Can you mix 3 medications in a syringe?

[GQRN]

Benadryl, Dilaudid, and Promethazine are all compatible with each other.

For an IM shot, can you mix all three in one syringe and administer?

I've been giving a lot of Dilaudid/Promethazine or Morphine/Promethazine or Morphine/benadryl or dilaudid/benadryl IM Shots.

Today I had an order for benadryl, Dilaudid, and promethazine IM. I didn't mix all three but just curious if I could had done it tho they are all compatible with each other.

Anyone?

[blondy2061h, MSN, RN]

They're all compatible? Then you answered your own question! If it's going to be a large volume though, make sure you use a large muscle.

[lizva101]

Hi, I have seen nurses mix 2 together.

The only problem I can think about - Pt may have severe reaction to one of those three medications, if all three are given you have no idea which med cozed it. And believe me, the MD will want an answer. You could always run it by the doc if you are uncomfortable, then he becomes a resonsible party.

I would be very careful mixing drugs.

[blondy2061h, MSN, RN]

Hi, I have seen nurses mix 2 together.

The only problem I can think about - Pt may have severe reaction to one of those three medications, if all three are given you have no idea which med cozed it. And believe me, the MD will want an answer. You could always run it by the doc if you are uncomfortable, then he becomes a resonsible party.

I would be very careful mixing drugs.

Good point on the rxn, however, a doctor telling you something is okay does not relieve you of responsibility or liability.

[GQRN]

They're all compatible? Then you answered your own question! If it's going to be a large volume though, make sure you use a large muscle.

I guess I never mixed 3 meds in the same syringe and administered as an IM shot. So I wasn't sure if you CAN mix 3 compatible meds in 1 syringe.

[Dixielee, BSN, RN]

Hi, I have seen nurses mix 2 together.

The only problem I can think about - Pt may have severe reaction to one of those three medications, if all three are given you have no idea which med cozed it. And believe me, the MD will want an answer. You could always run it by the doc if you are uncomfortable, then he becomes a resonsible party.

I would be very careful mixing drugs.

It doesn't matter if you are mixing several meds in one syringe or separately, if they are going to have a reaction, you are still not going to know which one was the problem, because they are already in the system.

My only hesitation about giving 3 is the volume of meds. If each are under 1cc you might be OK, but for patient comfort, you might consider splitting them.

[rjflyn, ASN, RN]

Sounds like Haldol, Benadryl and Ativan for some of our out of control psych pts in the ER. Never have given all three in one shot but two in one. Personally at the time I just want them nighty night so they, me, my staff or an innocent bystander does not get hurt. Have never had a bad reaction, though we do monitor them closely.

Rj

[lizva101]

It doesn't matter if you are mixing several meds in one syringe or separately, if they are going to have a reaction, you are still not going to know which one was the problem, because they are already in the system.

Good Point. thanks.

[Jdl2002]

It is probably best to consult a pharmacist if there is any question about mixing drugs. Just because each drug can be mixed with the other two, doesn't mean that they won't form a precipitate or have some other reaction when mixed all together.

[BinkieRN, BSN, RN]

Pt may have severe reaction to one of those three medications, if all three are given you have no idea which med cozed it. And believe me, the MD will want an answer. You could always run it by the doc if you are uncomfortable, then he becomes a resonsible party.

I would be very careful mixing drugs.

If all 3 meds are compatible and the total to be injected is not over 3cc, please give it all in one injection. Would you like to receive 3 injections when only one is necessary? Chances are very minimal that the pt will have an reaction to one of the drugs. The doctor who ordered the drugs is not responsible and neither is the nurse if the patient has an allergic reaction to a medication. It just happens. It's nobodys fault unless the patient has a previously known allergy to one of the medications.

[GQRN]

If all 3 meds are compatible and the total to be injected is not over 3cc, please give it all in one injection. Would you like to receive 3 injections when only one is necessary? Chances are very minimal that the pt will have an reaction to one of the drugs. The doctor who ordered the drugs is not responsible and neither is the nurse if the patient has an allergic reaction to a medication. It just happens. It's nobodys fault unless the patient has a previously known allergy to one of the medications.

So far this is the most logic post in this enitre thread I've started. I did not mention the patient is allergic to any of the meds and most of you are jumping to allergies and reactions.

All I simply wanted to know was whether it is safe to mix 3 compatible drugs in one syringe, not allergic reactions.

[nightmare, RN]

3 medications are quite often mixed together especially in a syringe driver.In our drug 'Bible ' the BNF there is a section which tells you which drugs are compatible so that they can be mixed.