PRN blood pressure medications??

[AREED12]

There is an order on someone's MAR for a PRN calcium channel blocker. Supposedly the MD made it PRN because one of a communication in put that this particular person had the med held often. The cartizam was scheduled QID previously and held about every other time. Why would it go from QID to PRN, why not once Or twice a day? Or why not have a different BP med? Has anyone else come across a PRN BP med, and know why this is done (and shouldn't there be an order for daily BPs, or twice a day) To go along with this?

[Rose_Queen, BSN, MSN, RN]

Have you addressed your concerns with the prescribing physician? He or she would be able to best give you the rationale behind the change. Have I personally seen PRN BP med orders? Absolutely. In my setting, it's typically PRN IV push meds for high blood pressures.

[VANurse2010]

They're pretty common in acute care (IVP as stated above, or sometimes po meds like clonidine). Diltiazem is an odd choice for a PRN blood pressure medication anyway, as it has far, far more of an effect on the heart rate than the BP.

In any case, I suspect you're in LTC, in which case I would say PRN BP meds are not really appropriate. The person needs to be on a regimen.

I don't really think you need an order for PRN BP checks; it's prudent nurse practice to check a BP before giving PRN BP meds (note: I did not say scheduled meds - that depends on the context).

[PennyS]

I do see PRN bp meds in my setting (pedi acute care) But there are always very specific orders with very specific parameters. Hydralazine is the one I see most often. I agree with PP and would address this directly with prescribing MD.

[gouranga]

I gave a prn bp med the other day for a pt who was npo and had htn. The parameters were clearly set at q6h for sbp > 140 and dbp > 90. I guess it depends on the pt.

[Dranger]

Labetalol and hydralzine are pretty common PRN BP meds

Clonidine PRN is usually used for alcohol withdrawal symptoms, but can be used for hypertensive urgency or other times when BP control is needed.

I agree that cardizem is an odd choice for a PRN it is usually an infusion or given as a 24 hour release/scheduled set time drug.