Important Drug Tips!!

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I am a new nurse. I know I should of learned all of this in pharm... But seriously that was so long ago I can't remember...

But can some experienced nurses jot down some important drug tips that could possible lead to patient injury/death. Just to remind me and warn me..

For example:

Protonix must have it's own line when infusing...

Never push potassium...

Lantus must be given with meals or within 15 minutes of eating...

Specializes in CCRN, CNRN, Flight Nurse.
IV potassium can be run at 20 meq/hr if pt has a central line/PICC.

This apparently varies from facility to facility. Check your regulations and policies and run accordingly.

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Specializes in Hospice, Med/Surg, ICU, ER.

Toradol can only be mixed w/ NS.

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Specializes in Psych, Med/Surg, LTC.
About Lantus. It is so slow acting, (70 minute onset and duration of 24 hours), it can be given before bedtime without regard to meals.

We also give it before bedtime and not in regard to meals/snacks.

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Specializes in Med/Surg.

potassium is never given iv push, do not crush potassium...although i have a question about that one...if you are not supposed to crush potassium, then why is it you can dissolve a particular one in h2o...what is the difference?

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Specializes in Med-Surg.
potassium is never given iv push, do not crush potassium...although i have a question about that one...if you are not supposed to crush potassium, then why is it you can dissolve a particular one in h2o...what is the difference?

Good question. I guess you can't crush it and give it with pudding, but dissolving it without crushing and giving it as a liquid to drink is o.k. but I'm not sure what the differece is.

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Specializes in Emergency room, Flight, Pre-hospital.

The reason you aren't supposed to crush po pills of potassium like K-dur, is because it has a micro coating on it so it breaks down differently in the stomach. The effervesant kind is called k-lyte and it is formulated differently (no micro coating)to be dissolved in 4 oz of water per 25meq. For those people who cannot swallow those huge 20meq tablets. I hope this makes sense.:)

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

There is also sprinkles that are especially for mixing with a food substance or sprinkling on food.

The reason you aren't supposed to crush po pills of potassium like K-dur, is because it has a micro coating on it so it breaks down differently in the stomach. The effervesant kind is called k-lyte and it is formulated differently (no micro coating)to be dissolved in 4 oz of water per 25meq. For those people who cannot swallow those huge 20meq tablets. I hope this makes sense.:)
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NCLEXy things i learned:

if you have a central line (single lumen) being used for TPN, don't run anything else through that lumen, if you need another line, poke a new one peripherally.

We run lipids with our TPN.

Also, make sure to check your IV compatibility before you mix anything!

Some good tips here, but bottom line, LOOK IT UP. If you don't know what you're doing, ask for help, and KNOW YOUR FACILITY'S POLICIES! If your policy is to run K Riders at 10 mEq/hr, but you do 20 and get busted for it, you can't say "Well, on allnurses.com, they said I could do that!" :specs:

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as far as potassium, the big pill that can't be crushed but can very easily dissolve, it has to do with the molecular chain. you can think of it as being similar to doing a belly flop in the pool vs. diving; both get you wet and it happens all at once, but one definitely hurts while the other is fun.

but, a little fyi, which you won’t see much of anymore, but can be fatal, may interest you. i had a patient being treated with verapamil and digoxin concurrently, this was soon after verapamil had been approved but soon learned that this form of treatment can cause third degree heart block. also, watch for patient’s that may travel to the far east, and decide taking herbs would help; again making third degree block a possibility.

p.s. i think this is a great idea for a thread. we all have such different experiences and work in different areas and settings; some big city settings; some community settings; some rural settings. just think of all the information we can share – and gain!!! good job coming up with this = )

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Specializes in retail NP.

exactly, lipids can run with tpn per order.

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Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

Time release tablets (Slo-K, KlorCon, K-Dur) allow once a day dosing (or sometimes 2) whereas the immediate release products such as K-Lyte may require 2 to 4 doses daily.

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One good tip is that anytime you have to use more than one vial for anything...double check your dosage again!

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