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Discussion

Medication help

Patient is 40yo. She has a trach and receiving 1 can of Jevity through a G-tube between each meal. My question is that she is receiving Pepcid 20mg through an IV. Why through IV? Why can't pepcid be crushed in order for it to be administered through the g-tube? Also she was ordered Fragmin 18000units. I've only had the experience to give 5000 units. What could be the reason that she would be getting that high of an order. Her platelet count is currently 372.

Thanks for any type of help!

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    I have seen prefilled Fragmin syringes with a 18000u dose but I don't know the reason such a high dose.

    Pepcid is not supposed to be crushed.

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    Most anti-reflux meds are coated/not to be crushed. Because its protecting the stomach...

    As far as Fragmin goes:

    "Extended Treatment of Symptomatic Venous Thromboembolism in Patients with Cancer-

    In patients with cancer and symptomatic venous thromboembolism, the recommended dosing of FRAGMIN (dalteparin) is as follows: for the first 30 days of treatment administer FRAGMIN (dalteparin) 200 IU/kg total body weight subcutaneously once daily. The total daily dose should not exceed 18,000 IU. Table 3 lists the dose of FRAGMIN (dalteparin) to be administered once daily during the first month for a range of patient weights"

    So, if this patient was around 210 lbs or more, the does could max out at 18,000...

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