Sedation PRNs

1 minute read

Sedation PRNs are important drugs that are used to treat agitation in the ICU. They are especially important in getting people off the powerful sedation drips that may limit them from awakening and being able to be extubated or recover properly. In some cases, intubated patients may be able to have their sedation needs met soley with PRNs.

Common sedation medications and dosages

  • Haloperidol (Haldol) 5-10 mg q4-6 prn IV: an antypical antipsychotic that should generally be used as first line for as needed agitation medication. They are generally safer and with less risks than benzos.
  • Midazolam (Versed) 1-2 mg q2-4h prn IV: 2q2h of Versed is very common in intubated patients. It may serve as an adjunct for treating withdrawal (in addition to a CIWA protocol) as it is also a benzo. Be weary of this in patients who are not intubated with a protected airway as it suppresses the respiratory drive.
  • Zyprexa (Olanzapine) 2.5-10 mg q4-6h PRN IM: A closely related medication to Haldol. Sometimes this works better for some patients when haldol doesn’t touch them. This is only available as IM in ECMC, which makes it more appropriate for floor level patients.

Keep track of them

  • When pre-rounding, ensure that you know what PRNs are ordered for your patients and how many doses they received. This will help guide the decision to increase or wean their scheduled PO sedation medications.
  • DC orders for PRNs that are not being used.
  • 2q2h of Versed is not appropriate for floor level patients. Ensure that your floor transfers are not requiring this much Versed, and that the order is cancelled.