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Imferon (Iron Dextran) (102.078)

Imferon (Iron Dextran) (102.078) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Medications, Drug-Specific

102.078

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UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: IMFERON (Iron Dextran)

Effective Date: April, 2004 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed April, 2005 April, 2008 May 2009

PURPOSE: To provide guidelines for the administration of Imferon at UWMF Clinics.

DEFINITION: Imferon (Iron Dextran) is a medication used to treat patients with iron
deficiency and for whom oral administration is unsatisfactory or impossible.

POLICY: Clinical staff with IV ability will utilize the following guidelines to properly
administer IV Imferon to UWMF patients.

SUPPLIES: IV set-up, 22-gauge angio-set, normal saline, tape, alcohol wipe
Prescribed Imferon in prepared syringe from pharmacy, normal saline
Hydrocortisone, Methylprednisone, Diphenhydramine, acetaminophen
Anaphylaxis equipment and medications available
Non-sterile gloves, Pen, Provider’s order, Patient’s record

PROCEDURE:

1. Check provider’s order and clarify any inconsistencies.
2. Wash hands and gather equipment.


3. Introduce yourself and identify the patient.

4. Explain medication, procedure to the patient and answer any questions. Provide
patient informational handout on Iron Dextran.

5. Provide good light and provide privacy by closing curtains or door.

6. Take vital signs and review allergies (Imferon, Hydrocortisone,
Methylprednisone, and Diphenhydramine) with the patient.

7. Obtain venous access using non-sterile gloves and IV equipment.
Keep IV (.9% normal saline) open at (keep open rate) or prescribed rate.

NOTE: Review policy and procedure on IV therapy.

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8. Pre-medicate patient with prescribed medication: acetaminophen 650 mg PO or
(prescribed amount), 30 minutes prior to test dose.

9. Pre-medicate patient with prescribed medications: Hydrocortisone 100mg IV,
Methylprednisone 125 mg IV, Diphenhydramine 50mg PO or (prescribed
amounts), 15 minutes prior to test dose.

10. Place anaphylaxis equipment and medications (Epi 1:1000 SQ, Diphenhydramine
50mg IV, and Hydrocortisone 100mg IV) near patient.

11. Administer a test dose of medication (25mg IV over 5 minutes) or (prescribed
amount) adhering to the five rights of drug administration.
- Right – drug, dose, time, route, patient

12. If no adverse reactions, administer remainder of schedule dose as ordered.

NOTE: If total dose is less than 1000mg, administer over 2-3 hours
If total dose is greater than 1000mg, administer over 3-4 hours.

13. Flush the IV line well with normal saline.

14. Discontinue IV and immediately dispose materials in proper container.

15. Make the patient comfortable.

NOTE: If reaction occurs
Stop Dextran immediately and flush line with saline (wide open)
Contact provider and begin Anaphylaxis Protocol

16. Perform discharge teaching and verify next appointment and labs (if appropriate).

17. Instruct the patient and/or family to call clinic for fever or flu-like symptoms.

NOTE: These symptoms can occur up to 2 days post administration.

18. In the patient’s record document:

vital signs
drug name, amount, time and site of injection
pre-medications (if given) names and amount and side effects (if any)
how the patient tolerated the procedure
educational instructions and follow-up care (if needed)
follow-up care or appointment (if needed)




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19. When completed, wash hands.

WRITTEN BY: Ronnie Peterson, R.N., M.S., Clinical Staff Educator

REVIEWED BY: Nina Jones, R.N. Oncology Clinic, 2009

REVISED BY: Nina Jones, RN, Oncology Clinic, 2008

REFERENCES:

1. Ambulatory Care Nursing: Policies and Procedure, 1999, Apsen Pub.
2. Basic Skills and Procedures: Perry & Potter, 4th Ed., 1998, Mosby.
3. Hematology/Oncology Iron Dextran Infusion protocol.


AUTHORIZATION:


Medical Director Date