This entry is dedicated to all of the PA’s and NP’s out there who use a hand-held device (palm pilot, iphone, whatever) to dose medications.
STOP FUCKING USING THEM.
Lets be completely honest here. We are both professionals so we can have this conversation. Do you really think a welfare mother of 4 is going to have the mental horsepower to measure anything other than what is clearly marked on a measuring spoon? Do you think they can comprehend the idea of anything smaller than 1mL? Do you really believe in their ability to use a dosing syringe and draw up liquid to a big black line which I draw on there with a sharpie?
No? THEN QUIT WRITING DOSAGES THAT REQUIRE THEM TO DO THAT!
If you cannot use some common sense and round up or down dosages of amoxicillin or Prelone to either 1/2 or 1 full teaspoonful, then please save us both the trouble and write for something else which can. Seeing dosages of 435mg tid of amoxicillin suspension just makes me wish that you didn’t have prescriptive authority. I’m just going to round up to 500mg, and when you call me to bitch, I’m just going to tell you to use a little common sense and less calculator. I’m also going to tell you that the idiot mother in front of me (who has yes to realize that penis + vagina = kid) doesn’t have a snowballs chance in hell in measuring what dose you initially wrote for.
Idiots who write super-precise dosages like that are the retards in college that score 100% on the tests, but can’t apply that knowledge to any real-world situation to save their life. Unless you are dealing with a hospital staff with very narrow therapeutic drugs, whats the point of writing dosages like that? Are you proud that you can do math using mg/kg units? Are you proud that you have a program that figures out the dosages for you? Have you ever in your life seen the thick pink amoxicillin death that you wish to be dosed out to .004mL digits?
When you write for those dosages, think for a whole 2 seconds knowing that amoxicillin comes in 125mg/5cc (1 cc = 1 mL in case you didn’t know), 250mg/5cc, and the ever not-used 400mg/5cc. Now, use your math skills and shoehorn the dose that the stupid palmpilot program gives you into one (1) of those dosage bottles so the twatmuffin mother will give 1/2 or 1 teaspoon. If you can’t, then just round up. If some kid dies from getting an extra 25mg of amoxicillin, then obviously your diagnosis was so far off you shouldn’t be practicing.
Finally, please, when the pharmacist comments on your dose over the phone, don’t just blow him/her off with a “uh huh” and proceed to write again for stupid dosages. That just makes us angry (and you get a rant written about you).