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DOES ANY OF THESE DRUGS OR COMBINATION OF CAUSE DRUG TOXICITY?

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Posted on Wed, 12 Feb 2025
Question: DOES ANY OF THESE DRUGS OR COMBINATION OF CAUSE DRUG CAUSE DRUG TOXICITYTOXICITY
albuterol (conc: 2.5mg/3 mL) (PROVENTIL) nebulization solution 2.5
mg [0000] albuterol-ipratropium (conc: 2.5-0.5 mg/3 mL)
(DUONEB) nebulization solution 3 mL [0000] albuterol HFA
(conc: 90 mcg/puff) (VENTOLIN) COMMON CANISTER inhaler 2 puff
[0000] albuterol-ipratropium (conc: 2.5-0.5 mg/3 mL)
(DUONEB) nebulization solution 3 mL [0000]
azithromycin (ZITHROMAX) 500 mg in 0.9 % sodium chloride (NS)
250 mL ADDEASE [0000]
cefTRIAXone (ROCEPHIN) 1,000 mg in 0.9 % sodium chloride (NS)
50 mL ADDEASE [0000]
Currently Receiving VTE Prophylaxis / Therapeutic Anticoagulation 1
each [0000]
dabigatran etexilate (PRADAXA) capsule (Do NOT crush/chew) 150
mg [0000] 2 TIMES A DAY
famotidine (PEPCID) tablet 20 mg [0000] TWO TIMES A DAY
fentaNYL (conc: 20 mcg/mL) PF in NS DRIP [0000 25MCG/HR
fentaNYL citrate PF (SUBLIMAZE) (conc: 50 mcg/mL) injection 25
mcg [0000] 25MCG AS NEEDED
fentaNYL citrate PF (SUBLIMAZE) (conc: 50 mcg/mL) injection 50
mcg [0000] (CHANGED)
fentaNYL citrate PF (SUBLIMAZE) (conc: 50 mcg/mL) injection 25
mcg [0000] CHANGED
fentaNYL citrate PF (SUBLIMAZE) (conc: 50 mcg/mL) injection 50
mcg [0000] CHANGED AGAIN
2
fentaNYL citrate PF (SUBLIMAZE) (conc: 50 mcg/mL) injection 100
mcg [0000 CHANGED AGAIN EVERY 30 ,MIN.
fentaNYL citrate PF (SUBLIMAZE) (conc: 50 mcg/mL) injection 100
mcg [0000] EVERY 15 MIN.
Performed 06/14/20 1849 Documented: 06/14/20 1849 Rate Change
150 mcg/hr 7.5 mL/hr Intravenous Performed by: XXXXXXX J Hull, RN
EVERY 15 MIN
furosemide (LASIX) (conc: 10 mg/mL) injection 20 mg [0000]
furosemide (LASIX) (conc: 10 mg/mL) injection 20 mg [0000] 2
TIMES A DAY
gabapentin (NEURONTIN) capsule 300 mg [0000] 300MG DAY
GIVEN 2 TIMES A DAY ?
gabapentin (NEURONTIN) capsule 600 mg [0000] PER DAY
glycopyrrolate (ROBINUL) (conc: 0.2 mg/mL) injection 0.2 mg
[0000] 4 TIMES A DAY
guaiFENesin 12 hr (mucINEX) ER tablet (Do NOT crush/chew) 1,200
mg [0000 2 TIMES A DAY
haloperidol (HALDOL) (conc: 5 mg/mL) injection 1 mg [0000]
EVERY 4 HRS
haloperidol (HALDOL) (conc: 5 mg/mL) injection 2 mg [0000] 8
HRS
hydrALAZINE (APRESOLINE) (conc: 20 mg/mL) injection 5 mg
[0000] 1 TIME
hydrALAZINE (APRESOLINE) tablet 10 mg [0000] 4 TIMES A
DAY
hydrALAZINE (APRESOLINE) tablet 25 mg [0000] 4 TIMES A
DAY
3
HYDROcodone-acetaminophen (5-325 mg/tab) (NORCO) tablet 1
tablet [0000] Ordering Provider: XXXXXXX XXXXXXX Milch, MD EVERY
4 HRS
HYDROcodone-acetaminophen (5-325 mg/tab) (NORCO) tablet 2
tablet [0000] EVERY 4HRS
HYDROmorphone (conc: 0.5 mg/mL)(PF) 15 mg in 30 mL NS PCA
[0000] 1 MG PER HOUR
HYDROmorphone (DILAUDID) (conc: 1 mg/mL) injection syringe 0.4
mg [0000] 1 TIME
LORazepam (ATIVAN) (conc: 2 mg/mL) injection 0.5 mg
[0000]EVERY 4 HRS
LORazepam (ATIVAN) (conc: 2 mg/mL) injection 0.5 mg
[0000EVERY 3 HRS CHANGED
LORazepam (ATIVAN) (conc: 2 mg/mL) injection 1 mg
[0000]EVERY 3 HRS
methylPREDNISolone sodium succinate PF (Solu-MEDROL) (conc:
125 mg/ 2 mL) injection 125 mg [0000 EVERY 8 HRS
morPHINE (MS CONTIN) ER tablet (Do NOT crush/chew) 15 mg
[0000] EVERY 12 HRS
naloxone (NARCAN) (conc: 0.4 mg/mL) injection 0.1 mg [0000]
AS NEEDED
OLANZapine (ZyPREXA) tablet 5 mg [0000]EVERY EVENING
ondansetron (ZOFRAN) (conc: 2 mg/mL) injection 4 mg [0000]
EVERY 6 HRS
propranoloL (INDERAL) tablet 40 mg [0000] DAILY
doctor
Answered by Dr. Aaron Branch (26 hours later)
Brief Answer:
Several interactions

Detailed Answer:
Hello,
There are several interactions between the medications listed, none of which is an absolute contraindication to using it, but there are several serious interactions that I will describe.

Haloperidol can increase the effect of fentanyl. It appears fentanyl is being used as needed, so this is likely not a major issue.

There are several opiate medications in this list (fentanyl, morphone, morphine, hydrocodone), which can increase the chances of side effects, such as sedation, constipation, and respiratory depression.

Azithromycin and ondansetron can both increase the risk for a heart arrhythmia, however ondansetron is only being used as needed so I wouldn't be too concerned about this.

Olanzapine and ondansetron can also increase the risk for that heart arrhythmia, but both are being used only as needed, so I wouldn't be concerned about this either.

These are all of the serious interactions, almost every medication has some interaction with other medications, and that is the case for many of these, but there are no other serious interactions that would need to be addressed.

I hope that helps, please let me know if you have any other questions about that, and I would be glad to discuss it with you further.
Thanks.
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Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Aaron Branch

General & Family Physician

Practicing since :2011

Answered : 1202 Questions

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DOES ANY OF THESE DRUGS OR COMBINATION OF CAUSE DRUG TOXICITY?

Brief Answer: Several interactions Detailed Answer: Hello, There are several interactions between the medications listed, none of which is an absolute contraindication to using it, but there are several serious interactions that I will describe. Haloperidol can increase the effect of fentanyl. It appears fentanyl is being used as needed, so this is likely not a major issue. There are several opiate medications in this list (fentanyl, morphone, morphine, hydrocodone), which can increase the chances of side effects, such as sedation, constipation, and respiratory depression. Azithromycin and ondansetron can both increase the risk for a heart arrhythmia, however ondansetron is only being used as needed so I wouldn't be too concerned about this. Olanzapine and ondansetron can also increase the risk for that heart arrhythmia, but both are being used only as needed, so I wouldn't be concerned about this either. These are all of the serious interactions, almost every medication has some interaction with other medications, and that is the case for many of these, but there are no other serious interactions that would need to be addressed. I hope that helps, please let me know if you have any other questions about that, and I would be glad to discuss it with you further. Thanks.