Editing Intravenous therapy (section)

====Medication and treatment====
[[File:Glass IV.jpg|right|thumb|[[Saline (medicine)|Saline]] and 5% [[dextrose]] solution (left), [[levofloxacin]] 750mg (right), and log sheet hanging from an IV pole|alt=Photograph of two intravenous solution bags (containing glucose and levofloxacin, respectively) and a paper log sheet hanging from a pole]]
[[Medication]]s may be mixed into the fluids mentioned above, commonly normal saline, or [[dextrose]] solutions.<ref name="Flynn2007" /> Compared with other [[route of administration|routes of administration]], such as [[Oral administration|oral medications]], the IV route is the fastest way to deliver fluids and medications throughout the body.<ref>{{cite web |title=What is an IV Vitamin Therapy? A Complete Guide by Nepenthe |url=https://www.nepenthewellness.com/complete-guide-to-iv-vitamin-therapy/ |access-date=2022-09-02 |language=en-US}}</ref> For this reason, the IV route is commonly preferred in emergency situations or when a fast onset of action is desirable. In extremely high blood pressure (termed a hypertensive emergency), IV antihypertensives may be given to quickly decrease the blood pressure in a controlled manner to prevent organ damage.<ref name=JEM2012>{{cite journal |last1=Peacock |first1=W. Frank |last2=Hilleman |first2=Daniel E. |last3=Levy |first3=Phillip D. |last4=Rhoney |first4=Denise H. |last5=Varon |first5=Joseph |title=A systematic review of nicardipine vs labetalol for the management of hypertensive crises |journal=The American Journal of Emergency Medicine |date=July 2012 |volume=30 |issue=6 |pages=981–993 |doi=10.1016/j.ajem.2011.06.040|pmid=21908132 }}</ref> In atrial fibrillation, IV [[amiodarone]] may be administered to attempt to restore normal heart rhythm.<ref>{{cite journal |last1=Vardas |first1=Panos E. |last2=Kochiadakis |first2=George E. |title=Amiodarone for the Restoration of Sinus Rhythm in Patients with Atrial Fibrillation |journal=Cardiac Electrophysiology Review |date=September 2003 |volume=7 |issue=3 |pages=297–299 |doi=10.1023/B:CEPR.0000012400.34597.00|pmid=14739732 }}</ref> IV medications can also be used for chronic health conditions such as cancer, for which chemotherapy drugs are commonly administered intravenously. In some cases, such as with [[vancomycin]], a loading or bolus dose of medicine is given before beginning a dosing regimen to more quickly increase the concentration of medication in the blood.<ref>{{cite journal |last1=Álvarez |first1=Rocío |last2=López Cortés |first2=Luis E. |last3=Molina |first3=José |last4=Cisneros |first4=José M. |last5=Pachón |first5=Jerónimo |title=Optimizing the Clinical Use of Vancomycin |journal=Antimicrobial Agents and Chemotherapy |date=May 2016 |volume=60 |issue=5 |pages=2601–2609 |doi=10.1128/AAC.03147-14|pmid=26856841 |pmc=4862470 |s2cid=9560849 }}</ref>

The [[bioavailability]] of an IV medication is by definition 100%, unlike oral administration where medication may not be fully absorbed, or may be metabolized prior to entering the bloodstream.<ref name="Flynn2007">{{cite book | last=Flynn | first=Edward | title=xPharm: The Comprehensive Pharmacology Reference | chapter=Pharmacokinetic Parameters | publisher=Elsevier | year=2007 | isbn=978-0-08-055232-3 | doi=10.1016/b978-008055232-3.60034-0 | pages=1–3}}</ref> For some medications, there is virtually zero oral bioavailability. For this reason certain types of medications can only be given intravenously, as there is insufficient uptake by other [[routes of administration]],<ref name="BCcampus">{{cite book |last1=Doyle |first1=GR |last2=McCutcheon |first2=JA |title=Clinical Procedures for Safer Patient Care |date=13 November 2015 |publisher=BCcampus |location=Victoria, BC |url=https://opentextbc.ca/clinicalskills/chapter/6-9-iv-main-and-mini-bag-medications/ |chapter=7.5}}</ref> such is the case of severe dehydration where the patient is required to be treated via IV therapy for a quick recovery.<ref>{{cite web |url=https://my.clevelandclinic.org/health/treatments/21635-iv-fluids |access-date=2023-09-30 |website=Cleveland Clinic |title=IV Fluids|language=en}}</ref> The unpredictability of oral bioavailability in different people is also a reason for a medication to be administered IV, as with [[furosemide]].<ref>{{cite journal |last1=Boles Ponto |first1=Laura L. |last2=Schoenwald |first2=Ronald D. |title=Furosemide (Frusemide) A Pharmacokinetic/Pharmacodynamic Review (Part I) |journal=Clinical Pharmacokinetics |date=1 May 1990 |volume=18 |issue=5 |pages=381–408 |doi=10.2165/00003088-199018050-00004|pmid=2185908 |s2cid=32352501 }}</ref> Oral medications also may be less desirable if a person is nauseous or vomiting, or has severe diarrhea, as these may prevent the medicine from being fully absorbed from the gastrointestinal tract. In these cases, a medication may be given IV only until the patient can tolerate an oral form of the medication. The switch from IV to oral administration is usually performed as soon as viable, as there is generally cost and time savings over IV administration. Whether a medication can be potentially switched to an oral form is sometimes considered when choosing appropriate antibiotic therapy for use in a hospital setting, as a person is unlikely to be discharged if they still require IV therapy.<ref>{{cite journal |last1=Wetzstein |first1=GA |title=Intravenous to oral (iv:po) anti-infective conversion therapy. |journal=Cancer Control |date=March 2000 |volume=7 |issue=2 |pages=170–6 |doi=10.1177/107327480000700211 |pmid=10783821|doi-access=free }}</ref>

Some medications, such as [[aprepitant]], are chemically modified to be better suited for IV administration, forming a [[prodrug]] such as [[fosaprepitant]]. This can be for pharmacokinetic reasons or to delay the effect of the drug until it can be metabolized into the active form.<ref>{{cite journal |last1=Patel |first1=P |last2=Leeder |first2=JS |last3=Piquette-Miller |first3=M |last4=Dupuis |first4=LL |title=Aprepitant and fosaprepitant drug interactions: a systematic review. |journal=British Journal of Clinical Pharmacology |date=October 2017 |volume=83 |issue=10 |pages=2148–2162 |doi=10.1111/bcp.13322 |pmid=28470980|pmc=5595939 }}</ref>