Would this be considered a med error?

[Theone40]

you have an order for Adderall 275mg, on had you have Adderall 100mg capsules, how many capsules would you give? If you do the math it comes out to 3 capsules.

Wouldn't the extra amount of medication be consider a med error ? are you essentially prescribing by giving 3 capsules with the extra amount ? also wouldn't you call the provider to clarify ?

Thanks

[BuckyBadgerRN, ASN, RN]

If I had an order like this, all sorts of red lights are going off---That is a TREMENDOUS dose of Adderall---sounds like a "street" order to obtain quite the high!

Sometimes you need to think beyond the simple math and know if the med even seems right!

you have an order for Adderall 275mg, on had you have Adderall 100mg capsules, how many capsules would you give? If you do the math it comes out to 3 capsules.

Wouldn't the extra amount of medication be consider a med error ? are you essentially prescribing by giving 3 capsules with the extra amount ? also wouldn't you call the provider to clarify ?

Thanks

[JustKeepSmiling, ADN, BSN, RN]

I would question the entire dose! HOLY MOLY!!!!

[Sunnilee]

You are speaking my thoughts. I actually laughed when you said it was enough to kill an elephant. Indeed I completely agree. Med errors are not limited to what you give but also understanding the medications, side effects, usual dosing ect. You may get a minor attitude by checking with the physician but you will gain respect by ensuring that patient safety is top priority.

[KelRN215, BSN, RN]

you have an order for Adderall 275mg, on had you have Adderall 100mg capsules, how many capsules would you give? If you do the math it comes out to 3 capsules.

Wouldn't the extra amount of medication be consider a med error ? are you essentially prescribing by giving 3 capsules with the extra amount ? also wouldn't you call the provider to clarify ?

Thanks

If you do the math, it comes out to 2.75 capsules. You don't round in these kinds of situations. An extra 25 mg is increasing the dose by almost 10%. Yes, that is a med error. And adderall doesn't come in 100 mg capsules nor is 275 mg an acceptable dose so yes you'd need to call the provider. When I worked in the hospital, such an order would be rejected by the pharmacy.

[RNsRWe, ASN, RN]

Wondering if this was a stupidly written question given to a first-semester student.....or a question designed to make a third or four-semester student think outside the box for the answer?

If the former, the student's answer should be that pharmacy needs to provide the correct dosages in capsule form, or tablet form, or whatever form required to total 275mg.

If the latter, it's the correct answer if the student writes "I cannot administer this dosage as ordered as I prefer my patients to still be breathing at the end of my shift. I'd call the prescribing provider to get a new order for this patient" :)

[CT Pixie, BSN, RN]

You wouldn't give three 100mg capsules, you would give what's called a med equivalent that you hopefully have access to that would be capsules of different strengths that add up to 275mg, like two 100mg's and a 75mg capsule...It would be a med error if three 100mg tablets were given because, as you know, this is not the dosage ordered.

Let's pretend that the dose falls within the recommended dose

A) if you do the math it comes out to 2.75, not 3 (275/100=2.75). The number you should be giving is 2.75 capsules. But since you can't split capsules if you give 3 you are giving too much and its a med error

B) Again, capsules can't be split so if you only gave 2 its still an error because you gave too little. Again, its a med error.

Answer would be, call the doctor and clarify as well, explaining that the on hand medication comes in 100mg capsules.

now lets go with we KNOW that dose does not fall within the recommended dose and we do have capsule dosages that we can give that will total 275mg.

you should still contact the doctor because the dose is much higher than the recommened dose.