combining PRNS

[sassyann85]

Hi everyone.

I tried to research this, but I can't seem to find anything specific. I came from a floor that treated mainly depressed patients, and now I am working on a floor where there is more psychosis, aggression, etc. I am trying to figure out which PRNs can be safely combined, as a general rule.

For example, I have seen Ativan + Haldol frequently.

I have seen Prolixin + Ativan.

But what about Geodon + Ativan at the same time in someone really agitated? Is this ok, as a general rule of combining meds? What about Risperdal + Ativan (either both as PRNS given together, or if a patient gets scheduled risperdal and then when he is getting this scheduled med, asks for a PRN ativan? Can I give it, or should I have him wait awhile?)

Thanks for any help!

[vintagemother, BSN, CNA, LVN, RN]

When I order them as PRNs I stipulate they need to be separated by 1 hour. There have been instances of patient death when the two were administered together, by IM I think.

We have std admission orders that state not to give Ativan and zyprexa IM together. Now that you bring that up, I think we can give zyprexa and Ativan as PO at same time, but don't quote me on that. Not entirely sure.

[Jules A, MSN]

We have std admission orders that state not to give Ativan and zyprexa IM together. Now that you bring that up, I think we can give zyprexa and Ativan as PO at same time, but don't quote me on that. Not entirely sure.

You are correct. I checked it out and it does look as if the problems were with injections but I'd just hate to take the chance. How would it sound in court if something horrible happened? "Sooooo Ms. Jules are we to understand that you knew there was a risk and that other patients had died from this combination of medication and yet you felt it was prudent to administer them together because....they were a different route?"

[302queenpa]

So so true Ms Jules better to be safe then sorry.