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Discussion

Phenobarb dosing

Say you have a patient on q12h phenobarb. The MD writes an order to increase the dose plus give a loading dose. You give the loading dose and the next dose from the old dosage is due in 2 hours. Do you give the new dosage? If not , how long do you wait to start the new maintenance dose? I couldn't find the answer in my Neofax nor online.

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Say you have a patient on q12h phenobarb. The MD writes an order to increase the dose plus give a loading dose. You give the loading dose and the next dose from the old dosage is due in 2 hours. Do you give the new dosage? If not , how long do you wait to start the new maintenance dose? I couldn't find the answer in my Neofax nor online.

I would take my MAR to the MD and ask exactly what they want done.

I am basing this response off of how my unit works. Nurses/Docs have good working relationship for the most part. They would rather us ask then try and figure it out on our own.

If it is a bolus because the level is low, then they may want you to give the new dose at the usual time. But, that being said, you need an order as to what they want.

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I would walk over and ask him/her what they want you to do.

Phenobarb is one of those drugs you have to be careful with.

They'll probably say to just give the new maintenance dose on schedule following the reload.

This is one of those situations that is best left to the physician to clarify, rather than the RN having to try to figure it out.

Yes, clarify that next routine dose and make sure they D/C the order for the old dosage.

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