how to find the right answers?

[sassyann85]

I am wondering where everyone gets their resources at. I try to look things up in my old nursing textbooks/online and ask coworkers, but it seems every coworker gives me a different answer. For example, I tried to post a question on the general forum about methadone and PRN pain meds, but got varying answers. I just want to make sure I am doing things correctly/safely.

I never really worked with patients on methadone and suboxone before. Now I am seeing alot of patients on these meds. Often times, the methadone maintenance patients will have PRN oxycodone for pain. Sometimes, they ask for both their methadone and oxy together. Some nurses say absolutely DO NOT give them together, while others say it is ok to give. Sometimes they will have PRN Ativan for anxiety and it's the same thing...some nurses say wait and others say that methadon has such a long half life that it won't make a difference if you wait or give them together. I just want to do what is safe for the patient, but I can't figure out what is best practice. Same thing with suboxone maintenance patients--I have seen them ordered PRN ultram for pain and I dont know if these can be given together/how fart apart they should be spaced for safe administration? IF a sub maintenance patient gets their suboxone q 8am and 5pm daily, and come up and asks for PRN ultram at 6am, is it ok to give it then? Or will the suboxone they take at 8am come and knock the tramadol off the receptors and cause withdrawal sx? IF given along with the suboxone, would it could decreased respirations and those worries?

Any insight is much appreciated. I want to be informed, but not sure where to get the information from!

[Rose_Queen, BSN, MSN, RN]

Your facility pharmacist can be an excellent resource. I know that I've used the OR satellite pharmacist as a resource when asking questions about some of the newer or infrequently used medications we've used for surgical patients. Additionally, if your facility has any sort of policies regarding these types of patients, familiarize yourself with them, and they should also have references that you can refer to.