How do you write "Zofran orally dissolving"

[Ephie]

Is there a Latin equiv. for "orally dissolving" or do you just write "Zofran 8mg po prn orally dissolving" ?

Thanks

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[AggieSean]

I think you can write "Zofran ODT...."

 

[cpants]

when in doubt, write it out.

 

[braluk]

when in doubt, write it out.

👍 I even write out the shorthand notations that I know but are typically not as common also so no lapse in meaning or interpretation.

 

[NAVY DDS 2010]

when in doubt, write it out.

or ask your pharmacist friends since they will fill it. If you are like me, just ask your wife. 🙂

 

[SoCuteMD]

👍 I even write out the shorthand notations that I know but are typically not as common also so no lapse in meaning or interpretation.

Yeah, that works until you are an intern and have substantially less time to actually write stuff out!

OP, you'd write it as "Zofran ODT 4 mg PO" and then your frequency (x1 now, q4h, q4h PRN nausea/vomiting)

 

[Blesbok]

Zofran ODT 1 tab SL q4-6h PRN n/v

 

[cpants]

Zofran ODT 1 tab SL q4-6h PRN n/v

I'm pretty sure it's not supposed to be taken sublingually, but rather held in the buccal mucosa til it dissolves.

 

[SoCuteMD]

Zofran ODT 1 tab SL q4-6h PRN n/v

I don't think "q4h-q6h" is a valid interval. You have to specify an interval, not a range. q4h PRN is fine, as Zofran can be taken every 4, and if you put it PRN then the patient can just ask for it as they need it, which may be less frequently than q4h.

 

[braluk]

Yeah, that works until you are an intern and have substantially less time to actually write stuff out!

OP, you'd write it as "Zofran ODT 4 mg PO" and then your frequency (x1 now, q4h, q4h PRN nausea/vomiting)

Nah I understand the time constraints but I write fast and annotate efficiently. I don't think writing out in shorthand versus full latin annotation will significantly change the time it takes for me to get finished, but having to explain and clarify a script in less-than-common notation might eat a chunk out of time (but who knows). As I said, I'll typically be using the common ones (qam, qhs, po, qd, bid, tid, etc..) but for less well known shorthands like orally dissolving, I'd just generally write it out in abbreviated form.

 

[SoCuteMD]

Nah I understand the time constraints but I write fast and annotate efficiently. I don't think writing out in shorthand versus full latin annotation will significantly change the time it takes for me to get finished, but having to explain and clarify a script in less-than-common notation might eat a chunk out of time (but who knows). As I said, I'll typically be using the common ones (qam, qhs, po, qd, bid, tid, etc..) but for less well known shorthands like orally dissolving, I'd just generally write it out in abbreviated form.

It's actually the name of the med, not an abbreviation. It's in Pyxis, epocrates, and pharmacies as "Zofran ODT"

Also, I put my scripts into the computer. Won't print them 'til they are filled in properly. As long as i write my DEA # for narcotics, I don't get calls.

You may not feel a time crunch now, but trust me that you will at some point - likely not 'til intern year.

 

[Ephie]

Yeah, that works until you are an intern and have substantially less time to actually write stuff out!

OP, you'd write it as "Zofran ODT 4 mg PO" and then your frequency (x1 now, q4h, q4h PRN nausea/vomiting)

Thank you.

 

[cpants]

Yeah, that works until you are an intern and have substantially less time to actually write stuff out!

OP, you'd write it as "Zofran ODT 4 mg PO" and then your frequency (x1 now, q4h, q4h PRN nausea/vomiting)

You shouldn't really write PO as the patient isn't supposed to just swallow it.

I would write "Zofran ODT 4mg dissolve one tab in mouth Q4 PRN for n/v". If there are special instructions, it really is important to write them out longhand. The nursing staff may never have used this form of the med before depending on the floor, and swallowing the ODT kindof defeats the purpose of having an ODT. If the patient can tolerate PO, they can just swallow a regular tab. The ODT is much more expensive from what I hear.

 

[SoCuteMD]

You shouldn't really write PO as the patient isn't supposed to just swallow it.

I would write "Zofran ODT 4mg dissolve one tab in mouth Q4 PRN for n/v". If there are special instructions, it really is important to write them out longhand. The nursing staff may never have used this form of the med before depending on the floor, and swallowing the ODT kindof defeats the purpose of having an ODT. If the patient can tolerate PO, they can just swallow a regular tab. The ODT is much more expensive from what I hear.

I know our ordering system will not allow us to order it that way. We have to specify a route and our choices are pretty limited (subq, PO, NGT, SL, IM, intradermal, and a few others). It is the nurse's job to understand the meds they are giving and how they are giving them.

The tablet dissolves incredibly quickly - within a couple seconds. Even the most talented pill-swallower would have a hard time washing it down before it had dissolved. In the end, though, both are swallowed, so both carry the same risk of vomiting up the dose. The ODT is not absorbed like sublingual nitro, it's just that it reaches the stomach in already dissolved format while the tablet doesn't.

Plus, if a patient can't tolerate PO why are you giving them the ODT? Just give them IV Zofran. The ODT is incredibly expensive (30x the cost of the generic tablet, btw) and should probably be reserved for outpatient use or use on patients who need nausea/vomiting control but who don't have IV access for the most part. Almost every patient in the hospital needs IV access, so inpatient use should be very limited.

 

[cpants]

I know our ordering system will not allow us to order it that way. We have to specify a route and our choices are pretty limited (subq, PO, NGT, SL, IM, intradermal, and a few others). It is the nurse's job to understand the meds they are giving and how they are giving them.

The tablet dissolves incredibly quickly - within a couple seconds. Even the most talented pill-swallower would have a hard time washing it down before it had dissolved. In the end, though, both are swallowed, so both carry the same risk of vomiting up the dose. The ODT is not absorbed like sublingual nitro, it's just that it reaches the stomach in already dissolved format while the tablet doesn't.

Plus, if a patient can't tolerate PO why are you giving them the ODT? Just give them IV Zofran. The ODT is incredibly expensive (30x the cost of the generic tablet, btw) and should probably be reserved for outpatient use or use on patients who need nausea/vomiting control but who don't have IV access for the most part. Almost every patient in the hospital needs IV access, so inpatient use should be very limited.

I know it is not absorbed in the mouth, but idea is that you don't have to swallow anything other than your saliva which will have the medicine dissolved in it. The whole point of the ODT is that it is easier to tolerate than the pill if you are unable to tolerate anything PO. You don't have to swallow a pill or any water to take it. If the patient can tolerate the regular tab, there is no reason for the ODT.

Obviously if the patient has IV access that is the better choice, and any inpatient with n/v requires iv access. There are times when you can't get that access however. I've had IV drug users for example with absolutely wrecked veins. I had one patient who couldn't tolerate PO and would blow every IV within 30 minutes. Getting a new one started would require at least a few hours while the nurses, residents, and eventually anesthesia attempted. Until she got the picc line a few days later, the ODT helped her.

Anyway, it sounds like you have a crappy ordering system, but that's not an excuse to write crappy orders and depend on the nurses to figure out what they're supposed to do.

 

[SoCuteMD]

I know it is not absorbed in the mouth, but idea is that you don't have to swallow anything other than your saliva which will have the medicine dissolved in it. The whole point of the ODT is that it is easier to tolerate than the pill if you are unable to tolerate anything PO. You don't have to swallow a pill or any water to take it. If the patient can tolerate the regular tab, there is no reason for the ODT.

Obviously if the patient has IV access that is the better choice, and any inpatient with n/v requires iv access. There are times when you can't get that access however. I've had IV drug users for example with absolutely wrecked veins. I had one patient who couldn't tolerate PO and would blow every IV within 30 minutes. Getting a new one started would require at least a few hours while the nurses, residents, and eventually anesthesia attempted. Until she got the picc line a few days later, the ODT helped her.

Anyway, it sounds like you have a crappy ordering system, but that's not an excuse to write crappy orders and depend on the nurses to figure out what they're supposed to do.

I actually thought the point of the ODT was that it hits your stomach fully dissolved, instead of spending an hour+ churning around in your stomach being broken down by the acid. I highly doubt the sip of water used to take a pill is going to make THAT much difference.

All of the nurses I work with regularly understand "ODT." There are a number of other drugs that come in ODT form as well - Lamictal, prednisolone, Geodon, Zyprexa to name a few. I do not write "crappy orders" either, and am happy to clarify orders for nurses who don't understand (though I can't say that's ever been a problem). In fact, I'm not convinced the way you'd write the order would be acceptable by JCAHO standards.

As I said before, there are very few occasions when giving the ODT to an inpatient or patient in the emergency department is even justified. I understand the point of the ODT completely, I just contest it's usefulness in most situations where it's administered by a nurse as it's mostly a home medication.

 

[masterofmonkeys]

one thing to remember with zofran is that it really shouldn't be used as a PRN like we do with promethazine but rather scheduled. It's much better at preventing nausea than it is in aborting it.