IV forms of Zofran and Decadron given PO???

[GleeGum, BSN, RN]

Have any of you ever heard or worked in an ER where they gave the IV/IM form of Zofran or Decadron PO instead?

[tiddles]

Yes..it's common to give the IV decadron po. Don''t know about zofran tho.

[FlyingScot, RN]

Yep, all the time.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I've never given the IV Zofran PO, but give the IV Decadron PO all the time.

[mendu]

decadron PO and sublingual zofran yes but i do not work ER. mostly we use IV forms.

[medicrn13]

My question is...why would you? I'd be very hesitant to administer anything IV by the P.O. route...particularly if you have a patent IV site...why run the risk?

"JCAHO requires those who administer medications to verify the following: the medication is stable (based on visual examination for particulates and discoloration), the medication has not expired, there is no contraindication to administration of the medication (e.g., drug allergy), and the medication is being administered at the proper time in the prescribed dosage by the correct route." Joint Commission on Accreditation of Healthcare Organizations. 2004 National Patient Safety Goals

[pennyaline]

My question is...why would you? I'd be very hesitant to administer anything IV by the P.O. route...particularly if you have a patent IV site...why run the risk?

"JCAHO requires those who administer medications to verify the following: the medication is stable (based on visual examination for particulates and discoloration), the medication has not expired, there is no contraindication to administration of the medication (e.g., drug allergy), and the medication is being administered at the proper time in the prescribed dosage by the correct route." Joint Commission on Accreditation of Healthcare Organizations. 2004 National Patient Safety Goals

If the I.V. med has been ordered for P.O. administration, the requirement for correct route is satisfied.

I am not concerned about giving those I.V. meds P.O. What risk would be involved in doing so? It's not as though you're giving P.O. meds I.V.

[nicole109]

I'm confused about this post...who is making the decision to change from IV to PO? If it is the doctor, then wouldn't you ask them which route they prefer? In my hospital, we don't even carry PO Zofran, I do know that it exists because we have sent people home with scripts for it. There is a form of PO Decadron, but in my experience we give people IV decadron in the beginning and later convert them to PO and then taper them. Are you asking about the conversion of doses from IV to PO?

[Halinja, BSN, RN]

Have given IV decadron PO. Haven't heard of doing it with Zofran. And of course, it was done with a doctor's order.

[OldnurseRN]

We give IV Decadron PO in the ED. Have not done Zofran but would have no problem.

[Altra, BSN, RN]

I'm confused about this post...who is making the decision to change from IV to PO? If it is the doctor, then wouldn't you ask them which route they prefer? In my hospital, we don't even carry PO Zofran, I do know that it exists because we have sent people home with scripts for it. There is a form of PO Decadron, but in my experience we give people IV decadron in the beginning and later convert them to PO and then taper them. Are you asking about the conversion of doses from IV to PO?

No - IV Decadron (10mg/1mL) is frequently mixed in juice or other oral fluid and administered to peds. They tolerate it MUCH better than OraPred. It is ordered this way - no nurse is making the decision to change routes of administration.

In this scenario, we're talking about one-time doses given in the ER - not longer term therapy that might start with IV doses and then convert to p.o.

Now the Zofran - I have not heard of using the IV form p.o., but that doesn't mean it's not done. Love the fact that the cost of the Zofran ODT tabs has dropped. And again - for a vomiting peds patient who is otherwise stable, it's much less traumatic to squeeze a 4mg dissolving tab or even 1/2 for 2mg between their lips than it is to start a line.

[FlyingScot, RN]

I'm confused about this post...who is making the decision to change from IV to PO? If it is the doctor, then wouldn't you ask them which route they prefer? In my hospital, we don't even carry PO Zofran, I do know that it exists because we have sent people home with scripts for it. There is a form of PO Decadron, but in my experience we give people IV decadron in the beginning and later convert them to PO and then taper them. Are you asking about the conversion of doses from IV to PO?

Most of the time this is done with kids who do not have IV's in place who have acute airway issues (croup, wheezing, etc) or in the case of Zofran little kids with vomiting but no evidence of significant dehydration. This is especially common since Phenergan got black-boxed. It generally works like magic so no need for the further torture of needles (IV/IM) which can worsen the original issue by getting the kid to scream. You must remember this is in the ER setting not an admitted patient. Also if you've ever tasted Orapred (prednisolone suspension for kids) then you know why we don't like to give it. You can pretty much guarantee your wheezing kid will become a puking one about 5 minutes after you give it. It's nasty!!!