This Year 2024 edition marks the 51st year of publication of Intravenous Medications. All previous editions are considered out of date. We would like to welcome the expert contributions from the National Coalition for IV Push Safety in this new edition.

Intravenous Medications is designed for use anywhere intravenous medications are prepared and administered, such as in critical care areas, at the nursing station, in the office, in public health and home care settings, and by students and members of the armed services. Pertinent information can be found in a few seconds. Take advantage of its availability and quickly review every intravenous medication before administration.

When a medication is prescribed, the nurse must evaluate it for appropriateness and may need to prepare it, administer it, and observe the effects. If, after reviewing the information in Intravenous Medications, you have any questions about any order you are given, clarify it with the physician, consult the pharmacist, or consult your supervisor. The circumstances will determine whom you will approach first. If the physician thinks it is imperative to carry out an order even though you have unanswered questions, never hesitate to request that the physician administer the medication instead of you. In this era of constant change, the physician should be willing to provide you, your supervisor, and/or the pharmacist with current studies documenting the validity and appropriateness of orders.

All information presented in this handbook pertains only to the intravenous use of the drug and not necessarily to intramuscular, subcutaneous, oral, or other means of administration.

In this 40th edition, a total of ten new drugs approved by the FDA for intravenous use have been incorporated.

The new drugs include isatuximab for multiple myeloma; lurbinectedin for metastatic small-cell lung cancer; sacituzumab govitecan for breast or urothelial cancer; trilaciclib for chemotherapy-induced myelosuppression; etesevimab for COVID-19 treatment under emergency use authorization (with bamlanivimab); efgartigimod alfa for myasthenia gravis; casimersen for Duchenne muscular dystrophy; aducanumab for Alzheimer’s disease; avalglucosidase alfa for Pompe disease; and anifrolumab for systemic lupus erythematosus.

In addition, ado-trastuzumab, busulfan, carfilzomib, crizanlizumab-tmca, daratumumab, droperidol, elotuzumab, and ipilimumab have been moved from the text to the Evolve website.

Several of the drugs in this text and on the Evolve website are biosimilars. Biosimilars are biological products that are licensed (approved) by the FDA because they are highly similar to an already FDA-approved biological product (known as the reference product (known as the reference product, such as trastuzumab [Herceptin]) but have allowable differences because they are made from living organisms. Biosimilars also have no clinically meaningful differences in terms of safety, purity, and potency from the reference product.

Many new uses have been approved for established drugs, and numerous safety issues have been identified by the FDA. All of these changes are incorporated so that our readers have the most current information available.

We continually strive to make the information in this handbook informative and easy to access. We continue to identify drugs with a Black Box Warning in the main heading of the monograph. In addition, Black Box Warning statements are shaded in light gray, and a different typeface is used for instant identification wherever they appear in the text. Blue-screened text emphasizes a special circumstance not covered by a Black Box Warning. The FDA is now identifying Limitations of Use of drugs under Indications. Previously this information had been placed in Precautions. Common Toxicity Criteria (CTC) are available at https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm.

The Joint Commission and the Institute for Safe Medication Practices (ISMP) have strongly emphasized various ways to reduce errors in drug ordering and administration. Intravenous Medications uses both generic and trade names and spells out all symbols (except in charts where space is limited). The symbols are included in the Key to Abbreviations (p. xvii) if you need a refresher.

The Joint Commission, the ISMP, the American Pharmaceutical Association, and several other organizations have identified “High-Alert Medications” (a list of medications with the highest risk of injury when misused). The websites of these organizations contain considerable information and identify common risk factors and suggested strategies to reduce the risk of errors. All IV medications are considered high risk because they have an immediate effect, are irretrievable, and can cause life-threatening side effects with incorrect usage. We advise the readers to consider several important sources for intravenous medication safety such the National Coalition for IV Push Safety, the Infusion Nurses Society, and the Institute for Safe Medication Practices.

Elsevier offers electronic versions of Intravenous Medications for handheld devices, tablets, laptops, and desktop computers. These electronic versions are convenient and portable alternatives or supplements to the printed book. In addition, all drugs currently on the Evolve IV Meds website (http://evolve.elsevier.com/IVMeds) for Intravenous Medications (because of space limitations for the print version) are now all incorporated in these electronic versions in alphabetical order to give you a complete package. Although the electronic versions are accessible wherever you have an electronic device, keep in mind that on some devices the entire monograph may not be visible at the same time. It is the user’s responsibility to be familiar with the complete monograph and all aspects of each drug before administration.

Health care today is an intense environment. The speed of change is overwhelming, but the authors and publisher of Intravenous Medications have a commitment to provide all healthcare professionals who have the responsibility to administer IV medications with annual editions that incorporate complete, accurate, and current information in a clear, concise, accessible, and reliable tool. FDA websites are monitored throughout the year and provide many important updates, such as dose changes, new pediatric doses, additional disease-specific doses, refinements in dosing applications, new indications, new drug interactions, additional precautions, updates on post-marketing side effects, and new information on antidotes. Most drugs currently approved for intravenous use are included in the print version or are on the Evolve website: http://evolve.elsevier.com/IVMeds/. (See pp. xiv and xv for a listing.) Helpful charts for dilution and/or rate of administration are incorporated in selected monographs. A General Dilution Chart to simplify calculations is found on the inside front cover. Front matter material provides a Key to Abbreviations and Important IV Therapy Facts.

Appreciation is extended to Sonya Seigafuse, Danielle M. Frazier, and Jodi M. Willard at Elsevier and to Joe Rekart at Graphic World.

And a thank you to the users of this reference. By seeking out this information, you serve your patients’ needs and contribute to the safe administration of intravenous medications.