV) bolus drugs constituted 68.8% with pantoprazole and ondansetron (85.4%) being the most frequent combination. To have the most complete information possible ASHP recommends multiple sources of IV drug information be available to hospital pharmacy. To view compatibility results for a list of drugs, enter multiple IV drugs and/or solutions then click "Analyze". ReTweet. Five years after the implementation of a simple "colour code system". Y = compatible for at least 30 minutes P = provisionally compatible; give within 15 minutes P(5) = provisionally compatible; give within 5 minutes . adsorption). Precipitation of a drug from its concentrated injection solution when it is diluted with water or saline is counter-intuitive. Budgeting and Consolidation with CCH Tagetik. Integrate our IV compatibility tool into anyEMRorHITsystem to create customized alerts for incompatibilities, or create customized queries for any compatibility. These monographs may include formulation or reconstitution information, stability and storage information, light effects, pH, and/or other details regarding the physical/chemical properties of the drug. Each monograph contains stability data, administration guidelines, and methods of preparation. Click on "Trissel's IV Compatibility" to open the module. Acyclovir NO Albumin ? Read our privacy policy. The King Guide has been updated quarterly since 1971 and is an excellent addition to any drug information library with complete monographs for over 600 injectable drugs. Glucose 5% infusion solution, which has a pH of 4.3-4.5, will precipitate phenytoin almost immediately. Specialized in clinical effectiveness, learning, research and safety. Don't let the courthouse door close on you. 164 0 obj <>/Filter/FlateDecode/ID[<2786D62A495E4BAFB8F09C87CC37D585>]/Index[140 55]/Info 139 0 R/Length 108/Prev 379717/Root 141 0 R/Size 195/Type/XRef/W[1 2 1]>>stream medication compatibility chart I.v. [/quote'] If circumstances are so compelling as to warrant mixing any two or more solutions, there should be support from published compatibility data. Intravenous rehydration is a simple, safe and common procedure with a low risk of complications. Available on any smart phone or tablet, or by integrating the IV Compatibility Checker into your EMR, HIS or patient portal with the PEPID Knowledge Base to accurately identify any potentialincompatibilities. arrow_forward. Morphine: A narcotic pain reliever, morphine is used to reduce moderate to severe pain. Latest news, evidence and CPD opportunities. Practical information, tools and resources for health professionals and staff to help improve the quality of health care and safety for patients. Any change in pH towards the other end of the pH scale will reduce the proportion of ionised to un-ionised drug in solution and will therefore reduce the water solubility of the drug. IV diazepam (valium) is incompatible with most drugs and fluids, including normal saline. Copyright 2022 - King Guide Publications, Inc. - All rights reserved. Please contact your country representative for product availability and information. endstream endobj 11 0 obj <> endobj 12 0 obj <> endobj 13 0 obj <>stream Micromedex IV Compatability is a reliable resource for on-the-go access to the industry's most trusted clinical reference information, providing users with more informed treatment decisions at the point of care. We coordinate your medical care when discharged from the hospital. A number of references, in addition to the manufacturer's product information, are available. Not all products are registered and approved for sale in all countries or regions. This can include the rinsing of the infusion system with a neutral IV solution prior to the application of another drug. Australian Prescription Products Guide. .1-.15mg/kg repeat q15 mins : Max .3mg/kg or 50mg . Do NOT use solutions where there is a visible change in colouration. 9803 0 obj <>/Filter/FlateDecode/ID[]/Index[9787 28]/Info 9786 0 R/Length 94/Prev 331636/Root 9788 0 R/Size 9815/Type/XRef/W[1 3 1]>>stream Among repeat test samples, microparticulate formation was electronically determined to have formed in some samples but not others. NPS MedicineWise disclaims all liability (including for negligence) for any loss, damage or injury resulting from reliance on or use of this information. If intravenous drugs are not mixed but are given consecutively, the infusion line should be flushed through with compatible fluid between each administration. Incorporation services for entrepreneurs. Addition of an acidic drug solution to a solution containing a carbonate or bicarbonate may result in production of carbon dioxide gas. Morphine is frequently used for both acute pain and long-term chronic pain. Of the 196 co-infusions, 110 had additional restrictions on time in solution. With workflows optimized by technology and guided by deep domain expertise, we help organizations grow, manage, and protect their businesses and their clients businesses. Rare side effects of Nitroglycerin IV include: none. B. Braun ensures high security standards throughout the product life cycle by using globally accepted standards. The single user license allows access from any computer or device from any location and limits access to one person at a time while the site license allows access from an unlimited number of computers or devices. In editis INTRAVENOUS COMPATIBILITY CHART - Drug Information For The . J Res Pharm Pract; (1): 37-40. : Australian Pharmaceutical Publishing Company; 2007. PEPID helps healthcare professionals avoid adverse events encountered in administering intravenous drugs & solutions, and optimize IV management & preparation. Sodium bicarbonate and mannitol solutions should not be used as diluent for intravenous drug administration. Ketorolac Tromethamine IV Drug Compatibility Chart L Alteplase (Activase, rTPA) Amiodarone (Cordarone) Argatroban Atropine Calcium chloride Diltiazem (Cardizem) Dobutamine (Dobutrex) Dopamine Epinephrine (Adrenalin) Esmolol (Brevibloc) Furosemide (Lasix) Heparin Insulin (regular) Lidocaine (Xylocaine) Lorazepam (Ativan) Magnesium Sulfate COMPATIBILITY Compatibility is dependent on the concentration of each medication in the total final volume being infused, rather than the actual dose. Assessment and planning of regimes to avoid mixing of drugs, which have to be administered separately. The majority of sources cited define compatibility by physical compatibility rather than chemical compatibility This table is a guide only. As a general guide, line compatibility of different drugs often depends on the pH of the drugs concerned. All subscriptions provide for access from any computer, tablet or phone. Use the reset filter button to go back to the default view. Drug Name Dose &/or Ranges Administration Compatibility Precautions Adenosine (adenocard) First dose 6mg, repeat within 1-2 minutes at . For more information, please visit our home care page. BHz8DOGvcPoHH~` iNJ2)uIarvCmWp(l 6%{k`7;I;B+ H& 4T "!U=/p aQ]N{iT2,&dOK.~;.u;Oyem~/Q_s(d;;HMYE -"bpVghUmM01@#nS|x5213$qHfd6hAH%icIsI5sR%> `$`S_?) Rapid IV bolus Nursing: March 2008 - Volume 38 - Issue 3 - p 15. doi: 10.1097/01.NURSE.0000312600.67772.13. %PDF-1.6 % Corporations and LLCs doing business in another state? Disclaimer: This IV Drug Compatibility Chart is provided as a quick reference, however since information is . What you should know about drug compatibility. A cost evaluation of the risk can be done by assigning costs to their related clinical treatment and resulting extended length of stay. This website uses cookies. We apologize for any inconvenience. Step 1. They are used in people of all ages who are sick, injured, dehydrated from exercise or heat, or undergoing surgery. Factors correlating with Nurses errors. Thyroid disease: challenges in primary care, To mix or not to mix compatibilities of parenteral drug solutions, difficulties with venous access limiting the number of intravenous lines available for continuous administration of multiple drugs, multiple drugs requiring parenteral administration within a short time frame such as in a home visit by a general practitioner. hb```f``9Abl,P&/ZTlb`Po&$s]/ Murney P. To mix or not to mix compatibilities of parenteral drug solutions. Some of the drugs more commonly given by this method include: chemotherapy drugs such as doxorubicin,. The King Guide is available everywhere, so we designed our subscriptions to be flexible. This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. For example, some medications shouldn't be stored in PVC plastic containers. Search our global job market for interesting job profiles. Deputy Director, Pharmacy Department, Concord Repatriation General Hospital, Sydney. Any other research result that does not fit the conventional guidelines of compatibility or incompatibility. 9787 0 obj <> endobj When this occurred, "incompatible" was used. GPO Box 5480, Sydney NSW 2001 Australian Commission on Safety and Quality in Health CareLevel 5, 255 Elizabeth StreetSydney NSW 2000, We are always looking for ways to improve our website, Please help us to improve our services by answering the following question. hbbd```b``:"g[A$$)i"eAti"C$40D?Hh _#)Pd?= 1S5 (2007) Preparation of a compatibility chart for intravenous drug therapy in neonatal and pediatric intensive care units. 6-Methylmercaptopurine (MMPR) A Abciximab Acetaminophen Acetazolamide Sodium Acetylcysteine ACTH Acyclovir Sodium Adenosine Alatrofloxacin Mesylate Albumin, Serum Human Alcohol, Ethyl The compatibility results are presented in a chart or list view, with the default chart view displaying all methods within the fields for the selected drugs and solutions. %PDF-1.5 % Empowering physicians with fast, accurate clinical answers, Beyond the call: How to differentiate your telehealth experience post-visit, Implementing 2023 updates to your Antimicrobial Stewardship Program. Extensive TPN/TNA data. Mixing is best avoided. Prescription and OTC drugs (over 100,000 drug products), 900+ nutraceuticals, including herbal medicines, Presented in prescriptive, immediately actionable bullet points for busy clinicians and students. Standards for Infusion Therapy. )sHQVzP` , Diazepam is very poorly water soluble so it is formulated as an injection solution in a vehicle comprising 50% propylene glycol and 10% ethanol. Purpose/objectives: To examine the cause(s) and types of IV incompatibilities that can occur in the oncology population, to present information on commonly used oncologic medications, to identify resources available to nurses, and to provide specific interventions designed to prevent incompatibilities in various oncology settings. This was the third project that I was assigned at Oconee Medical center. Compatibility of a drug(s) is dependent on the manufacturer(s) of the products and/or the use of specific product formulations. Eur J Clin Pharmacol; 59(11): 815-7, (2) Emami S, Hamishehkar H, Mahmoodpoor A, Mashayekhi S, Asgharian P. (2012) Errors of oral medication administration in a patient with enteral feeding tube. This trial version of the IV-Compatibility Checker is not currently being maintained and may not feature updated information. BMJ Qual Saf; 20(12): 1027-34, 6 Hpner JH, Schulte A, Thiessen J, Knuf M, Huth RG. For more products, please check the B. Braun Product Catalogue. All drug components in the test samples were found to be chemically stable (less than 10% loss of intact drug) for the entire period of the study under the conditions being tested, even if the study period was less than 24 hours. A 10% or greater loss of intact drug within 24 hours is also considered evidence of incompatibility. The King Guide to Parenteral Admixtures exceeds TJC requirements for updated references, is NABP endorsed and listed by name by many state pharmacy boards as a required reference. Mixing magnesium sulfate 50% and calcium chloride 10% results in precipitation of insoluble calcium sulfate. medication compatibility chart Crit Care Nurse. High-Risk IV Medications Dosing Limits Guidelines of Care The purpose of this tool kit is to provide evidenced-based recommendations and best practices on setting and managing high-risk IV medications limit settings for adult patients in intensive and acute care units. X^P7&+5 Reference texts can provide information, but data are often unavailable for new drugs. 2. Some cannot be safely diluted in infusion bags. Only 212/820 (26%) co-infusions of drugs were compatible. Source: hqinstitute.org Clinical Resource: Toolkit Product images are for reference only. Fig. Separating the drug doses by time and place. When two drug solutions are mixed together the absence of a visible reaction does not exclude degradation of either drug. Copyright 2021 GlobalRPH - Web Development by, IV Dilutions Medication Reference and Infusion Guidelines, Renal dosing for healthcare professionals, HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication. Incompatibility can also occur between medications or fluids and certain types of container materials. within the same infusion line (simultaneous infusion) and/or IV container - administered one after the other, but within the same infusion line Includes routes, dosages, temperatures, and containers used to determine compatibility and stability. iv drug compatibility chart Many don't know how to do it. Please allow at least 3 seconds for click feedback on this limited version. There are a number of drugs that are commonly delivered via syringe driver to patients having palliative care in the community (see box). %%EOF any changes or additional incompatibilities. revised9/08' adult&intravenous&medications' standard'and'maximum'allowableconcentrations,' guidelinesforcontinuousortitratedinfusions ' medication . 2 below shows the results of a calculation for selected examples of complications. 140 0 obj <> endobj The Australian recommendations for the use of antibiotics in the prevention of endocarditis have been revised by Therapeutic Guidelines. To search on compatibility information, begin by typing the desired drug or solution name into the appropriate search box. 0 A recent warning has been issued about mixing calcium-containing solutions, including Hartmann's solution, with ceftriaxone causing the formation of the insoluble ceftriaxone calcium salt.1. In some cases, the manufacturer recommends administration of the undiluted drug. How tax and accounting firms supercharge efficiency with a digital workflow, Tax pros and taxpayers take note farmers and fisherman face March 1 tax deadline, IRS provides tax relief for GA, CA and AL storm victims; filing and payment dates extended, 3 steps to achieve a successful software implementation, 2023 tax season is going more smoothly than anticipated; IRS increases number of returns processed, How small firms can be more competitive by adopting a larger firm mindset, OneSumX for Finance, Risk and Regulatory Reporting, BECRIS 2.0 How to prepare for next-level granular data reporting, Implementing Basel 3.1: Your guide to manage reforms. However, a small number of injection solutions are formulated in non-aqueous solvents to allow dissolution of a poorly water soluble substance in a small volume. When both drugs are present in the "Drug List" on the left, click the "Run Report" button. The IV drug compatibility chart is based on information from the, ThisIVDrugCompatibilityChartisprovidedasaquickr, itisadvisedthatyoucheckwithapharmacistforr. However, in some circumstances there may be compelling reasons for mixing two or more parenteral drug solutions in the same infusion bag, in the same syringe or at a Y-site junction where two or more intravenous lines meet. Drugs in Syringe Compatibility Y-Site Injection Compatibility (1:1 Mixture) Additionally, in some cases one brand of product may be compatible but another brand of drug is not. Explain visual inspection of a parenteral solution. About this app. Search for and click on a drug 2. Possible drug/solution selections will be displayed as you continue to type. Relevant, timely and evidence-based information for Australian health professionals and consumers. The precipitate may or may not show up again later. Aminophylline IV Push IV Push IV Push IV Push IV bolus infuse over 20 -30 minutes not to exceed 25 mg/min; max concentration 25 mg/ml.