Dilution Protocol
Introduction
Medication administration errors can have a number of negative consequences, including
- Increased costs
- Prolonged hospital stays
- Psychological distress
- Loss of public confidence in healthcare
- Patient morbidity or mortality
To help prevent medication administration errors, it is important to have clear and accurate guidelines for the dilution and administration of injectable drugs.
Malaysia
Published in 2011, the Dilution Guide for High Alert Medications serves as a general resource for the approppriate use of HAMs.
While informative, the JKN Selangor Dilution Protocol 2017 only covers a select number of drugs.
The Dilution Guideline for Injectable Drugs, 2020 is a general reference for healthcare professionals on how to prepare dilutions of certain injectable drugs before administering them to patients.
- The guideline currently only covers Part 1, which focuses on antimicrobials.
In 2022, Antidote Quick Guide (Adult Dose) is prepared to facilitate the healthcare professional to react fast to poisoning and overdose injuries.
This is followed by the publication of the Dilution Guide for Fluid-restricted Critically Ill Adults in 2024.
However, as new drugs are approved and existing drugs are modified, a more dynamic and accessible website or mobile application would be a better format for this guideline.
- This format would allow all drugs to be searchable in one database, with continuous updates made as new information becomes available.
Established Injectable Drug Reference
Some of the most popular injectable drug references include
- ASHP Injectable Drug Information, 2022
- Australian Injectable Drug Handbooks, 2023 - free trial is available
- Davis's Drug Guide for Nurses, 2022
- Elsevier's 2023 Intravenous Medications, 2022
- External Stability for Parenteral Drugs, 2022
- GlobalRPh IV Dilutions Medication Reference and Infusion Guidelines
- Injectable Drugs Guide, 2011
- King Guide
- Pediatric Injectable Drugs (The Teddy Bear Book), 2024
- Stabilis.org
- Trissel's Stability of Compounded Formulations, 2018
- UKCPA: Minimum Infusion Volumes, 2012
NOTE: Lexicomp and Micromedex both use Trissel's Clinical Pharmaceutics Content for their IV compatibility databases, so there is no significant difference in the information they offer. Hence, if you are looking for additional information on IV compatibility and stability data, you may want to consult other references, such as King Guide or ASHP Injectable Drug Information.
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