IV Dex for PO Dex?

[stayseerrn]

I have started working in a new hospital that uses IV dexamethasone when it is ordered po for pediatric patients that cannot swallow pills. You draw the prescribed amount out of the vial that is ordered and mix it with cherry syrup. This is what is traditional practice instead of crushing the pills and dissolving them in cherry syrup. The argument is that when the pills are crushed, you lose some of the medication, so using the IV dex is a more accurate means of giving the desired dose.

So, has anyone else ever heard of this practice? Does anyone have any resources regarding the efficacy and safety of this practice? Plus what about the taste? Does this produce more or less of a "vomit factor" than when giving prednisolone or crushed dexamethasone tablets?

[DiannaK]

I have started working in a new hospital that uses IV dexamethasone when it is ordered po for pediatric patients that cannot swallow pills. You draw the prescribed amount out of the vial that is ordered and mix it with cherry syrup. This is what is traditional practice instead of crushing the pills and dissolving them in cherry syrup. The argument is that when the pills are crushed, you lose some of the medication, so using the IV dex is a more accurate means of giving the desired dose.

So, has anyone else ever heard of this practice? Does anyone have any resources regarding the efficacy and safety of this practice? Plus what about the taste? Does this produce more or less of a "vomit factor" than when giving prednisolone or crushed dexamethasone tablets?

I gave this for the first time last night ...

we give it in ibuprofen to kill the taste. My pt (8 yrs old) swallowed it like a champ, and chased it down with some Sprite. He didn't vomit at all.

Sorry .. I don't have any info about the efficacy/safety. Did you check with your pharmacist??

[Medic/Nurse, BSN, RN]

I have given it like that in several facilities. Double check with YOUR pharmacy - but I have never had ANY problems. (As long as you "mask" the taste!) :)

Great idea, IMHO and no needles!

Practice SAFE!

[jayne109, RN]

We do this all the time. It beats giving them a shot any day!

[RunnerRN, BSN, RN]

We do this as well, but generally mix it with Tylenol. Can't imagine it tastes good at all! Agreed - beats giving a kiddo a shot!!!

[teeituptom, BSN, RN]

do it all the time

works as well

[WSH-RN]

Very interesting. I will have to submit this to our pharmacy.

[Knoodsen]

Steroids generally have a slow onset of action so PO is just as efficacious.

[canoehead, BSN, RN]

Yep, we do that. IV is more concentrated and lowers the volume the kids have to take. 1ml vrs 30ml

[Kidrn911]

I have started working in a new hospital that uses IV dexamethasone when it is ordered po for pediatric patients that cannot swallow pills. You draw the prescribed amount out of the vial that is ordered and mix it with cherry syrup. This is what is traditional practice instead of crushing the pills and dissolving them in cherry syrup. The argument is that when the pills are crushed, you lose some of the medication, so using the IV dex is a more accurate means of giving the desired dose.

So, has anyone else ever heard of this practice? Does anyone have any resources regarding the efficacy and safety of this practice? Plus what about the taste? Does this produce more or less of a "vomit factor" than when giving prednisolone or crushed dexamethasone tablets?

We use IV Dex all the time, I mix it with apple juice and have a popsicle handy

[Freshman RN]

We do this all the time. such a little amount and accurate. Trying to get a sick kid to take meds is hard enough.

[NYCRN16]

We do this all the time. Never had any adverse effect and it works like a charm. The small volume prevents it from being spit out most of the time!

Edited to add: We also give the IV Zofran PO too and this works well and is approved by pharmacy.