Monday October 16, 2006

Scenario: You have a patient in unit whose blood sugar is hard to control despite aggressive insulin therapy. You wrote an order to prepare all drips and medications in either 0.9 or 0.45 NS (Normal Saline), as far as compatible. Next day, you noticed that pharmacy continue to prepare NOREPINEPHRINE (LEVOPHED) drip in mix with D5W. What do you think?

Answer: NOREPINEPHRINE (LEVOPHED) is less stable in normal saline (loose its potency from oxidation). Dextrose containg solution is preferred as the dextrose protects against oxidation of the norepinephrine and keep it active and stable.