Memorizing drug interactions!

  1. Hi everyone! I am a nursing student trying to prepare to be the safest nurse I can and I have been trying to memorize as many drug interactions, contraindications and major adverse reactions as possible lately. Please feel free to leave a comment with any and all interactions, interesting contraindications, or major adverse reactions or Rx. gems you have memorized or have come across or use on a regular basis. I'll list as many as I have in my head right now that I have come across recently
    .octreotide and pantoprazole in a Y site IVP
    .lorazepam and ondansetron IVP
    .Dilantin and D5 IV
    .succinylcholine(all depolarizing muscular blockades) For RSI Is contraindicated in CKD/ESRD, burns, crush injuries, and muscular dystrophy.(anything causing hyperK)
    .dantroline is a vesicant and hyaluronidase is the antidote for extravasation.
    .Bicarb, calcium gluconate/calcium chloride, Dilantin and potassium are drugs that should pretty much have their own primary tubing/no piggy and should not have meds pushed through them to be safe.

    This is just what's in my head at the moment. I'll post as I learn more or come across others that I know but am not thinking of at the moment!

    please feel free to ad or correct/clarify anything I have said.
    Thank you in advance.
    -ND
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  2. 33 Comments

  3. by   beekee
    I prefer to not trust my memory on these things. I look it up. Every time.
  4. by   Noctor_Durse
    So you look up every time that labetalol is contraindicated below50-60bpm and should not be given With an SBP OF less that 90-100mmHg every time you give it?
  5. by   JKL33
    I agree this is not going to be a productive way to memorize the innumerable various interactions, adverse effects, administration recommendations or quirks about a particular drug.

    To answer your question, if one is not significantly familiar with labetalol (or any other medication) then yes, s/he should look it up every time. If one is significantly familiar with a medication, say they give it 5-10 times a day, then it stands to reason that it might not be necessary to look it up 5-10 times per day, right?
  6. by   Noctor_Durse
    As I understand it neither poster thus far has any specialized knowledge to impart on this highly motivated nursing student, eager to learn.
  7. by   KelRN215
    Memorizing interactions is NOT the way to be the safest nurse you can be. The way to do that is to verify interactions prior to administering the drugs. Are there some things you may do frequently so you'll remember? Sure. I don't need to look up that ambisome is only compatible with D5 because that's a drug I deal with fairly regularly but when one of my home PN patients needs to go home on an IV antibiotic, I look up the compatibility every time before I teach the parents whether or not they have to pause the PN when administering the antibiotic. The same applies any time I get a referral for someone who needs to go on double antibiotics, one of which needs to be on a continuous pump. When I get called for a referral for nafcillin and ceftriaxone, I'm going to look up compatibility before I make a recommendation about whether or not the child needs a double lumen PICC. I'm not going to try to remember if I ever had a patient on these same drugs before and if he had a double lumen or single lumen with a Y site.
  8. by   chare
    Quote from Noctor_Durse
    As I understand it neither poster thus far has any specialized knowledge to impart on this highly motivated nursing student, eager to learn.
    Actually, both of them have given you excellent advice.

    ETA: As did KelRN215.
  9. by   beekee
    Quote from Noctor_Durse
    As I understand it neither poster thus far has any specialized knowledge to impart on this highly motivated nursing student, eager to learn.
    Nothing stopping you from doing it your way. The information you seek to memorize is all in a book and online. There's nothing I can add to the resources already available to you. When you are working as a nurse, you will see certain drugs over and over again and others rarely or not at all. I think I've given maybe three of the drugs you listed in your original post in IV form, ever. Why would I memorize the others?

    Drugs that I give every day, I pretty much know them so I don't need to look them up anymore. For the drugs I give infrequently, I'll look them up before I give just to refresh, especially if it's new to the patient. However, I do look up or call the pharmacy for IV drug-drug interactions every time.

    There are far too many drugs and far too few brain cells in my head to memorize everything. I'm also fond of printing out the drug handout and giving it to the patient with the first dose so the teaching is both verbal from me and written for later reference (with the added benefit that I have a cheat sheet when I'm doing my teaching)
  10. by   Noctor_Durse
    The medications listed are all Rx I have given or come across in my short lived student nurse career. Every time I am giving a new med I 100% absolutely look up the medication interactions before giving anything. If I am not familiar with or have not previously given a medication there are hospital resources and pharmacy available 24/7. If there is even the slightest question of incompatibility I look the medication up.

    I have been getting so much guidance and mentoring at my employment from veteran nurses that I thought this might be a great recourse, clearly this forum is not keen on discussing specialized Rx. knowledge with students. That’s fine.
    Last edit by Noctor_Durse on Nov 19
  11. by   chare
    Quote from Noctor_Durse
    Every time I am giving a new med. I 100% absolutely look up medication interactions before giving anything I am not familiar with and have not previously given. If there is even the slightest question of incompatibility I look my medications up. I have just been getting so much guidance and mentoring at my employment from veteran nurses that thought this might be a great recourse clearly this forum is not keen on discussing specialized Rx. knowledge.
    Keep doing what you are doing, if you are not absolutely positive that the two, or more, medications that you are giving or infusing together, are compatible; look it up. After you've looked up the same combination a few times, you'll remember it. I know that furosemide is compatible with lipids, because I looked it up; I know that epinephrine, norepinephrine, and vasopressin are compatible because I looked these up. There is no short-cut for this repetitious verifying compatibility and that is what the previous posters were trying to say. And if you try it your way, by trying to memorize random medication combinations, you'll likely only confuse yourself.

    Best wishes.
    Last edit by chare on Nov 19 : Reason: Corrected content
  12. by   Noctor_Durse
    I do nott understand How the above posters are so well versed in how my brain works and what my capacities are. I have many things memorized far beyond most. I.e. credit card numbers, Rubics cube algorithms etc. I really appreciate you mentioning a few compatibilities that you know and use. This gives me something to study and ad to my bag of medication familiarities. I believe I will be encountering these medications in the near future and this for me is a great jumping off point for study. It is also highly motivating because when I actually get the medication in my hands and it's my pt I'm giving it to I can look it up to confirm my knowledge. To me that is exciting.
  13. by   macawake
    Quote from Noctor_Durse
    As I understand it neither poster thus far has any specialized knowledge to impart on this highly motivated nursing student, eager to learn.
    Careful, unless you want other posters to perceive you as being arrogant. People are taking time to answer your post and you shouldn't assume that you know what knowledge they have or don't have.

    Quote from Noctor_Durse
    Hi everyone! I am a nursing student trying to prepare to be the safest nurse I can...
    I commend you for having the goal of being as safe a nurse as you can be.

    Quote from Noctor_Durse
    ...and I have been trying to memorize as many drug interactions, contraindications and major adverse reactions as possible lately.
    I agree with other posters that this isn't the best way to learn. When you start working, you'll notice that you'll become very familiar with certain meds or drug classes simply because you administer them so often and you'll learn a lot about them. My advice is that should always look up the particulars about a drug before you administer them, do not rely solely on memorized contraidications and drug interactions.

    If you want to learn more now and be as prepared as you can be, you might want to study more pharmacology in general instead of memorizing specific details about specific drugs. In my opinion you'd be better served by having a solid grasp of physiology and pharmacology and how the two "interact". For pharm I personally like this book:

    Rang & Dale's Pharmacology, 8e: 9787253627: Medicine & Health Science Books @ Amazon.com

    If you for example know that metoclopramide is a dopamine D2 antagonist, you'll easily understand why it's generally not recommended to prescribe to a patient with Parkinson's disease.

    Some of the medications that you've listed in your post are meds that most nurses might not even administer a single time during their entire careers, depending on where they end up working. I am a nurse anesthetist and I have had exactly two of my patients develop Malignant Hyperthermia. I honestly think it's a bit of an overkill to study the specifics of Dantrolene while you're still in nursing school. Don't get me wrong, I value knowledge and I like people who are driven to collect lots of it but I think there are more efficient things to spend time and energy on than learning the nitty-gritty details about narrow-use drugs that you are years away from administering.


    Good luck!
    Last edit by macawake on Nov 19
  14. by   Noctor_Durse
    Thank you for taking the time to give me solid advice. Very helpful. I appreciate the direction you are turning me in. That book is on its way to my house.

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