iv tigan??

[kbear]

Another nurse and I were covering patients for a nurse who was late for work. One of her patients was ordered iv Tigan . The patient was retching loudly and had already received a prn dose of zofran a few hours earlier as well as phenergan a few hours before that. She had a new order for Tigan which had not yet been given since ordered.(This patient had history of gastroparesis and had chronic nausea). I've never given Tigan IV or heard of it given intravenously--only PR. The other nurse who was covering was trying to be helpful and drew it up and handed me the syringe and said "here". I said " I've never given that--I don't know how fast or if it gets diluted. She said-"oh, I've given it-it can be given straight undiluted as a push." As we learned in nursing school--Don't give a drug that you don't know about--how to give, side effects,etc. or that you didn't draw up. The patient received the dose and within 30 minutes was confused for the remainder of the night. I later found the vial that the other nurse used and it said for IM USE ONLY! I called pharmacy and he said that it can also be used for IV. I still didn't feel right after reading that label. I looked up the literature and EVERY REFERENCE listed administration routes as IM or ORAL!! The physician was informed and proceded to order mental status change work-up (ABG, Chem 7 ) despite being told about IV Tigan given. I spoke to our floor's unit pharmacist in the morning and she said it should not be given IV. It was ordered as IV, transcribed as IV by pharmacy on the CMAR and delivered to our floor with computerized label that indicated IV route (the vial itself said IM use only as I said before). Luckily the patient's confusion gradually wore off over the course of the night. Don't rely on another person to tell you about a drug that you don't know about-- Remember-the person giving the drug has the ultimate responsibility!! Take the time and look up the drugs!!

[imanedrn]

So how was the situation resolved? Obviously, the pharmacist who stated it can be given IV was wrong and should be included in an incident report of some sort. What else though?

[kbear]

It just happened last night so not sure how the patient is doing now. Our unit pharmacist is going to let the first pharmacist know of his erroneous advice.

[BinkieRN, BSN, RN]

The pharmacist was wrong to send it up as an IV push med, should have known the label said IM only. The pharmacist should have called the floor and spoke to you before sending up the med.

The nurse who pulled it up for you was WRONG to then hand it to you. NEVER EVER give a med you haven't pulled yourself. Who ended up giving the IV Tigan?

I'm glad the patient is okay. I don't think I've ever given Tigan, IM or any other route

[kbear]

Unfortunately, I gave the drug despite my knowing inside that I shouldn't. I trusted the other nurse's actions and let myself down. It won't ever happen again, that's for sure!!

[shala]

Just as the Haldol bottle says not to give IV, it is safe to give both of these (just not common and well studied). The sedation from you patient was just the typical side effect of the drug, esp since they had already received Phenergan that itself causes sedation. It had nothing to do with the route of administration (IV vs IM). The suppositories were good though pulled off the market (as the other replies weren't familiar with that).

[NJNursing, ASN, RN]

I have heard of Tigan, but have not given it in years and I've given it IV push, just slow IV push like Phenergan or it can make the vomiting worse.