Quick question... IV protonix

WalkieTalkie, RN · Sep 11, 2009

I'm not entirely sure either, but injection site reaction comes to mind.

Protonix is a PPI, not a pro-kinetic drug like Reglan, so things like dystonia wouldn't be a common side-effect.

zilla704 · Sep 11, 2009

So I called our pharmacy, and I just got off the phone with Wyeth, and both pharmacists confirmed that Protonix has not been tested nor FDA approved for IVP

HappyBunnyNurse · Sep 11, 2009

I think very rarely protonix can cause an anaphylactic reaction. That is why you push slow.... so you can stop if need be. I was told to be especially careful when giving it to a patient the first time.

zilla704 · Sep 11, 2009

She told him today when he told her that we had contacted the pharmacy and Wyeth, that Protonix can be ototoxic.... :cool: Anybody ever heard of that????

cherrybreeze, ADN, RN · Sep 11, 2009

What confuses me the most is the reason for the question, I guess.....there are tons of meds that have to be given over a few to several minutes. I don't usually question why not; if it's in the parenteral drug guide to be given over a certain time, I follow it (not to be a lemming, but it wouldn't say that if there wasn't a reason, KWIM? It would be darn near impossible to find the reason why every med is given over x amount of time). I know that Nexium, which is also an acid med (but forgive me for not looking up the class or mechanism of action) is pushed over 3 to 5 minutes. Is there a particular reason to want to challenge the guideline? Does this person push most meds quickly?

mcknis · Sep 13, 2009

I will have to admit that I do push protonix faster than that although it is not recommended too. I have always been taught to push it slowly but to mainly watch the pt for any kind of problems. Of course, I do not push all meds faster than 2minutes, ie Lasix, Bumex, Hydralazine, Lopressor (for obvious reasons of course).

cherrybreeze, ADN, RN · Sep 13, 2009

I will have to admit that I do push protonix faster than that although it is not recommended too. I have always been taught to push it slowly but to mainly watch the pt for any kind of problems. Of course, I do not push all meds faster than 2minutes, ie Lasix, Bumex, Hydralazine, Lopressor (for obvious reasons of course).

Can you explain why you would do this? Push a med faster than what's recommended, or how you've been taught? The recommendations are in place for a reason, and if you don't know what you're watching for, there could be damaging consequences (or could be even if you DO know what you're watching for). If it's a possible site reaction (or any other type of reaction, really, for that matter) by the time it's happening, it's too late. You can't take it back. If it's a potential systemic reaction, are your patients all on monitors to ensure there are not status changes? Even if they are, what do you/would you do if/when a reaction begins? Are you ok with being responsible for having a patient suffer in ANY way just because you're not patient enough to push it at the rate you're supposed to?

hypocaffeinemia, BSN, RN · Sep 13, 2009

What confuses me the most is the reason for the question, I guess.....there are tons of meds that have to be given over a few to several minutes. I don't usually question why not; if it's in the parenteral drug guide to be given over a certain time, I follow it (not to be a lemming, but it wouldn't say that if there wasn't a reason, KWIM? It would be darn near impossible to find the reason why every med is given over x amount of time). I know that Nexium, which is also an acid med (but forgive me for not looking up the class or mechanism of action) is pushed over 3 to 5 minutes. Is there a particular reason to want to challenge the guideline? Does this person push most meds quickly?

I don't want to sound rude, but why are you pushing a drug of which you know neither its class nor its mechanism of action?

Virgo_RN, BSN, RN · Sep 13, 2009

She told him today when he told her that we had contacted the pharmacy and Wyeth, that Protonix can be ototoxic.... Anybody ever heard of that????

If you look under the side effects profile, both vertigo and tinnitus are listed, indicating ototoxicity. Ototoxicity can be related to rate of administration.

chenoaspirit, ASN, RN · Sep 13, 2009

I would say that most people have been guilty at one time or another of pushing a drug alittle faster than they should, especially when things are getting wild and they are running around like a chicken on fire. It can be done without even realizing it, when you push meds on a constant basis.

Ive noticed how some people are so quick to pass on an attitude and show off their "knowledge" and quick to "correct" another poster. No need for that. The OP was asked a question and we need to stay focused on that question and try to find the answer.