I am missing something obvious?

Is there a reason why we would give a PO medication to a patient who is vomiting? I can understand giving that prescription to someone at home with no option but PO, but in the hospital when the patient has IV access...what am I missing?

I don't think you're missing anything, but you did not specify what the medicine is. I would call the MD or the NP, whatever the case may be.

Before you call, make sure the order was transcribed correctly (unless you transcribed it yourself).

If the med was phenergan, we're under a national shortage of IV. So says my workplace.

If the med was phenergan, we're under a national shortage of IV. So says my workplace.

Yeah we haven't had IV phenergan for about a month now.

Curious, too, about the med. Some meds can't be given IV in order for them to work. PO vanco for c-diff comes to mind just as an example.

Yeah we haven't had IV phenergan for about a month now.

Many places do not give IV Phenergan anymore, even in a 50 ml bag. It's off the formulary. I'm surprised to hear that is still being used, as some of you have indicated here. I didn't know there was a shortage of IV though. What about Zofran or Reglan?

Any one who is vomiting.. must be NPO. They can't keep anything down and stimulating the GI tract will exacerbate their GI issue.

You would not administer po anti-emetics, for active vomiting in the home or the hospital. You need to obtain an order for a different route of administration.

The sub-lingual, IM, IV, or rectal route of administration is now required.

I had an order for IV zofran, which I gave. 30 minutes later the poor patient is still getting sick, and the doctor put in an order for PO Phenergan. I didn't realize there was a national shortage. We still have IV phenergan in our pyxis, I checked. I work at a university hospital, so I didn't know if the first year just didn't understand or if I should have made it more clear. I was perplexed because I asked specifically for zofran IV with no issue, I didn't think I would need to ask for IV, as it was obvious IV was needed. Or maybe rectally, sublingual...anything but a pill.

Thanks all.

Many places do not give IV Phenergan anymore, even in a 50 ml bag. It's off the formulary. I'm surprised to hear that is still being used, as some of you have indicated here. I didn't know there was a shortage of IV though. What about Zofran or Reglan?

We never get Reglan orders. Our docs are quite partial to zofran and phenergan. I was told we wouldn't have IV phenergan until May/June.

I had an order for IV zofran, which I gave. 30 minutes later the poor patient is still getting sick, and the doctor put in an order for PO Phenergan. I didn't realize there was a national shortage. We still have IV phenergan in our pyxis, I checked. I work at a university hospital, so I didn't know if the first year just didn't understand or if I should have made it more clear. I was perplexed because I asked specifically for zofran IV with no issue, I didn't think I would need to ask for IV, as it was obvious IV was needed. Or maybe rectally, sublingual...anything but a pill.

Thanks all.

The first year resident may have ordered Phenergan PO because it is not given IV in may places anymore because its pH is so low (4, I think), and it can be a vesicant with devastating results. He may have thought PO is better than nothing! I love Phenergan but understand the concerns. Compazine is given PR too. When I would get stumped trying to help the patient and the resident, I often called a pharmacist, who was my savior more than once. That is terrific that you are in a University Hospital, where you have many resources.

As I said before, I'm stunned that Phenergan is still being used. But maybe if it's in a 50 ml bag of NS and given over 15 minutes, that is acceptable at some places. I few years I was very nauseated post-op and tried everything with no relief. I begged the Fellow for Phenergan, and he ordered a tiny dose IM, which gave me relief.

to be honest i have never actually seen any oral antimetic medications. almost every pt has IV zofran or compazine