Question

Order: Lopressor \(25 \mathrm{mg}\) per nasogastric tube b.i.d. Available: Scored Lopressor tablets labeled \(50 \mathrm{mg}\)

Short answer

Use half a tablet (25 mg) per dose, administered twice daily.

Step-by-step solution

Understanding the Order

The order prescribes Lopressor at a dosage of 25 mg to be administered twice daily (b.i.d.) through a nasogastric tube.

Understanding the Available Medication

Lopressor is available in scored tablets, each tablet containing 50 mg. Since the tablets are scored, they can be safely divided into smaller doses.

Divide the Available Tablet

Since each scored tablet is 50 mg and the order requires 25 mg, divide one tablet into two equal halves. Each half will contain 25 mg.

Determine Dose Administered per Time

Administer one half of the tablet (25 mg) per dose, twice a day, as the order is b.i.d.

Key concepts

Medication Administration

Medication administration is a critical process in healthcare, involving giving medications correctly to patients. This specific practice ensures that patients receive the correct dosage, route, and timing of drugs, aligning with the prescriptions provided by healthcare professionals.

When administering medication, several key factors must be considered:

• Dosage: Precise calculations are necessary to ensure the patient gets the correct amount of medication. For instance, in the exercise, the prescribed dosage for Lopressor is 25 mg.
• Frequency: This denotes how often the medication should be given. The term b.i.d. means 'twice a day' or every 12 hours. Adhering to the correct frequency is vital for maintaining the therapeutic level of the medicine in the body.
• Route: This is the path by which the medication is administered. The route in this exercise is via a nasogastric tube, which is different from oral or intravenous routes and requires special attention.
• Monitoring: After administration, it's crucial to monitor the patient's response to the medication. This ensures effectiveness and helps identify any adverse effects early on.

Effective medication administration ultimately helps in achieving the desired therapeutic outcomes and enhances patient safety.

Nasogastric Tube

The use of a nasogastric tube (NG tube) for medication administration is common when patients cannot take drugs orally. An NG tube is a flexible tube that is inserted through the nose and extends to the stomach.

This method is beneficial in various situations, such as:

• Patients with difficulty swallowing: Ensures medication is delivered directly to the stomach.
• Unconscious patients: Allows necessary medicines to be given safely.
• Gastrointestinal issues: It bypasses the need for normal swallowing and digestion in the upper GI tract.

Administering medication via an NG tube requires some specific steps to ensure proper delivery:

• Check the tube's placement to confirm it's in the stomach.
• Dissolve the medication in water to prevent clogging.
• Flush the tube with water before and after administering medications to clear the tube and ensure the full dose reaches the stomach.

Proper technique and understanding of using an NG tube are essential to ensure the intended therapeutic effects are achieved without complications.

Scored Tablets

Scored tablets are pharmaceutical tablets with a line or groove in the middle. This design feature allows the tablet to be split easily, making it more flexible to administer smaller or divided doses.

Here are a few important points about scored tablets:

• Adjustable Dosing: When a patient requires a lower dose than the full tablet offers, scored tablets allow caregivers to divide the tablet into equal parts.
• Precision: The score line ensures that when a tablet is split, it results in approximately equal halves. This precise division is crucial, especially when managing medications like Lopressor, where the exact dosage is necessary for effectiveness and safety.

In our exercise, Lopressor is available in scored 50 mg tablets. Splitting one tablet along the score gives two 25 mg doses, matching the prescribed dosage. Always ensure tablets are scored before attempting to split them, as not all tablets are designed to be divided.