Q: Is full-dose delivery the total volume delivered (eg, 250 mL) or does this also include the amount of overfill within an intravenous piggyback or the amount left in the infusion set? What is the best practice standard for the full delivery of medications via intravenous pump when only a primary bag with a medication is used? How is the remaining medication in the tubing/cassette (15–20 mL) delivered to the patient if no carrier fluid is used?

A: Earnest Alexander, PharmD, and Amanda Zomp, PharmD, BCPS, reply:

In today’s age of smart infusion pumps, a major focus has been placed on guardrails or limits on infusion rates, with predetermined drug concentrations, infusion rates, dose limits, and total volumes. Both safety and efficacy are key considerations for dose infusions. A great deal of focus is placed on safety, by limiting infusion rates to avoid toxic effects. There often is not as...

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