DILAUDID drug freference error in nursing drug books

[NRSKarenRN, BSN, RN]

from march 2007 issue of nurse advise-err®

error in drug references.

incorrect dosing information for

dilaudid

(hydromorphone) appears

in several drug references, which

could lead to serious overdoses.

monographs on page 815 in the

2006 nurse's drug guide (pearson-

prentice hall) and page 138 in the

2006 nurse's pocket drug guide

(mcgraw-hill medical, 2nd edition)

erroneously indicate that the dose

ranges for hydromorphone are the

same for oral, subcutaneous, im, and

iv routes of administration. the same

errors occur in the 2007 editions

of these texts. the usual oral dose in

opioid-naïve patients is 2-4 mg every

3 or 6 hours prn; parenteral doses are

typically one-fifth of oral doses, or

0.2 to 0.6 mg every 2 to 3 hours. the

error was discovered by a resident

after nurses questioned the doses of

hydromorphone he had been prescribing

using the above texts.

fortunately, no patients received the

incorrect dose prescribed. the publishers

for each handbook have been

notified and have forwarded the information

to the appropriate editors for

correction in the 2008 editions. if you

use either of these references, please

correct the error directly in the publication

and be sure to verify doses before

administration.

visit www.ismp.org/errata/default.asp for other reports of

textbook errors.

www.ismp.org/newsletters/nursing/issues/nurseadviseerr200703.pdf

[meandragonbrett]

Thanks for the heads up! We routinely give 1-2mg Dilaudid IV. Knocks people off their feet too.

[sshannon]

Thanks for this post. My nursing class is using the 2006 edition of the Nurse's Drug Guide. I passed the info along to my clinical instructor so she can forward to others.

[meandragonbrett]

I wonder why nobody else knows this? I am even seeing orders now for 2-3mg q2h prn