IV Drug incompatibilities

Specialties NICU

Published

Hi All,

I'm starting a new job in a level 3 NICU and my job offer is contingent on me passing a NICU pharmacology test. I feel pretty confident about all the topics on the study guide except IV incompatibilities. At work right now (a level 2 NICU), I look up everything in our med book to make sure it's compatible with TPN and lipids before I give it. I just don't trust my memory on this! And we don't give the full range of meds a level 3 NICU would. But for this test, I'm supposed to have the common incompatibilities memorized.

So far I have ampicillin, versed, albumin, acyclovir, gancyclovir, amphotericin B, indocin and ibuprofen, and phenobarb down for being incompatible with TPN and lipids. Am I missing any? Are there any other common drugs you might give at the same time if they were compatible (like 2 antibiotics that can't mix?) Anything else you can think I should have memorized? Thank you so much!

Specializes in NICU, PICU, PACU.

Get the you-know-what out!!!!! I know I could not have kept my mouth shut over that one!!! And she stuck a needle into the TPN bag which is a huge no no!!!!

Specializes in CDI Supervisor; Formerly NICU.

Yep. Welcome to the wilderness.

I know exactly which test you are studying for, and I HOPE you passed it!! I am studying for this same exact test from Prophecy for a NICU III hospital entrance. Some important tips are:

-Nitroprusside must be protected from light

-Dilantin (Phenytoin) DO NOT use with Dopamine

-DO NOT use hydrocortisone with indomethacin as there is a increased risk of GI perforation.

-Blood products can't be given in PICCs, need to use 24 gauge IVs.

-DO NOT combine in IV Prostin with Intralipids and Milrinone

-Adverse reaction signs to IVIG: skin flushing, wheezing, tachycardia, nausea, and hypotension

-Large dose of Ampicillin associated with seizures.

-Metoclopromide (Reglan) associated with tardive dyskinesia (dystonia reaction).

I will try to post more after I take my test. If as nurses we come together and have a website to help other nurses who must complete these competency exams required by hospitals we could RULE THE WORLD! =)

Am i just a really inexperienced NICU nurse? We don't give half of those drugs at my level III facility.

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