Ascorbic and a 1 year old

Nurses Medications

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In our hospital, when a MD orders syrup we usually use what the client has due to financial constraints. the client sometimes cant buy the meds. so anyway, there was this order to start vit c syrup 2.5ml and the parent has the vit c drops. so I asked my senior about it, she said it's the same thing. I said, the dosage is different. she has been there longer, she said I should use what the patient has. so it's 2.5ml then. but the drops is 100mg/ml while the syrup is 100mg/5ml. what to do? what to do? i havent given it yet though, since i already endorsed it to the next shift. the patient is a 1 year old. i wanna know what you guys think? is it safe dosing also?? thankssss -----worrywart

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

What is the order?

Do your math...If the order is 2.5ml of the 100mg/5ml....that is 50mgs.

So...if the drops are 100mg/ml....0.5ml (half of a cc) is 50mgs.

Either way you would be giving 50mgs.

Make sense?

i know that but when i asked, they said i should give the 2.5ml in the drops which is a megadose right? or is that safe dosing? I havent given anything but Im bothered though.

my dilemma is what is the real dose that the pedia wants is it 100 mg in 2 divided doses or the one my coworkers said the 250 mg bid dose for a 1 year old??? or did she base it on the weight??I didnt have the chance to ask the dr since he was in a hurry (damn, I need to have asked him!)

In the future, to avoid confusion, a physician should order a drug in the mg they want the patient to have, not the ml. If the ml are specified, the drug concentration should also be mentioned as clarification so you are sure how many mg of a medication you are giving (or units, etc).

In your case, 2.5ml of one concentration is a very different dose than 2.5ml of the other. The question is actually how many mg does the physician want the patient to receive? You must be very careful when dealing with the same drug in different concentrations because they are NOT the same dose (think of infant Tylenol drops and children's Tylenol elixir) and cannot be interchanged ml per ml just because they are the same medication. You must do the math and know how many mg you need to give.

thanks for that input.

Specializes in Complex pedi to LTC/SA & now a manager.
In the future to avoid confusion, a physician should order a drug in the mg they want the patient to have, not the ml. If the ml are specified, the drug concentration should also be mentioned as clarification so you are sure how many mg of a medication you are giving (or units, etc). In your case, 2.5ml of one concentration is a very different dose than 2.5ml of the other. The question is actually how many mg does the physician want the patient to receive? You must be very careful when dealing with the same drug in different concentrations because they are NOT the same dose (think of infant Tylenol drops and children's Tylenol elixir) and cannot be interchanged ml per ml just because they are the same medication. You must do the math and know how many mg you need to give.[/quote']

That's exactly why Tylenol infant and child are now the same concentration 160mg/5mL instead of child elixer 160mg/5mL and infant drops 80mg/0.8mL as of a year ago. Only ibuprofen is concentrated for infants. Way too many overdoses of children receiving 5mL (500mg) infant instead of 5mL children's (160mg)

In pedi private duty, both agencies I work for all orders must be in mg not mL.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
my dilemma is what is the real dose that the pedia wants is it 100 mg in 2 divided doses or the one my coworkers said the 250 mg bid dose for a 1 year old??? or did she base it on the weight??I didnt have the chance to ask the dr since he was in a hurry (damn, I need to have asked him!)
Ok what is the exact order.....it needs to specify how many mg per dose BID. If it doesn't it needs to be clarified with the MD.

The usual dose for a "dietary supplement" is 15mgs daily...however if it is a deficiency it can be as much as 300mgs total daily...if they are trying to change the pH of the urine the dose can be as high as 500mgs per 24 hours...and be "safe"....Medscape: Medscape Access medscape is free but requires registration.

Vitamin C is a water soluble vitamin and excess is excreted by the kidneys

Specializes in Med-Onc, Telemetry.

I see the seriousness of needing to give the correct dose, and orders for "x" mLs should not be acceptable without knowing the concentration (which you did: 100mg/5mL). So you just do the math, as Esme stated.

What gets me is 50 mg of vitamin C is a joke. I have given my kids up to 1000 mg/day since they were 2 y/o. I myself take up to 10 g (10,000 mg) in one day if I need to fight something. I'd take more but those 1-g horse pills are a challenge. My mother, now 83, gets up to 20 g (20,000 mg) IV on a quarterly basis during her "tune-ups". My 2c. Sorry it's a bit off-topic. Maybe this should be posted in a thread titled "Natural remedies sadly underused".

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