Infusion
Nursing Notes
By Nufactor

Infusion Nursing Notes by Nufactor provides education, resources and support to promote successful patient therapy within the infusion nursing community.

Understanding Titration: IVIG and Infliximab

By Jean McCaslin, RN, IgCN
Nurses in a variety of settings follow an infusion titration (increasing or decreasing the rate of the dose) when infusing many medications. While it is understood that the use of titration is prudent particularly for first-dosing, there are no established uniform standards in the industry for infusing many medications, including intravenous immunoglobulin (IVIG) and infliximab (brands include Remicade®, Inflectra® and Renflexis®). Titration standards may be developed by individual prescribers, hospital systems, nursing agencies, outpatient infusion centers, or specialty pharmacies, yet each may differ from the other. [More]

How to Pool Medications into a Pooling Bag

By Candy Finley, RN, IgCN and Joe DiStefano, RPh

Pooling is the process of transferring the total dose of drug plus overfill into an empty IV bag ("pooling bag"). Although NuFACTOR prefers administering IVIG by spiking vials one at a time sequentially or adding drug directly into a bag of diluent (e.g., infliximab/Remicade®), there are some times when pooling is appropriate. These include lyophilized powder IVIG requiring reconstitution (e.g., Gammagard® SD and Carimmune®), HyQvia® (IG component only) and infliximab doses greater than 1000 mg. The process of pooling medications into a specially designed pooling bag is a relatively simple process. [More]