What are the typical as-needed (PRN) medications for a hospital admission?

From the Guidelines

Typical PRN medications for a hospital admission include pain relievers, antiemetics, sleep aids, anxiolytics, antacids, laxatives, and antipyretics to address common symptoms that may arise during hospitalization. When considering pain management, opioids such as morphine (15-30 mg PO Q4-6h PRN) or hydrocodone/acetaminophen (5-15 mg/325mg PO Q4-6h PRN) are commonly used for moderate to severe pain, as seen in the study by 1. Some key points to consider when selecting PRN medications include:

• Pain relievers: acetaminophen (325-650mg every 4-6 hours), ibuprofen (400-800mg every 6-8 hours), and opioids like morphine or hydrocodone/acetaminophen for moderate to severe pain.
• Antiemetics: ondansetron (4mg IV/PO every 6-8 hours), promethazine (12.5-25mg IV/PO every 6 hours), or metoclopramide (10mg IV/PO every 6 hours), with promethazine also being mentioned in the study by 1 as 25-50 mg pr every 6 h prn.
• Sleep aids: zolpidem (5-10mg at bedtime) or trazodone (25-50mg at bedtime).
• Anxiolytics: lorazepam (0.5-2mg every 6-8 hours) or alprazolam (0.25-0.5mg every 6-8 hours), with lorazepam also being mentioned in the study by 1 as 1 mg po every 1-2 h prn.
• Antacids and acid reducers: famotidine (20mg twice daily) or pantoprazole (40mg daily).
• Laxatives: docusate sodium (100mg twice daily), senna (8.6mg daily or twice daily), or polyethylene glycol (17g daily) to prevent constipation, especially with opioid use.
• Antipyretics: acetaminophen (650mg every 4-6 hours) or ibuprofen (400-800mg every 6-8 hours). These medications are ordered as PRN to address common symptoms that may arise during hospitalization, allowing nurses to administer them promptly when needed without requiring new orders, thus improving patient comfort and addressing symptoms quickly, as supported by the evidence from 1 and 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Typical PRN Meds for Hospital Admission

• Antiemetic medications are commonly prescribed as PRN meds in hospitals to manage nausea and vomiting [ 2 ]
• The main antiemetic classes used as PRN meds include:
  • Serotonin antagonists (e.g. ondansetron)
  • Dopamine antagonists (e.g. metoclopramide)
  • Histamine antagonists (e.g. antihistamines)
  • Neurokinin antagonists (e.g. aprepitant)
  • Corticosteroids
  • Benzodiazepines [ 2 ]
• Specific PRN meds may be chosen based on the cause of nausea and vomiting, such as:
  • Ondansetron and aprepitant for chemotherapy-induced nausea and vomiting [ 2 ]
  • Metoclopramide and antihistamines for nausea and vomiting in pregnancy [ 2 ]