MGH/McLean Residency Training Program in Psychiatry

Massachusetts General Hospital and McLean Hospital, Harvard Medical School

Edition Massachusetts General Hospital, 1999

PART 3 / CH 71

McLean: Orders

General principles:

1. medication orders must have a specified duration

eg: Trazodone 50mg PO QHS x31d

2. when changing medication dosages, need to d/c prior orders:

eg: d/c Clozaril

Clozaril 75mg PO QHS x31d

3. PRN’s cannot include ranges for dosages or frequency,

but using QID rather than q6h allows more flexibility.

eg: Trilafon 4mg PO QID PRN agitation

Admitting orders:

1. All patients should have PRN’s:

· dyspepsia (e.g., mylanta 30cc PO qid PRN)

· constipation (e.g., dulcolax 1 PO/PR q12h PRN)

· pain (e.g., tylenol 650mg PO q6h PRN)

· sleep (e.g., trazodone 50mg PO QHS PRN)

2. All patients should have a suggested chemical restraint.