Help with this doctors order....

misslo · Mar 21, 2008

Wouldn't gr be grain?

misslo

ragincajunstudent · Mar 21, 2008

20 grains

1 grain= 60, 64 or 65 milligrams

misslo · Mar 21, 2008

What we learned today in our dosages class is that gr1=60-65mg. Don't know if that helps.

misslo (again)

tvccrn, ASN, RN · Mar 21, 2008

the doctor gave me an order of Phenobarbital capsule gr XX .
what is gr XX? the bottle contains 200 mg per capsule.

I would go back to the doctor to clarify the order, but I would think the gr=grain and XX=20 in roman numerals. There fore the order MIGHT be 20 grains.

Once again, please DON'T take my word for it. Clarify with the prescribing physician.

bollweevil · Mar 21, 2008

Looks like grains 20 = approx 180 mg. phenobarb

There are a couple of weird things like this in medicine. For example, iron comes as 324 mg. tabs, yet it's always ordered 325 mg. :banghead: :no: :bugeyes: . Go figure, huh? Best to check w/ doc and/or pharmacist.

nightmare, RN · Mar 21, 2008

20x 60= 120mg 20x65= 130mg neither equate to 200mg caps!Definitely check with doctor!

FireStarterRN, BSN, RN · Mar 21, 2008

I hate it when doctors order things in grains! It's utterly archaic!

Melandru · Mar 21, 2008

yes its GRAIN, but apparently, the problem is the XX

i dont think its a roman numeral because the doctor should give it in metrics....

geeze.... perhaps its an incorrect order... this is a question of my professor in masters degree.

so i cant verify the doctors order hehehehe

she is asking if this is correct or incorrect.

Multicollinearity, BSN, RN · Mar 21, 2008

It looks like the order is for twenty grains, to me. If this is the case - wouldn't the order be for 1200 mg? Twenty gr * 60 mg per grain? And if 200 mg capsules are on hand, then this would mean administer 6 capsules. Six capsules and 1200 mg sounds awfully strange and high, so isn't the answer to hold the med and clarify the order with the physician because it is an unsafe dose?

PMHNP10 · Mar 21, 2008

maybe I'm missing something, but isn't 20 gr=1200mg if using 60mg/gr; and I'm pretty sure gr. is how phenobarb is commonly ordered

So I don't think you'd kill the patient if it's a QD dose, but if it's a BID dose, you are in the dangerous range.

aeauooo · Mar 21, 2008

I don't know about the Philippines, but in the U.S. that is a completely inappropriate order that needs to be rewritten. No pharmacy at any hospital I have ever worked would fill that order.