Compatibility of intravenous drugs in a coronary intensive care unit

In a coronary intensive care unit (CCU) it is often necessary to utilize extensive pharmacologic interventions and multiple intravenous medications in order to stabilize a critically ill patient. However, the necessity of several intravenous infusions often presents the problem of compatibility of these medications when infused within a common line. The pharmacist must possess adequate skill to identify potential incompatibilities by retrieving information on the physical and chemical compatibilities of various intravenous medications. In a critical care setting, time is an important factor, and information that can be obtained rapidly and reliably is vital for the pharmacist to prevent the administration of an irritating substance or a medication that has undergone deterioration as a result of chemical inactivation. A compatibility table containing the most commonly used drugs in a CCU has been developed based on currently available literature, including standard reference texts, about these medications. The table outlines the potential for interactions, within a single intravenous line, when several drugs are infused concurrently. In addition, a review of the concepts of physical and chemical incompatibility is presented. The stability of an admixture is defined utilizing requirements established in the USP NF monographs and manufacturers' specifications. The resulting table concisely organizes vital information in a form that allows rapid, accessible information to the pharmacist in a critical care setting, where it is most needed.