Unique Plan Description: Pharmacy Concentrated IV drips (FOR PHARMACIST USE ONLY)
Plan Selection Display: Pharmacy Concentrated IV drips (FOR PHARMACIST USE ONLY)
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2020-12-02 17:42:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 14:45:12
Available at all facilities: No

Pharmacy Concentrated IV drips (FOR PHARMACIST USE
IV Solutions
	DOPamine 800 mg/D5W 250 mL (Concentrated)
		250 mL, IV, Routine, Start: T;N, Increment Increase: 2.5 mcg/kg/min, Increment Decrease: 2.5 mcg/kg/min, Increment Freq: 10 min(s), Max Dose: 20 mcg/kg/min
			Comment: Concentration: 3200mcg/mL. .Notify MD if > 20mcg/kg/min.  If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
		800 mg, EVERY BAG, 5 mcg/kg/min
	norepinephrine 32mg/D5W 250mL (High Dose)
		250 mL, IV, Routine, Start: T;N, Increment Increase: 1 mcg/min, Increment Decrease: 1 mcg/min, Increment Freq: 3 min(s), Max Dose: 30 mcg/min
			Comment: **LEVOPHED** Concentration: 128mcg/mL .  If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
		32 mg, EVERY BAG, 8 mcg/min
	norepinephrine 8 mg/D5W 250 mL (Concentrated)
		8 mg, EVERY BAG, 8 mcg/min
		250 mL, IV, Routine, Start: T;N, Increment Increase: 1 mcg/min, Increment Decrease: 1 mcg/min, Increment Freq: 3 min(s), Max Dose: 30 mcg/min
			Comment: **LEVOPHED** Concentration: 32 mcg/mL .  If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
	phenylephrine 100 mg/NS 250 mL (Concentrated)
		250 mL, IV, Routine, Start: T;N, Increment Increase: 10 mcg/min, Increment Decrease: 10 mcg/min, Increment Freq: 3 min(s), Max Dose: 180 mcg/min
			Comment: **NEO-SYNEPHRINE**, Concentration: 400mcg/mL. If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
		100 mg, EVERY BAG, 100 mcg/min
	vasopressin 20units/NS 50mL (Concentrated)
		50 mL, IV, Routine, Start: T;N, Increment Increase: 0.01 unit/min, Increment Decrease: 0.01 unit/min, Increment Freq: 30 min(s), Max Dose: 0.1 unit/min
			Comment: If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
		20 units, EVERY BAG, 0.01 unit/min
	EPINEPHrine 10mg/NS 250mL (Concentrated)
		250 mL, IV, Routine, Start: T;N, Increment Increase: 1 mcg/min, Increment Decrease: 1 mcg/min, Increment Freq: 3 min(s), Max Dose: 50 mcg/min
			Comment: If the dose has been titrated twice within the specified timeframe and goal parameter is not achieved, the titration dose can be doubled until the ordered parameter is achieved or maximum dose is reached.  IV may be re-initiated after weaning within 12hours, re-initiate at the last dosing rate that maintained Goal parameter. Discontinue order after 12hr if patient does not require IV re-initiation.
		10 mg, EVERY BAG, 1 mcg/min
	dexmedetomidine 1000 mcg/NS 250 mL Premix
		1,000 mcg, EVERY BAG, 0.2 mcg/kg/hr
		250 mL, IV, Routine, Start: T;N, RASS Goal: 0 to -1, Incremental Increase: 0.1 mcg/kg/hr, Incremental Decrease: 0.1 mcg/kg/hr, Incremental Freq: 30 min(s), Max Dose: 1.5 mcg/kg/hr
			Comment: Begin at 0.2mcg/kg/hr if RASS +1 to +2, begin at 0.4mcg/kg/hr if RASS +3 to +4. Notify MD if target RASS 0 to -1 OR BIS 45-60 not met at 0.7mcg/kg/hr. Hold if HR<50, SBP<100mmHg or MAP<50 and notify MD, Notify MD if patient remains delirious at 24hr.
	dexmedetomidine 400 mcg/NS 100 mL Premix IV
		100 mL, IV, Routine, Start: T;N, RASS Goal: 0 to -1, Incremental Increase: 0.1 mcg/kg/hr, Incremental Decrease: 0.1 mcg/kg/hr, Incremental Freq: 30 min(s), Max Dose: 1.5 mcg/kg/hr
			Comment: Begin at 0.2mcg/kg/hr and titrate to goal RASS 0 to -1 OR BIS 45-60, Notify MD if target RASS not met at 0.7mcg/kg/hr. Hold if HR<50, SBP<100mmHg or MAP<50 and notify MD.
		400 mcg, EVERY BAG, 0.2 mcg/kg/hr
	morphine 5 mg/mL PCA 30 mL IV
		Continuous Dose (mg/hr) __ mg/hr, Patient Admin Bolus (mg) __ mg, Lockout Interval (min) = 15, 4-hour Limit (mg) 40, Nurse Admin Bolus (mg) __ mg breakthrough pain, Nurse Admin Bolus Freq 1 hr, 30 mL, PCA IV, 0 mg/hr
			Comment: Notify provider for any concerns about dosing.  Do not adjust dose without a provider order.  Re-assess pain, respiratory rate, respiratory pattern and sedation level 15 minutes after any dose change or nurse bolus.
		150 mg, EVERY BAG
	morphine 10mg/mL PCA 30mL IV
		Continuous Dose (mg/hr) __ mg/hr, Patient Admin Bolus (mg) __ mg, Lockout Interval (min) = 15, 4-hour Limit (mg) 40, Nurse Admin Bolus (mg) __ mg breakthrough pain, Nurse Admin Bolus Freq 1 hr, 30 mL, PCA IV, 0 mg/hr
			Comment: Notify provider for any concerns about dosing.  Do not adjust dose without a provider order.  Re-assess pain, respiratory rate, respiratory pattern and sedation level 15 minutes after any dose change or nurse bolus.
		300 mg, EVERY BAG
	HYDROmorphone 1 mg/mL PCA 30 mL High Dose IV
		Continuous Dose (mg/hr) __ mg/hr, Patient Admin Bolus (mg) __ mg, Lockout Interval (min) = 15, 4-hour Limit (mg) 4, Nurse Admin Bolus (mg) __ mg breakthrough pain, Nurse Admin Bolus Freq 1 hr, 30 mL, PCA IV, 0 mg/hr
			Comment: Notify provider for any concerns about dosing.  Do not adjust dose without a provider order.  Re-assess pain, respiratory rate, respiratory pattern and sedation level 15 minutes after any dose change or nurse bolus.
		30 mg, EVERY BAG
	HYDROmorphone 5 mg/mL PCA 30mL IV
		Continuous Dose (mg/hr) __ mg/hr, Patient Admin Bolus (mg) __ mg, Lockout Interval (min) = 15, 4-hour Limit (mg) 4, Nurse Admin Bolus (mg) __ mg breakthrough pain, Nurse Admin Bolus Freq 1 hr, 30 mL, PCA IV
			Comment: Notify provider for any concerns about dosing.  Do not adjust dose without a provider order. Re-assess pain, respiratory rate, respiratory pattern and sedation level 15 minutes after any dose change or nurse bolus.
		150 mg, EVERY BAG

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase