We are currently reviewing our organizational standards and have found a discrepancy between what we have listed from a PICC standpoint and what the pharmacy has listed. We have the only contraindicated medication through a PICC is Dilantin, the pharmacy also has that Mannitol, 50%Dextrose, and Glucagon cannot be given through a PICC. I understand these medications are not given "easily" through a PICC but it is not impossible. Anyone able to share their insight and expertise? I have been looking for substantiation on this and have been unsucessful....any help would be appreciated. thanks in advance!
Well, let me first start with my soapbox. I would put the responsibility on the pharmacy to produce information about what they are saying, rather than send you looking for their information. I do not think you will find any thing published on any of these drugs including Dilantin. Dilantin has many incompatibilities with other medications but I am not aware of anything that states it is incompatible with the catheter material itself. There could be medications that are entrapped in the biofilm and then get exposed to the Dilantin and cause a precipitate that occludes the catheter.
All those other medications can and have been safely given through a PICC. Since a PICC is a central venous catheter, there is no reason for avoiding these or any other medications through a PICC. It is the same as any other central venous catheter. These meds have a higher viscosity and the PICC length increases resistance to fluid flow. Manual pushes of these drugs through a PICC may be more difficult, however any number of electronic or mechanical pumps can be used for their infusion. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861