B52 cocktail

I understand that Benadryl, Ativan, and Haldol are not compatible when given in the same syringe IV push. However, is it safe to give when they are mixed in the same syringe and given IM? Thanks
Why do you think the three mixed in the same syringe for IV push are incompatible? Once you determine that then think about how they would be compatible mixing them in a syringe and delivering the medications another method.

I give them in the same syringe all the time. Micromedex says they're compatible except for Benadryl and Haldol which is inconclusive. I've never had an issue, though.

I believe haldol and ativan are compatible, at least for IM injections, not sure about IV, but a lot of facilities stay away from haldol ivp unless pt is on a monitor anyways. I always do my benadryl separate, however its been so long that I've been doing it I don't remember if its because pharmacy said to, or if I was trained that way or what.

Haldol and benadryl form a precipitant within 5 min...they are not to be mixed. Intramuscular Compatibility

I work with a nurse who suggested this for a client we have - IM Ativan 6mg does not even phase his behaviors. She asked the physician but he will not prescribe it. Always wondered why.

Haldol and Ativan are compatible. Ativan and Benadryl are compatible.Haldol and Benadryl are not compatible.So you are not able to give the B52 (or its variations) in one syringe: you will need at least two. Benadryl really can't be mixed with much. Many of the nurses I've worked with make it a practice to give it separately even if it is compatible with another med.

How about straight Geodon or Zyprexa? Quite effective.

Quote from lacusc93-1How about straight Geodon or Zyprexa? Quite effective.

I believe that the most you can give IM is 3cc. So he gets 2 injections.

I agree about the Zyprexa IM. It totally wears off in a couple of hours. Not effective for psychiatric emergencies with extreme violent agitation.

Geodon is very effective for agitation secondary to the DTs. Many years ago we gave a ten four over and out. 10 of haldol, 4 of ativan and 50 of benadryl.. This was only for the worst psychotic violent and truly dangerous patients in the ER.

I wish we could do a B52 cocktail, but our physicians will not do it. It is either haldol or ativan and not both. I have seen some give geodon with good results. I wish they would think about using that more.