Published May 31, 2015
I know these two medications are very similar with one being in tablet form vs the other being a capsule. Would it be a medication error if you gave one when the other is ordered?
loveofrn, BSN, RN
Yes it is a med error because part of the 8 rights of medication administration is right drug.
Similar drugs are not same drugs
Different Bases. A Med Variance (Error) that should have No Adverse Effects.
According to what a Pharmacist told me, "supposedly", the HCl has more of an Antihistamine affect whereas the Pamoate has more of an Antianxiety effect.
Meriwhen, ASN, BSN, MSN, RN
Technically, yes, it's a medication error. Both are hydroxyzine but different formulations and therefore different drugs. It's like the three Wellbutrins.
A provider would probably not spazz if you ended up giving a patient Vistaril instead of Atarax (or the reverse). But it's still an error nonetheless.
They're given interchangeably everywhere I've ever worked. At my last hospital, the docs could order Atarax (hcl) or Vistaril (pamoate) and they were getting hcl, no matter what. Hcl was the only formulation we carried. Where I work now, if a doc goes to order hydroxyzine, the order reads like This: hydroxyzine (Atarax/Vistaril) and the pt would get the pamoate because that's what we stock.
Jules A, MSN
I don't think we have both at my hospital but if we did and a RN called me to report a med error for the administration of one vs the other I'd just cover the order. To me they are virtually the same and although I might be mistaken I do not think the reported antihistamine vs anxiolytic effects differences are substantiated.
Both salts dissociate in the gut to a completely equal form at the same strength, therefore no therapeutic difference exists really. Only the dissociated drug crosses the BBB, so it's a moot point. Only real difference is that the pamoate salt is insoluble in water, thus not available as an IM. The HCL version, as an IM, was given the reputation over the years as being the effective drug for anxiety. No difference clinically, yet I suppose someone could nitpick on a med variance.
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