# Do you mix your Morphine and Zofran?



## Hockey (Oct 2, 2010)

Saw this in the ER the other night.  She mixed both in the syringe.  I usually prefer to do the Zofran first, prep the Morphine, then give it.  

Anyone else do this practice?  Never really seen it before nor would I think would be proper


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## TransportJockey (Oct 2, 2010)

Seen it a lot when I was working in the hospital as a tech. Never done it myself though


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## Pittsburgh77 (Oct 2, 2010)

There's a thread about this already. It should be like 2 spots down from this one.


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## TransportJockey (Oct 2, 2010)

Pittsburgh77 said:


> There's a thread about this already. It should be like 2 spots down from this one.


That one is phenergan and MS.


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## Smash (Oct 2, 2010)

What is the rationale for mixing them?  I assume that the ondansetron is being given for patients who already have nausea or who are known to develop nausea secondary to morphine administration?

The actual incidence of nausea post morphine is rather low (<5% I think, but I can't put my fingers on the figures right now) so I've never understood the desire to give everyone more drugs that they probably won't need.


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## jjesusfreak01 (Oct 2, 2010)

One common reason to mix IV meds is that doing so will dilute each medication, which could help if one of the meds had a necrotic effect in high concentrations or could cause problems if pushed too quickly. Of course, doing this would require that you know of any chemical interactions the medications might have as well as the typical side effects of each med.


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## LonghornMedic (Oct 3, 2010)

Hockey said:


> Saw this in the ER the other night.  She mixed both in the syringe.  I usually prefer to do the Zofran first, prep the Morphine, then give it.
> 
> Anyone else do this practice?  Never really seen it before nor would I think would be proper



Mix it? No. But I also don't give everyone Zofran either. If patients have had MS before and don't get nauseated, then I wait and see if the need arises.


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## Smash (Oct 3, 2010)

jjesusfreak01 said:


> One common reason to mix IV meds is that doing so will dilute each medication, which could help if one of the meds had a necrotic effect in high concentrations or could cause problems if pushed too quickly. Of course, doing this would require that you know of any chemical interactions the medications might have as well as the typical side effects of each med.



What's wrong with 0.9%NaCl to dilute? 



LonghornMedic said:


> Mix it? No. But I also don't give everyone Zofran either. If patients have had MS before and don't get nauseated, then I wait and see if the need arises.



Sounds sensible


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## gicts (Oct 3, 2010)

Smash said:


> What is the rationale for mixing them?  I assume that the ondansetron is being given for patients who already have nausea or who are known to develop nausea secondary to morphine administration?
> 
> The actual incidence of nausea post morphine is rather low (<5% I think, but I can't put my fingers on the figures right now) so I've never understood the desire to give everyone more drugs that they probably won't need.




Especially if you give it appropriately and not slam it like some ER's ^_^


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## medicRob (Oct 3, 2010)

Happiness is a warm gun, bang--bang, shoot--shoot. 

Sorry, couldn't resist. Personally, I don't mix Zofran and Morphine. I don't even give Zofran to all patients that I administer morphine on, it all depends on their tolerance to opioid analgesics and whether or not they have experienced nausea in the past.


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## jjesusfreak01 (Oct 3, 2010)

Smash said:


> What's wrong with 0.9%NaCl to dilute?



Nothing, but if you are lazy or want to get the meds in quick it means you don't need to draw and dilute meds twice. I can imagine that there are probably a lot of places where this isn't allowed for obvious reasons.


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## Hellsbells (Oct 6, 2010)

Sounds like sloppy practice to me.


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## Millerblade (Oct 17, 2010)

*to Mix or not to Mix*



LonghornMedic said:


> Mix it? No. But I also don't give everyone Zofran either. If patients have had MS before and don't get nauseated, then I wait and see if the need arises.



I have seen people do a lot of things over the years. I have seen mixing this with that, or dilute this or that. First, I don't do that, ever. 

I have found out that if you give your narcotics, s l o w l y, and don't get in a rush, you might find that they won't get sick at all. Back in the day, Promethizine was given, and by the time the medic finished giving the medications, they were trying to wake them up to ask them if their pain went away.......hahaha, couldn't resist.....I like Longhorn Medic's answer, and stick with what you know.


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