Do I give the med or hold? - page 6

I work in LTC, my resident is given gabapentin (time release capsule) along with a lot of other tablets. This resident chews all meds and will not listen that gabapentin states "swallow whole, do not chew, or crush". I see all... Read More

  1. 0
    Yes, it can be a slippery slope once you start bending the rules. First you say "I don't need to hold that." then you say "she doesn't really need a 8am dose AND a 1pm dose" then it's "I don't have time to give inhalers or eye drops". I've seen it happen. There's such a thin line....

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  2. 0
    You can change them, you just need to get a doc's order to do it. If patient is competent, they get to choose when, so you get that order from doc and write "per patient preference".
    Quote from spectrabrite
    Our facility wakes the residents for there 600 - 700 synthroid and prilosecs

    the state wouldnt let it get pushed for to long before they noticed
  3. 1
    Quote from spectrabrite
    can the tablet form be chewed? This resident chews any and every medication, from ibuprofen, to vicodin, to atenolol.
    I wouldn't really worry about that part of the conversation too much. Just call the dr., explain the situation, and ask if he can give you an order clarification stating either that it is OK to sprinkle the med, or that he would like to use another form of it.

    What I usually do, is notify the dr. that the patient is chewing meds and ask for an order to crush any meds possible and give in applesauce, then review the issue of capsules.

    It is a very common issue that comes up in nursing, so don't stress about it too much.
    spectrabrite likes this.
  4. 0
    Levothyroxine should ALWAYS be given on an empty stomach because of how it is absorbed. While there are a lot of drugs that are recommended to be taken on an empty stomach and don't really "need" to be, levothyroxinenus is not one of those. I would research that a little bit.
  5. 0
    Very well said. "this is the way we've always done it" is never the right answer. The suggestions in medication books aren't arbitrarily chosen, there is research supporting them.
  6. 0
    I take the Neurontin capsules which should not be crushed or chewed, however, I found this about
    the tablets:

    How should I use this medicine? (Back to top)
    Take this medicine by mouth. Swallow it with a drink of water. Follow the directions on the prescription label. If this medicine upsets your stomach, take it with food or milk. Take your medicine at regular intervals. Do not take it more often than directed. If you are directed to break the 600 or 800 mg tablets in half as part of your dose, the extra half tablet should be used for the next dose. If you have not used the extra half tablet within 3 days, it should be thrown away. A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time. Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
    Note: This medicine is only for you. Do not share this medicine with others.
  7. 0
    Quote from sarrah
    Levothyroxine should ALWAYS be given on an empty stomach because of how it is absorbed. While there are a lot of drugs that are recommended to be taken on an empty stomach and don't really "need" to be, levothyroxinenus is not one of those. I would research that a little bit.
    It absorbs *best* on an empty stomach. It's not like it doesn't absorb at all if given with food. Worst case scenario is the pt needs a slightly higher dose to maintaintherapeutic levels. This is a drug that requires regular blood work, so it must be working. We would *know* if it wasnt. We have not had to adjust a dose of synthroid on my floor in years. If you wake up 20 confused 90 year olds at the crack of dawn to give them a pill it's a recipe for disaster.
  8. 0
    I'm sorry but I believe th
  9. 1
    No offense, but you are wrong. Just because it's the way you've always done it and in "your experience" it's doesn't matter, that is not true. Until you have Pharm D after your name I don't think that you have the expertise to make that judgement call.
    spectrabrite likes this.
  10. 1
    Nor do I find it wise or ethical for you to tell new grads that the drug book shouldn't be followed because common sense supersedes research... I would hope that any new grads reading this post would have the common sense to not listen.
    spectrabrite likes this.


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