On-call scenario 1: Sources
You might have thought to look in the following resources:• BNF
• Injectable Medicines Guide (Medusa)
• Your local Trust guidelines
You establish that you do not have any local guidelines for ganciclovir administration, but the product SmPC and Medusa are helpful. They both state that the concentration of ganciclovir infusions should not be greater than 10 mg/mL.
Part of the nurse’s question was whether 500mg ganciclovir in a 100 mL bag of sodium chloride 0.9% was appropriate to administer, or if the dose needed further dilution.
This patient has 500mg ganciclovir in a 100mL sodium chloride 0.9% bag = 5 mg/mL. This is not exceeding the recommended concentration (10 mg/mL) and is therefore appropriate. No further dilution is needed.
Read on to see how this scenario resolves.