Patient had intractable pain and was recieving 20mg methadone (4 tablets) Q3 on a titration dose. Not sure what its like in other countries but methadone only comes in a 5mg tablet.
When the doctor added in a BD dose, which turned out to be roughly 55mg. We tried to give via eilxer (10mg/1ml) however patient couldnt tolerate the taste. In the end patient was taking 11 pills per BD dose and 4 tabs per q3PRN
My only experience with the exception to this med administration rule was also with methadone! Had a guy on med/surg once who needed something like 20x a "normal" dose. Crawling the walls until he could get his daily dose, which the pharmacy insisted couldn't be possible. Many calls back and forth between his methadone clinic and the hospital pharmacy later, he got his 20 syringes of liquid methadone squirted into a cup and knocked it back. Was an absolute peach the rest of the shift.
I was thinking this too! Have definitely given some larger amounts of Methadone this way...always to people who can't or won't take more than one at a time, LOL.
Oh, he chucked the containers (2 Med cups) in his mouth and swallowed them with only a sip of water! I was like-what the what????
LibraSunCNM, BSN, MSN, CNM
1,656 Posts
My only experience with the exception to this med administration rule was also with methadone! Had a guy on med/surg once who needed something like 20x a "normal" dose. Crawling the walls until he could get his daily dose, which the pharmacy insisted couldn't be possible. Many calls back and forth between his methadone clinic and the hospital pharmacy later, he got his 20 syringes of liquid methadone squirted into a cup and knocked it back. Was an absolute peach the rest of the shift.