Question for currently practicing/recent grads/veteran PAs (Rx Doses/Therapeutics

[Soulfari]

So we just took our PACKRAT and most of us are pleasantly surprised with how much medicine has stuck in our head since the beginning of didactic year. A common theme throughout our didactic year that I was wary of from the start is that our education regarding therapeutics is a bit vague in terms of dosages and the fine nuances of tweaking Rx therapy. 

 

For you recent grads - did you feel overwhelmed on rotations when it came to making the call on specific dosages for meds? 

 

For you veterans and current practitioners - when did you start to feel comfortable with your dosing knowledge - Trial by fire? Consult UpToDate frequently until it becomes muscle/brain memory? 

 

We're constantly told to "not memorize doses" (for the most part - we know a bit about the basics) - but I feel like that's not gonna fly during clinical year. 

 

Thanks,

[EMEDPA]

many of us older PAs knew a lot of pharmacology BEFORE starting PA school. as an er tech and paramedic I knew a lot of primary care and emergency meds, including indications and dosing before starting school. what I didn't know for the most part was mechanism of action of many drugs and esoteric side effects ( VANN side effects for vanco and other aminoglycosides for example)

[delco714]

Uh ohhhh who let the dinosaur in the room! Just kidding E :-X

 

When I first started out over a year and a half ago ..being in a surg subspec.. A lot of the meds were new anyway. You'll catch on to dosing quicky and find a handful of meds you stick to often. I still look at epocrates occasionally as well for alternatives or new ideas, or less familiar drugs.

[gbrothers98]

So we just took our PACKRAT and most of us are pleasantly surprised with how much medicine has stuck in our head since the beginning of didactic year. A common theme throughout our didactic year that I was wary of from the start is that our education regarding therapeutics is a bit vague in terms of dosages and the fine nuances of tweaking Rx therapy. 

 

For you recent grads - did you feel overwhelmed on rotations when it came to making the call on specific dosages for meds? 

 

For you veterans and current practitioners - when did you start to feel comfortable with your dosing knowledge - Trial by fire? Consult UpToDate frequently until it becomes muscle/brain memory? 

 

We're constantly told to "not memorize doses" (for the most part - we know a bit about the basics) - but I feel like that's not gonna fly during clinical year. 

 

Thanks,

Like E, I had exposure to dosing prior.

Up to date is not a good consult on the fly for med doses, Tarascon and others is.

I would memorize some doses, they havent changed ibu, apap, amox doses forever. But that will come in time with use.

What is helpful is to associate a diagnosis with a dose, that can help.

I am a big fan of EMRA antibiotic guide, that along with Tarascon is all I ever use.

Good luck

G Brothers PA-C

[rev ronin]

Medscape's free app is also nice for dosing/indications.  You memorize what you use, and you get nuanced usage and prescribing tricks from your docs once you're in practice.

[UGoLong]

Dosing came with time. I was very concerned that I would make a mistake and used the heck out of epocrates. Still use it a lot, especially with the newer meds or the ones I don't use very often. After a time, the dosing of the meds you use a lot will become second nature. 

 

If you feel the need to look meds up, by all means do it! You're not being a sissy. 

[Joelseff]

Medscape, epocrates, etc helps. I teach my MAs and MA students to memorize indications, doses, generic and trade names from the MPR.

 

Sent from my S5 Active...Like you care...

 

 

[EMEDPA]

Like E, I had exposure to dosing prior.

Up to date is not a good consult on the fly for med doses, Tarascon and others is.

I would memorize some doses, they havent changed ibu, apap, amox doses forever. But that will come in time with use.

What is helpful is to associate a diagnosis with a dose, that can help.

I am a big fan of EMRA antibiotic guide, that along with Tarascon is all I ever use.

Good luck

G Brothers PA-C

also a tarascon fan(always have one in my pocket), but I grew up on sanford's so that is my ID guide of choice. both are great. I just know my way around sanford's better because I used it as an er tech and medic.

[winterallsummer]

Yep the answer is Medscape.  Look up your doses and eventually you will remember them.

[Boatswain2PA]

Yes, the dosages come as you write them over and over and over (and over and over and over and over).

 

Until you get them down, find a couple of good references that you are adept at using.  Epocrates is good and fast on your phone.

 

You can also make your own guide, I did and I still have one in my pocket.  In school I would adjust this study guide for the most commonly used meds in each rotation.

 

Today, it is still in my pocket on each and every shift.  I rarely pull it out anymore because I have the common dosages down, but when that seizing infant with a sodium of 105 is in my ER, I know where I can find the dosage for the 3% saline (hint: it's not in Epocrates, Medscape, UpToDate, or WikEm).

 

To reiterate:  Find a good reference or two that you are competent in using, and make your own medication/dosage guide for the ones you use most commonly.

 

Lastly, relax.  If you know what drugs to use, how they work, and just as importantly when you CAN'T use them....the dosages will come with time and usage.