Mrx1

[Mariam Obregon]

Theorder reads Ambien 5mg 2tabs po qhs, mrx1 what do you think this is? I thought original Order of two 5mg tabs can be repeated once if needed. I was told you only repeat with one 5mg tab. I am confused. What do y'all think?

If mr is not an approved abbreviation, the order should have been clarified. Also, redoses may be limited by facility policy. Where I work, patients over 80kg have preoperative cefazolin orders automatically adjusted to 2g. However, if we redose the cefazolin in the OR because it's a long procedure, we are only allowed to redose with 1g, even though the patient's weight qualified for 2g. This means if the physician orders a 2g redose, pharmacy automatically changes it to 1g without having to call for clarification. If this is the case for your facility with regards to Ambien, pharmacy should be able to help you find the answer.

I would have called the prescriber to clarify. And I have never seen the abbreviation mr. Also, the recommended daily dose of Ambien for adults is 10mg immediately before bedtime. So the original order calls for two 5mg tabs, but to repeat it if necessary results in overdosing the patient.

I read it as give the patient........ two...... five milligram Ambien tablets..... (total of 10 milligrams) at bedtime. MR (we use this abbreviation frequently) may repeat the order one time. So if after an hour the patient complains of not being able to sleep.....give the patient...... two....five milligram (total of 10 milligrams) Ambien tablets.

I don't see it as confusing or being misinterpreted. I guess in the ideal world you would get a PDR or drug book and look up the recommended dose of ambien.....then call the Dr and say the drug book says that dose is too high.....then have the Dr reply....in a peeved tone......"No that dose is fine for Mr. Smith....please give it."

Thank you so much. I read it to mean repeat original dosage as well. I am going to call my nursing manager to clarify again myself. I definitely don't want to be in error and jeopardize a patient. Also I don't want to give the wrong dosage because others see this as a a repeat half dose when not stated as MRx1 as a a half dose. I am a new nurse and have been wrenching my brain on this. I so appreciate your input.

The way it's written, I would have repeated the original dose and given the two 5mg tabs as the repeat. Can't say I agree with the dosage (though I have seen 15mg and even up to 20mg given, but both rarely) but that's how the order was written. The total dosage alone should have prompted a call to the prescriber.

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