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

Lyophilized Powder IVIG: Dilution, Reconstitution, and Pooling

15. February 2017 Derrek Blake Infusion Basics, IVIG Essentials (0)
By Derrek Blake, RN, IgCN, and Joe DiStefano, RPh.

Intravenous immune globulin (IVIG) is available as either a liquid or lyophilized (freeze-dried) powder. Initially only powder products were available, requiring reconstitution before administration. Over time, manufacturers changed their manufacturing process to achieve stability of the IgG molecules in a suspended or liquid state. By doing so, the task of reconstitution has been eliminated, making the powder products relatively obsolete. Depending on the brand, IVIG liquid is available in 5% and 10% concentrations. Depending on the brand, IVIG powder is reconstituted to yield a concentration between 3% and 12%. [More]

Part Two of Two. Central Catheters used for IVIG: Care and Complications of PICC lines and Port-a-Caths

31. January 2017 Jean McCaslin Infusion Basics, IVIG Essentials (0)
By Jean McCaslin, RN, IgCN.

In our last blog, the types of central catheters typically used for the infusion of IVIG were discussed. Also reviewed, was the assessment of these ports as it relates to IVIG therapy. In this blog, the care of central lines (herein called VADs; Vascular Access Devices) and potential complications will be covered. This discussion will be limited to the intermittent use of VADs for IVIG therapy being given between 1-5 days monthly. For more detailed information regarding continuous VAD use, or the administration of other medications, please refer to the INS standards published on their website. [More]

Part One of Two. Types of Central Catheters used for IVIG, Assessment, Care, and Complications

5. October 2016 Derrek Blake Infusion Basics, IVIG Essentials (0)
By Derrek Blake, RN, IgCN.

It is essential all nurses know how to properly evaluate, access, and provide proficient central line care. NuFactor provides IVIG therapy to patients in the home and while the majority of these patients receive IVIG via a peripheral IV, there are some patients who receive IVIG via a PICC line or an implanted port (such as Port-a-Cath brand). We as nurses must be competent and comfortable providing care to these patients with a central catheter. While central catheters can be slightly confusing to a nurse who may only see one central catheter a year, this post will help you understand the differences between central catheters used and how to provide the proper care for each. [More]

The Curlin Pump

12. September 2016 Candy Finley & Joseph DiStefano Infusion Basics, IVIG Essentials (0)
By Candy Finley, RN, IgCN and Joe DiStefano, RPh.

NuFACTOR Specialty Pharmacy programs pumps specifically to the patient orders. Always verify the patient's order with the pump program. Pumps are sent out in Variable Mode, which means the pump will titrate up on its own as it has been programmed. Remember to attach the vented spike adaptor to the spike of Curlin tubing. Per our policy, after spiking three vials, the nurse must use a new spike adaptor and Curlin tubing as they become dull and it is nearly impossible to separate them. [More]

Management of Anaphylaxis

14. June 2016 Joseph DiStefano Infusion Basics, IVIG Essentials (1)
By Joe DiStefano, RPh.

Regardless of past tolerance to immune globulin (IG), a patient can have a reaction to any dose. Taking prescribed pre-medications and taking oral ones approximately 30 – 60 minutes before IG can help minimize or eliminate common adverse reaction such as headache and flu-like symptoms. While uncommon but serious, an anaphylaxis reaction can also occur and is the reason to always have the anaphylaxis kit readily available for use. [More]

The Role of the Clinical Pharmacist

22. April 2016 Amy Ehlers IVIG Essentials (0)
By Amy Ehlers, BS, PharmD, BCPS.

Historically, the pharmacist's role in healthcare has been limited to filling and dispensing drugs based on a prescription, and ensuring that these medications were accurately delivered to patients. Today, this is no longer true. As the healthcare system has grown and evolved, so has the role and responsibility of the pharmacist. It is now expected that "pharmacists establish relationships with patients to ensure the appropriateness of medication therapy, patients' understanding of their therapy, and to monitor the effects of that therapy." [More]

Pre-Medications Use, Side Effect Management & Intravenous Immune Globulin

23. March 2016 Joseph DiStefano IVIG Essentials (3)
By Joe DiStefano, RPh.

Intravenous immune globulin (IVIG) preparations are safe and effective treatments for a variety of medical conditions. Serious, but uncommon reactions occur, and include thromboembolic events, (e.g., pulmonary embolism, deep vein thrombosis, myocardial infarction, transient ischemic attack), renal dysfunction and acute renal failure. Mild to moderate side effects that occur during or after IVIG treatment are more common. These may include: headache, flushing, chills, myalgia, fatigue, low grade fever, changes in blood pressure and lower back pain. While many common side effects may be controlled by decreasing the IVIG infusion rate, administering physician-prescribed pre-medications can [More]

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