Unique Plan Description: Ophth Eye Intravitreal Injection Medications
Plan Selection Display: Ophth Eye Intravitreal Injection Medications
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2016-03-21 07:19:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-02-19 11:16:51
Available at all facilities: No

Ophth Eye Intravitreal Injection Medications
Medications
	proparacaine 0.5% ophthalmic solution
		1 gtt, Solution, Eye, Affected, Once
		3 gtt, Solution, Eye, Affected, Once
		1 gtt, Solution, Eye, Right, Once
		3 gtt, Solution, Eye, Right, Once
		1 gtt, Solution, Eye, Left, Once
		3 gtt, Solution, Eye, Left, Once
	lidocaine 2% preservative-free injectable solution
		0.1 mL, Injection, Conjuctival Sac, Once
	alteplase intravitreal 12.5 mcg/0.1ml
		0.1 mL, Injection, Eye, Affected, Once
			Comment: To be injected by physician, allow for 10mL Total Volume for waste if no other volume requested
	amikacin intravitreal 0.4mg/0.1ml
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	amphotericin B intravitreal 50mcg/1ml
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	cefTAZidime  intravitreal 2.25mg/0.1mL
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	cefTAZidime intravitreal  4.5mg/0.1mL
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	dexamethasone intravitreal 100mcg/0.1ml
		0.1 mL, Injection, Eye, Affected, Once
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	foscarnet intravitreal 2.4 mg/0.1ml
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	ganciclovir intravitreal 2 mg/0.1ml
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested.Extremely Hazardous Drug | Non-Antineoplastic |  PPE Requirements: Dispensed From Pharmacy In Rx Crush Bag, Double Gloves, Gown, Face Shield If Tube Admin Or Splashing Risk.
	vancomycin intravitreal 1mg/0.1mL
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
	vancomycin intravitreal 2mg/0.1mL
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection, T;N
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested.
	voriconazole intravitreal 200 mcg/0.1ml
		0.1 mL, Injection, Eye, Affected, Once, Other- type in, intraocular infection
			Comment: To be injected by physician, allow for 1mL Total Volume for waste if no other volume requested
Patient Care
	Obtain Consent/Permit for:
		T;N

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase