Safe drug administration

The following guidelines on preparing, administering,and monitoring drug therapy will help you ensure

patient safety and drug effectiveness.

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S2 Safe drug administration

Drug compatibilities

Use the table below todetermine if you can safely mixtwo drugs together in the samesyringe or administer themtogether through the same I.V. line.

KEYC: compatibleI: incompatible✳: conflicting data existBlank space: no data available

acyclovir sodium � I I I

amikacin � C I C C C C C I C C C C C C C

amiodarone C � C C C I I C I C C

amphotericin B I C � I C ✳ I I

aztreonam C I � C C C C C C C C C C

calcium chloride C C � ✳ C

calcium gluconate C C C � I I C C ✳ C

cefazolin C I C I � ✳ C C C C

cefepime C � C

ceftazidime I I C � C C C

clindamycin C C C I ✳ C C � C C

cyclosporine C C C � ✳

dexamethasone C C C C � ✳

digoxin I � I

diltiazem I C C C C C � C C

diphenhydramine C ✳ C C ✳ �dobutamine I C C ✳ ✳ I C � C C

dopamine I C I C C ✳ C C � C

enalaprilat C I C C C C C C C �epinephrine C C ✳ ✳ C

esmolol C C C C C C C C C C

famotidine C C C C C C C C C C C C

fluconazole C C C C C C

furosemide ✳ ✳ I I I

acyc

lovi

r sod

ium

amik

acin

amio

daro

neam

phot

eric

in B

aztr

eona

mca

lciu

m c

hlor

ide

calc

ium

glu

cona

te

cefa

zolin

cefe

pim

ece

ftazi

dim

ecl

inda

myc

incy

clos

porin

ede

xam

etha

sone

digo

xin

dilti

azem

diph

enhy

dram

ine

dobu

tam

ine

dopa

min

een

alap

rilat

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S12 Safe drug administration

Deltoid site● Locate the lower edge of the acromialprocess.● Insert the needle 1" to 2" below theacromial process at a 90-degree angle.

Dorsogluteal site● Draw an imaginary line from theposterior superior iliac spine to thegreater trochanter.● Insert the needle at a 90-degree angleabove and outside the drawn line.● You can administer a Z-track injec-tion through this site. After drawing upthe drug, change the needle, displacethe skin lateral to the injection site,withdraw the needle, and then releasethe skin.

Ventrogluteal site● With the palm of your hand, locatethe greater trochanter of the femur.● Spread your index and middle fin-gers posteriorly from the anterior su-perior iliac spine to the furthest areapossible. This is the correct injectionsite.● Remove your fingers and insert theneedle at a 90-degree angle.

Vastus lateralis and rectus femoris sites● Find the lateral quadriceps musclefor the vastus lateralis, or the anteriorthigh for the rectus femoris.● Insert the needle at a 90-degree angleinto the middle third of the muscle,parallel to the skin surface.

Identifying injection sites

Injection sites vary with administration route. The instructions below describeproper identification sites for I.M., subcutaneous, and I.V. drugs.

To begin, wash your hands, put on gloves, and locate the appropriate site.Clean the site with an alcohol pad, and administer the injection as described here.

I.M. injectionsYou can administer an I.M. injection into the muscles shown below. In theseillustrations, specific injection sites are shaded.

Deltoid

Dorsogluteal

Ventrogluteal

Vastus lateralis andrectus femoris

Acromial process

Deltoid muscle

ScapulaDeep brachial arteryRadial nerveHumerus

Posterior superioriliac spineGluteus medius

Gluteus maximus

Greater trochanter of femurSciatic nerve

Rectus femoris

Vastus lateralis

Iliac crestAnterior superior iliac spine

Gluteus medius

Greater trochanter of femur

Greater trochanter of femur

Quadriceps muscle

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