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Peritoneal Dialysis

Ampicillin IP

Does anyone have any experience with IP ampicillin? We are treating a patient with an enterococcus peritonitis sensitive to ampicillin and gentamicin. According to the ISPD guidelines, the ampicillin dose is 125 mg/L. However, I can only find stability data for 50 mg/L in Dianeal - 2 days (NPA Peritoneal Dialysis handbook). What do other centres do? My patient will be adding the antibiotics to their Dianeal at home for overnight dialysis.

Thanks!
Maryanne McDonald
Nephrology Clinic Pharmacist
Alberta Children's Hospital

polyethylene glycol in PD patients

Any experience using this product for bowel maintenance in our PD population? I vaguely remember going to a talk that promoted using small volumes (ie 100-250mL daily) instead of the regular stool softener/stimulant/osmotic laxative combinations. Thanks in advance.

calcium liquid

Funny that this hasn't come up since I have started in renal. I have a PD patient who wants to use calcium liquid instead of the regular tablet formulations. It is a lactate/gluconate mix yielding 100mg elemental calcium/5mL. I couldn't find any information on binding capacity in the KDOQI guidelines or through a MedLine search. Any experiences?

Dispensing Antibiotics for Peritonitis

Hello RPN members,

We currently draw up and refrigerate/freeze individual doses of PD
antibiotics for peritonitis. However, our outpatient pharmacy is closing in
the Fall and would like to look at having retail pharmacies provide these
antibiotics. I would like to do a survey (the results will be sent to the
RPN newsletter) on how other centres handle their peritonitis antibiotics.

Please send a quick response with your centre's name and how these antibiotics
are provided to your patients.

Thank you,
Lori Wazny

PD catheter clearance

Just wondering what the different sites do in terms of PD catheter clearance. Here we try flushing 1st with the hep-lock solution and then either replace the line or revise it. We are looking at whether we should add an alteplase protocol for adults since we are trying to add one for pediatric patients who have less options due to limited abdo wall. Thanks!
Alice Chan
U of A

RE: KCl in PD fluids

Hi All,
We have been supplying KCl 20 mEq and 40 mEq in 100 ml Sterile Water pre-made minibags for use in PD unit. The RN's were drawing out whatever volume they needed to obtain desired amount of K and then adding this to PD bags. We have been asked by the PD unit for alternatives and to find out what other centres are doing. Are many of you manufacturing the peritoneal bags with K added?
Thanks for your help!
Anna

Policy and procedures for IP medications (i.e KCl)

We have been asked to look into developping policies and procedures re: administration of KCl IP and are curious to know if other sites follow specific guidelines or policies and procedures (like those for administration of IV medications) for administration of IP medications? i.e KCl, antibiotics etc..

EPO and blood pressure monitoring

Our PD/pre-renal unit currently monitors BP on a monthly basis as part of a patient's monthly EPO follow-up. Due to time and space constraints the unit would like to discontinue this practice.
Does any other site monitor BP as part of monthly EPO follow-up?

Policy and procedures for IP medications (i.e KCl)

We have been asked to look into developping policies and procedures re: administration of KCl IP and are curious to know if other sites follow specific guidelines or policies and procedures (like those for administration of IV medications) for administration of IP medications? i.e KCl, antibiotics etc..

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