Changing Medications

The steps for updating the dose vary for pediatric and adult patients.

• Pediatric

  a.   If necessary, calculate the single dose using the calculator or update the patient's weight for more accurate dose information.

  b.  Select the line option for the desired dosing option.

  • By strength and form: Click the first line option. Complete entries for Strength & Form, Take, and Frequency, as needed, using drop-down lists. To add your own frequency, select the Other option, and type.

  • By weight-based dose: Weight-based dosing is only available for patients who are less than 19 years old with a recorded weight of less than 40 kgs.

  The Dose column displays the single dose amount, calculated by multiplying the weight-based dose by the patient's weight. From the Dose drop-down, select a dispensable dose option. Doses that are less than 90% or greater than 110% of the calculated dose appear in red.

  To select a different strength and form than the one listed, click the Strength & Form, Take drop-down. Complete the Frequency field, as needed, using the drop-down. To add your own frequency, select the Other option, and type.

  • By nonweight-based dose: Line options for nonweight-based doses display a basic dose (such as 200 MG), rather than a dose per kilogram calculation. Click an appropriate line option. To select a different strength and form than the one listed, click the Strength & Form, Take drop-down. Complete the Frequency field, as needed, using the drop-down. To add your own frequency, select the Other option, and type.

  • By manual entry: Click the last line option. Type the dose into the first field. Complete entries for Strength & Form, Take, and Frequency, as needed, using drop-down lists. To add your own frequency, select the Other option, and type.

• Adult

  Select the line option for the desired dosing option.

  • By strength and form: Click the first line option. Complete entries for Strength & Form, Take, and Frequency, as needed, using drop-down lists. To add a frequency, select the Other option, and type.

  Note: This method is useful if you have selected a combination drug.

  • By dose: Click any dose option. To select a different strength and form than the one listed, click the Strength & Form, Take drop-down.  Complete the Frequency field, as needed, using the drop-down. To add your own frequency, select the Other option, and type.

  • By manual entry: Click the last line option. Type the dose in the first field. Complete entries for Strength & Form, Take, and Frequency, as needed, using drop down lists. To add your own frequency, select the Other option, and type.

  Note: The dose marked as the default in the Partners Master Drug Dictionary (MDD) is highlighted in yellow. If no dose is marked as the default, then no line appears highlighted.

• Adult Chemotherapy

  These steps only apply if you have selected Show Oncology Info in Custom Preferences, and an oral chemo med with special BSA- or weight-based dosing requirements.

  a.   If necessary, click the associated link to update the patient's height or weight.

  Important:  If the recorded weight is more than 30 days old, the LMR will display the patient's weight as blank. You must update the weight to calculate correct dose information.

  b.  Select the line option for the desired dosing option.

  • By strength and form: Click the first line option. Complete entries for Strength & Form, Take, and Frequency, as needed, using drop-down lists. To add your own frequency, select the Other option, and type.

  • By BSA- or weight-based dose: The Dose column displays the single dose amount, calculated for the patient's weight and BSA. From the Strength & Form drop-down, select a dispensable dose option. Doses that are less than 90% or greater than 110% of the calculated dose appear in red. To add your own frequency, select the Other option, and type.

  In some cases, you may wish to reduce the selected dose by a given percentage. If so, the LMR provides a dose reduction calculator to assist you. Click the  to display a pop-up box with options to reduce the dose by 5 - 50% (in increments of 5). Select the dose reduction from the drop-down list to display the new reduced dose. You must manually enter this calculated dose (as described below).

  • By nonweight-based dose: Line options for nonweight-based doses display a basic dose (such as 200 MG), rather than a MG/M2 or MG/KG calculation. Click an appropriate line option. To select a different strength and form than the one listed, click the Strength & Form, Take drop-down. Complete the Frequency field, as needed, using the drop-down. To add your own frequency, select the Other option, and type.

  • By manual entry: Click the last line option. Type the dose into the first field. Complete entries for Strength & Form, Take, and Frequency, as needed, using drop-down lists. To add your own frequency, select the Other option, and type.

Note: The LMR includes weight-based/BSA-based dosing for pediatric patients and adult chemo patients for certain medications.