Mixing amiodarone

[scratrat]

Question.....

When we first starting using amiodarone in NJ, we were told to mix it in a hard bag of D5W. We were told that you were not allowed to use a soft bag because it caused the amiodarone to leach the PVC out of the bag and into that patients circulation.

Here if FL, we used those same hard bags. For whatever reason the stock person got the soft bags, and was told thats all he could get because the others were on back order.

I tried to find these answers on the internet but to no avail. The only thing I found states that this problem only occurs at doses higher than recommended or longer than recommended. I also found that this seems to be more of a problem with pediatrics. The only other thing of significance was that amiodarone loses the drug properties within 12 hours or so when in plastic, but not in glass.

Anyway, my question is does anyone know if it's been proven safe to use soft bags of D5 or do you use hard bags/glass to administer a drip of amiodarone?

[emstrainer]

There is some literature that supports the Glass Bottle theory for both Nitro and Amiodarone. We put 150 mg of Amiodarone in a 250 bag of NaCl and run it over 10 minutes. You are not going to see any degradation of the drug in this short of time.

For the Nitro infusion we also use a 250 bag of NaCl ....... The hospital switches them over to a glass bottle.

Jason Kinley

Xenia, ohio

[Novisen]

We administer Amidarone in a singel bolus shot on VT and VF that don´t respond on defibrillation (300mg). If the patients is awake we give it mixed with 250ml D5W over 20 minutes.

[scratrat]

That's all the same here. But my question is, do you mix it in a soft bag or a hard plastic bag? We carried both. One bag was stiffer than the other.

[OVeractiveBrain]

Im pretty sure we use a soft bag. To be honest, i dont know what a "hard bag" is. We mix in the soft bag and run it over 10 minutes. Alternatively, when I was in connecticut, while new haven AMR didnt have them, hartford AMR had buretrols, which really eliminates that need. I cant remember ever having a problem (or hearing of anyone having a problem) with amio administration in a soft bag.

My bags, if held in the middle, flop over themselves, which I assume is the "soft bag"

[Novisen]

http://www.fda.gov/cdrh/safety/dehp.html

Amidarone can realese DEHP from bags. Nothing going to happen if you exposed to DEHP once or twice i your life in the prehospital setting.

[scratrat]

Yes, the soft bags fold over on themselves. They make the same size bag only a little narrower, it a harder plastic bag. It takes more to fold it.

I did read that about DEHP. That's where my question originated. I wasn't concerned with the adult population but it did have warnings about sending pediatrics into respiratory arrest. Although fixable, it's something I like to avoid.