ORITAVANCIN (KIMYRSA) INFUSION		version 2/2/2022		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Provider Communication 	

	
	Interval	Defer Until	Duration	
	☐	Provider communication	Every visit	S	Until discont'd	
		Exclusion criteria: Do NOT use if patient has osteomyelitis, diabetic foot infections, sepsis, confirmed/suspected bacteremia, necrotizing fasciitis, hemodynamic instability, or any other co-morbidities requiring inpatient admission.		
	☐	Provider communication	Every visit	S	Until discont'd	
		Indication for use: Indication for Use: Acute bacterial skin and skin structure infections (ABSSIs) - cellulitis, erysipelas, wound infection, or major cutaneous abscess with a minimum lesion surface area of approximately 75 cm2.		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☐	Insert Peripheral IV or Access Portacath	Every visit	S	Until discont'd	
		No details available for preview		
	☐	dextrose 5% flush syringe 20 mL	Every visit	S	Until discont'd	
		20 mL, intravenous, PRN, line care, Starting when released, Until Discontinued		
	☐	dextrose 5% infusion 250 mL	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, once, Starting when released
	To keep vein open		
	☐	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, for 10 doses		
	☐	sodium chloride 0.9 % infusion	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, PRN, Flush bag, Starting when released, Until Discontinued		
	☐	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		No details available for preview		
	☐	Nursing communication	Every visit	S	Until discont'd	
		If infusion-related reactions (itching, urticaria, flushing) occur, consider reducing the rate of infusion.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		Observe patient for 30 minutes following infusion for any kind of infusion-related reactions (pruritus, urticaria, flushing) and for signs of hypersensitivity reactions such as fever, chills, dyspnea, rash, hypotension, throat irritation.		
	☐	Nursing communication	Every visit	S	Until discont'd	
		If hypersensitivity/anaphylaxis occurs, stop infusion and notify physician immediately.		
	☐	HEParin, porcine injection 500 Units	Every visit	S	Until discont'd	
		500 Units, intra-catheter, once PRN, line care, Starting when released, Until Discontinued
	Heparin flush for Implanted Vascular Access Device Maintenance.		
	☐	Discontinue IV	Every visit	S	Until discont'd	
		No details available for preview		

Labs 	

	
	Interval	Defer Until	Duration	
	☐	CBC with platelet and differential	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		
	☐	Comprehensive metabolic panel	Every visit	S	Until discont'd	
		STAT, Normal, Clinic Collect		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	Every visit	S	Until discont'd	
		25 mg, oral, once, Starting when released		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	Every visit	S	Until discont'd	
		25 mg, intravenous, once, Starting when released		
	☐	acetaminophen (TYLENOL) tablet 650 mg	Every visit	S	Until discont'd	
		650 mg, oral, once, Starting when released
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	methylPREDNISolone sodium succinate (Solu-MEDROL) injection 40 mg	Every visit	S	Until discont'd	
		40 mg, intravenous, once, Starting when released		

Medications 	

	
	Interval	Defer Until	Duration	
	☐	oritavancin (KIMYRSA) 1,200 mg in dextrose 5% IVPB (RESTRICTED)	Once	S	1 treatment	
		1,200 mg, intravenous, at 250 mL/hr, Administer over: 1 Hours, once, Starting when released
	Do not infuse with other medications or electrolytes. Flush line with D5W syringe before administration and after completing infusion.		

Hypersensitivity 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	PRN	S	Until discont'd	
		650 mg, oral, every 4 hours PRN, mild pain (score 1-3), Starting when released, Until Discontinued
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, itching, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	PRN	S	Until discont'd	
		25 mg, intravenous, once PRN, for minor infusion reaction, Starting when released, Until Discontinued		
	☐	diphenhydrAMINE (BENADRYL) injection 50 mg	PRN	S	Until discont'd	
		50 mg, intravenous, once PRN, for severe infusion reaction, Starting when released, Until Discontinued		
	☐	epINEPHrine (ADRENALIN) injection 1 mg/mL 0.5 mg	PRN	S	Until discont'd	
		0.5 mL, subcutaneous, once PRN, anaphylaxis, Starting when released, Until Discontinued		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	PRN	S	Until discont'd	
		100 mg, intravenous, once PRN, for infusion reaction, Starting when released, Until Discontinued		
	☐	promethazine (PHENERGAN) tablet 25 mg	PRN	S	Until discont'd	
		25 mg, oral, every 6 hours PRN, nausea, vomiting, Starting when released, Until Discontinued		
	☐	sodium chloride 0.9% infusion 250 mL	PRN	S	Until discont'd	
		250 mL, intravenous, once PRN, Hydration, Starting when released, Until Discontinued