Hospital pharmacy III part 2 Flashcards
Patient is currently on oxycodone 10 mg TID. The provider would like to switch to IV hydromorphone four
times daily.
10mgx3 times daily=30mg/day
30mg PO oxyx1.5mg IV hydromorphone/20mg PO oxy=2.25mg IV hydromorphone daily/ 4 doses/ day=0.5 mg/dose
Hydromorphone IV 0.5mg 4 four times daily
Patient is currently on fentanyl 2 mg Q4H PRN pain and utilizes 5 doses per day. The provider would like to switch to PO oxymorphone.
2mg/dosex5 doses/day=10mg/day
10mg IV fentx10mg PO oxymorphone/0.1mg IV fent=1,000 mg PO oxymorphone per day
The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 1,000 units/hr. What should the infusion rate be set at in mL/hr?
25,000 units/250mL=100 units/mL
1,000 units/1 hourx 1mL/100 units=10 mL/hr
Can I open benzonatate capsules?
Where would you look?
Online drug reference of choice such as Lexidrug
What other information do you need to know?
Why do we need to open them?
Does the pt have swallowing trouble? Ng tube?
Things to keep in mind when
addressing clinical questions
Who is the patient?
Who is asking the question? Why did this question arise? Often it is not an easy yes or no answer
Can I order IV midazolam to be given on an acute care floor?
Based on hospital policy – no!
Why is this question being asked?
Can I order IV midazolam to be given on an acute care floor?
Based on hospital policy – no!
Why is this question being asked? Pt is currently seizing and already administered lorazepam & started
levetiracetam drip.Pt’s seizures have previously responded to midazolam
Why can it not usually be administered on acute care floor? Requires ICU level monitoring
Is an ICU nurse or provider at bedside to monitor? Is pt going to be transferred to
ICU?
