Memorizing drug interactions!

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Hi everyone! I am a nursing student trying to prepare to be the safest nurse I can and I have been trying to memorize as many drug interactions, contraindications and major adverse reactions as possible lately. Please feel free to leave a comment with any and all interactions, interesting contraindications, or major adverse reactions or Rx. gems you have memorized or have come across or use on a regular basis. I'll list as many as I have in my head right now that I have come across recently

.octreotide and pantoprazole in a Y site IVP

.lorazepam and ondansetron IVP

.Dilantin and D5 IV

.succinylcholine(all depolarizing muscular blockades) For RSI Is contraindicated in CKD/ESRD, burns, crush injuries, and muscular dystrophy.(anything causing hyperK)

.dantroline is a vesicant and hyaluronidase is the antidote for extravasation.

.Bicarb, calcium gluconate/calcium chloride, Dilantin and potassium are drugs that should pretty much have their own primary tubing/no piggy and should not have meds pushed through them to be safe.

This is just what's in my head at the moment. I'll post as I learn more or come across others that I know but am not thinking of at the moment!

please feel free to ad or correct/clarify anything I have said.

Thank you in advance.

-ND

Specializes in Psych, Addictions, SOL (Student of Life).
As I understand it neither poster thus far has any specialized knowledge to impart on this highly motivated nursing student, eager to learn.

You may be highly motivated to learn but you don't appear to be highly motivated to take sound advice. I commend you for what you are trying to do but there's a difference working hard and working smart. A certain amount of memorization is important but I have found that trying to rely solely on memory can get me in trouble. I still look things up often and I have been practicing 17 years. I have also seen physicians still and do a dosage calculation before prescribing.

If memorization is you fall back study method by all means keep doing it but I guarantee that there will coma an emergency when your mind will just go blank for a 2nd or two and in that instant you are likely to panic. In our facility (Psych) we have a handy little tag that goes with our ID badge and has common drug interactions on it.

Hppy

Enough people have already told you that this is a poor way to approach medications (memorizing is the lowest form of knowledge). But I will say really work on understanding the pharmacology behind classes of medications; know what body systems they work on, how they work, what receptors they bind to. Much more helpful in terms of knowing some medications that wouldn't work well together (e.g. you wouldn't give several hepatotoxic drugs together or give them to a patient with liver disease). And always ALWAYS look up medications you are not 100% familiar with before administering them.

So you look up every time that labetalol is contraindicated below50-60bpm and should not be given With an SBP OF less that 90-100mmHg every time you give it?

If that is what is required for safe practice, then yes. I would much rather have a nurse taking care of me that would check their resources than assume they already know everything.

If that is what is required for safe practice, then yes. I would much rather have a nurse taking care of me that would check their resources than assume they already know everything.

From what I have seen in the past with OP, he assumes that he does know everything so watch out if you end up in a hospital he works in in the future

From what I have seen in the past with OP, he assumes that he does know everything so watch out if you end up in a hospital he works in in the future

That's a very scary thought.

Specializes in NICU.

I deal with maybe 25 different medications routinely. I need to know everything about those drugs. The other 500 medications out there, a vast majority I will never administer in my career, has no use taking up space in my brain or the immense time it would take to memorize everything about each one of them.

Specializes in NICU, Psych.
In our facility (Psych) we have a handy little tag that goes with our ID badge and has common drug interactions on it.

I need one of those! Did you buy it online or did the hospital give it to you?

I don't even start nursing school for another month, but I've been working in hospitals for 5 years and just want to say you need to really consider looking at your attitude. Not because some people on the internet are disagreeing with you, but because as a nurse you are going to be in the trenches with a bunch of people that know more than you, and you will end up in a lot of situations where you can learn how better to do something from coworkers or even from patients. They aren't all going to handle you with little kid gloves. Some are just going to tell you they think you should do it differently. You can take offense, like you seem prone to do, or you can ask how they would do it, and practice saying "thank you for the advice" even when you want to argue. Rubbing everyone the wrong way is going to make life difficult for you, and you might miss out on some gems of information. When I hear a bunch of people saying not to bother memorizing interactions, I would wonder how they deal with the issue. One poster mentioned what I would do, which is familiarize yourself with the facility's online drug compatibility tool. This frees you up to memorize other things like maybe more advanced patho or EKG interpretation or something. Dale Dubin's Rapid EKG Interpretation has kept me busy for awhile, and helps learn a lot about cardiology. Sorry such a long post, but I was bored and wanted to help out.

"Everyone you meet knows something you don't." -Bill Nye

By the way, I would encourage you to memorize when to hold (and call the provider) medications. Some instances when you'd want to consider holding a medication: elevated creatinine, heart blocks, low potassium, low heart rate, low blood pressure, loose stools. I'm sure there are tons more, but I'll let you figure out what medications you'd hold if you had a patient with any of the above.

I've seen plenty of nurses dole out the senna without looking to see if the patient has diarrhea. Or milk of magnesia to a patient with poor renal function. Do you really want to give an albuterol new to someone with tachycardia? Maybe, but it might be worth asking about an alternative. What about giving warfarin with cranberry juice?

Careful, unless you want other posters to perceive you as being arrogant. People are taking time to answer your post and you shouldn't assume that you know what knowledge they have or don't have.

I commend you for having the goal of being as safe a nurse as you can be.

I agree with other posters that this isn't the best way to learn. When you start working, you'll notice that you'll become very familiar with certain meds or drug classes simply because you administer them so often and you'll learn a lot about them. My advice is that should always look up the particulars about a drug before you administer them, do not rely solely on memorized contraidications and drug interactions.

If you want to learn more now and be as prepared as you can be, you might want to study more pharmacology in general instead of memorizing specific details about specific drugs. In my opinion you'd be better served by having a solid grasp of physiology and pharmacology and how the two "interact". For pharm I personally like this book:

Rang & Dale's Pharmacology, 8e: 9787253627: Medicine & Health Science Books @ Amazon.com

If you for example know that metoclopramide is a dopamine D2 antagonist, you'll easily understand why it's generally not recommended to prescribe to a patient with Parkinson's disease.

Here's another example. You have an asthmatic pt who recently was prescribed propranolol by her psychiatrist for symptoms of anxiety. A month earlier her primary provider prescribed Ventolin HFA Q4 PRN.

So, WHY is this important? I know not because I memorized contraindications between the two, but because I knew the class and action of each drug. It would not have been helpful for me to simply have a list that states there are contraindications to the 2 taken at the same time. I used critical thinking which is WAY better for your memory than rote learning.

We know propranolol is a beta blocker right? So what's albuterol? A beta2 adrenergic AGONIST. Hence, taken together, they would decrease the efficacy of each drug.

Know your classifications and actions of drugs 1st. Then it will make sense to you why drugs aren't compatible with others. Consider route too!

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