Question about drugs and interactions and adverse reactions

Tweety, BSN, RN · Jun 22, 2005

Good question. That's a very weak point for me as well. I'm taking a course in pharmacology next year and hopfully that will shed some light. Right now I just rely on the drug books, but mainly rely on the pharmacy. They have a computer program that flags potential interactions and they notify nursing and make notes on the medication profile. That's a lifesaver.

AussieKylie · Jun 22, 2005

That sounds cool having pharmacy make nurses aware of interactions.

Besides that little bit of convenience, it would be great to be aware of the potential drug interactions etc :rolleyes:

jerryh55 · Jun 22, 2005

During clinicals our first semester, I posed this question to the RN who we were working under. She said the answer is experience. Over time you learn what drugs can't be mixed and which ones can. All the med rooms where we do clinicals has a drug book in them. She said dont ever be afraid of looking a drug up. When we do meds at clinical, we look every drug up before giving it. I have personally withheld meds on a patient due to questions regarding there ability to be mixed. On 2 occassions it was ok and we passed the med, but on one occassion it was contradited and the med wasn't given until DR looked at both and changed one. The drug book is your best friend, and should be used anytime you think something just ain't right.

Have a Great dat and Be Safe

Jerry

Nrs_angie, BSN, RN · Jun 23, 2005

Hi there SN,

I read your problem... First I would like to ask you, when you have to go on clinicals... does your instructor assign you a patient the day before??

At my school... for our Junior year... we would get our patient assignments the day before the clinical. I would write down all the meds that the patient was currently on... then at home I would look them all up with a drug book.

First you look up the class, action, side effects, and nursing responsibilities or implications.... then note the page number.

Once you have looked them all up... then you can go back to the beginning and look up the drug interactions for the first drug.... and so on... until you have looked them all up... and you can important notations at this time...

Such as: If the patient is on Digoxin: the cardiac glycoside... you note that you have to check the Potassium level before giving it... because hypokalemia could potentiate Digitalis toxicity.

another example: Usually if a patient is on more than one antihypertensive they may have increased risk of hypotension... so you would want to watch for signs of orthostatic such as dizziness.

In time you learn the the way the drugs work... and knowing the CLASS of a drug is a major thing...that will notify you to some potential interactions: like CNS depressants will have increased sedation when given with other CNS depressents.

The more meds you look up and write about, the more you become familiar.

Well that was my method for getting through Junior year... now we dont get the information a day in advance... As seniors we have to know it or look it up then and there.

Califlower · Jun 26, 2005

I agree. Don't be afraid to look things up. Most drug guides contain information about drug interactions. After taking pharmacology, you remember a lot of things, and more will become second nature as you progress. For example, you would tell a patient to avoid foods high in tyramine when they are taking MAOI's. Or taking two different kinds of diuretic. You would check labs to see if potassium levels are normal. For patients on lithium, sodium and potassium levels in food should be checked.

If you know what a drug does and how it works, you will know drug interactions. If you don't, there's no shame in looking things up -- I don't think any nurse knows all the drugs and their characteristics!