Administering IV meds

[maryjane1216]

I had a patient today who had LR running @ 30 ml/hr. Patient is also on demerol PCA. MD ordered Toradol IV ATC q6h. However, when I looked in the 2008 IV meds 24th Edition by Gahart and Nazareno, demerol and toradol are contraindicated. I asked one of my co-worker and she suggested to flush with 10 ml of NS admin the toradol then flush it again w/ 10 ml of NS. Is there any other way of administering it?

[emmakirst]

I work on an Ortho floor and a lot of patients have PCA's, i've only seen it a few times ordered, only if there is an allergy to it. A lot of times the ortho docs order torodol too to help with pain relief. I've only given it IM so I know that they can receive demerol and torodol at the same time. I'm unfamiliar with IV torodol though, I would just call pharamacy when in doubt. That or get the order changed to IM.

[emmakirst]

I work on an Ortho floor and a lot of patients have PCA's, i've only seen it a few times ordered, only if there is an allergy or sensitivity to it. It meaning morphine or some other narcotic.

[MIA-RN]

I may be reading your post incorrectly, but I'm picturing a patient with a Demerol PCA and an IV with LR running KVO (30mL/hour).

I know of no contraindication to giving both Demerol and Toradol, and I've checked my 2 drug guides without finding any contraindication. If you are concerned I would definitely check with pharmacy.

Since the IV is only running KVO, I would probably just stop the LR for 10 minutes or so and give the Toradol.

I read it as the way I am used to setting up PCA's, which is one pump with the LR on one channel and the PCA on the other channel, with the tubing Y-sited together into the same IV site.