can you give prevacid (PPI) "too early"?

  1. 0
    our hospital has prevacid scheduled at 7am as prophylaxis for most patient. I had this one patient who doesn't wake up to eat her breakfast until 8:30 or 9am ish..

    since Prevacid is normally recommend to take 30 minutes before breakfast.. is it still effective if it's given almost 1.5 - 2 hours earlier?

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  2. 12 Comments...

  3. 0
    oops.. nevermind.. I found the answer.. (don't know how to delete the question, thought might as well post the answer)

    Peak: 1.5 - 3hr
    Duration: 24hr
    Half-Life: 1.5 hr

    so it still works, just less effective...
  4. 1
    Why can't you just reschedule it for her to take it when she wakes up? I'd be pretty annoyed if I was in the hospital and got woken up several hours before I wanted to be awake to take prevacid.
    loriangel14 likes this.
  5. 1
    KelRN, don't go into the hospital.. You will be woken to take meds at strange hours, woken for vitals at midnight and 4am not to mention assessments. Hospital nursing is 24/7 so while we try to allow pts to sleep as much as we can, we can not stop treatments etc just because they are sleeping...

    Our pts are all scheduled protonix at 6am every morning. I wish we could get it changed to 4am. This way we only have to wake them once. Labs are due at 4am, assessments are due at 4 also. Then I have to wake them again for their 6am meds UGH...
    MMaeLPN likes this.
  6. 0
    I know what the hospital is like... I worked in one for 5 years and have spent time in one as a patient- multiple times. Prevacid is not a time-specific med, there's no reason why it HAS to be given at 7am.

    Why can't you change the protonix to 4am or even 8am? When I worked in the hospital, if I found meds scheduled for stupid times, I retimed them.
  7. 0
    We can't re-time them, it would make things so much easier if we could.. Pharm won't change the times with out MD order, and the protonix is a "fixed" time.. That's why I had the big UGH behind my response Some things should be changed and scheduled with others nursing duties to decrease interruption and I as well as many of my other co-workers do as much as we can to minimize but some things are out of our control..
  8. 3
    You know, this kind of thing... the hospital's "we have to do it this way because this is the way we do things" attitude is one of the reasons why I left hospital nursing. I can't deal with this kind of backwards rationale. "Why do we give the Prevacid at 7am? Because that's what time we give it here." If there's not a real reason why the PPI has to be given at 7am or at 6am, it's stupid to insist that it HAS to be given at that time. People who take this medication at home don't take it at precisely the same time every day just like I don't take my morning medication at the same time every day... I'm ddAVP dependent on BID dosing... I usually take my meds around 9 and 9 but if I sway from the norm, it's not a big deal. If I sleep until 10am on the weekends, I take it when I wake up. If I have to get up at 5am to drive 5 hours to New Jersey as I did on Saturday, I take a fractional dose (enough to prevent me from breaking through on the drive) and then get myself back on my normal schedule during the day. When I was in college, I would take my night time medication at 9pm on weeknights but sometimes not until 2 or 3 am on weekends.

    If I was a patient on either of your floors, the nurses would probably label me a "difficult patient" as I'd be refusing this med if the hospital insisted I wake up at the crack of dawn to take it. The only scheduled PO medication I have ever woken a patient up to take is decadron... and that's for patients who were on it q 6hrs following surgery. But, even then... try to get them on a 9, 3, 9 and 3 schedule- give them the 9pm dose before bed and then wake them up between 3-4 and do everything... VS, neuro checks, meds, all at once. I rescheduled meds every day of my life as a hospital nurse... our system was so dumb that if a patient was admitted in the middle of the night and ordered for "daily" meds, it timed them all to be given at 3am (or at whatever hour was closest to when they put the order in). Not when they take them, so we retimed them to the appropriate times. For some patients, maybe these were night-time meds that they'd just taken at 11 or midnight... were we going to give them again because that's what time they were timed for? No. Were we going to waste our time calling the Resident (who we finally got to enter these orders for the patients' regular meds after physically handing them the list and reminding them 3x) and telling him to enter a different start time? No. And, you know, the system was so stupid that even if the MD ordered a "daily" med and wrote a comment "give at 12pm", if the order was entered at 3am, it got timed for 3am. It was always the nurse who did the retiming. All BID meds were automatically timed at 8A/8P but, again, for some patients that wasn't when they took their meds. If I'd had to call the MD every time I needed to retime a med, I would have done nothing but stare at the MAR for 12 hours on end.
  9. 1
    I so feel ya and hear ya..
    KelRN215 likes this.
  10. 1
    Quote from Sun0408
    I so feel ya and hear ya..
    You made me feel happy that when I worked in the hospital, this (nursing not being able to retime meds) was one stupid rule I didn't have to deal with.
    Sun0408 likes this.
  11. 0
    My last hospital we could and then we would call Pharm and have them change all other times since we could only change the first dose.. This hospital while great has a few minor kinks I am still trying to get used to. No, I wouldn't call you a difficult pt, many of my pts I let them know ahead of time what to expect through out the night and love the ones that say"can we hold off on that" or "can we do that later".. I do try to let them be as much as possible but sometimes I/we can't

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