Re: med phenobarbital -- is it really an antianxiety agent?

[carol maher]

My pharmacist had the same questions, but the reference to Phenobarbital in the RAI was included in the December 2002 update.  My pharmacist made us a list of commonly prescribed medications that would be coded in O4 to use by the MDS coordinators.  We had to carefully check it against the RAI manual to make sure that our coding matched the directions in the RAI manual.  Phenobarbital is clearly listed as an antianxiety agent in the RAI manual in Appendix E.  Another med that is commonly miscoded is Trazadone.  Trazadone is often ordered for sleep, but is listed as an antidepressant in Appendix E.


-----Original Message-----
From: Callie Larson <[EMAIL PROTECTED]>
Sent: Oct 29, 2003 10:13 AM
To: [EMAIL PROTECTED]
Subject: Re: med phenobarbital -- is it really an antianxiety agent?

This one caught me by surprise:  I would not have thought to even consider phenobarbital as an antianxiety agent.  I have looked in the Physician's Desk Reference, Mosby's Nursing Drug Reference, at several references found via an internet search using Google, and on a drug classification reference sheet that our pharmacist issued and I can find no indication that Phenobarbital is an "anti-anxiety agent."  The PDR (I checked two different manufacturers.) lists it as an anticonvulsant and as a sedative/hypnotic. The nursing drug reference states that it's functional classification is as an anticonvulsant and its chemical classification is as a barbiturate.  The web references all supported these classifications with the addition of a narcotic schedule reference list that identified phenobarbital under "depressants." I could not find any reference to it as an anti-anxiety agent.

 

Have I missed something? Is the RAI manual wrong?  Is this an old classification of the drug?  It does not make sense to me to classify a drug on the MDS in a way that is not supported by the current common reference tools.

carol maher <[EMAIL PROTECTED]> wrote:

Appendix E of the RAI manual lists Phenobarbital as an  antianxiety agent.  Our instructions are to code the meds in O4 according to pharmacological classification and not use.(See the clarification bullet on page 3-180 of the manual).  So, yes, you would code Phenobarbital under O4b as an antianxiety agent even when ordered for seizures.


-----Original Message-----
From: [EMAIL PROTECTED]
Sent: Oct 28, 2003 1:53 PM
To: [EMAIL PROTECTED]
Subject: med phenobarbital ?

Hi

     Several years ago we were told that we had to code phenobarabital as an antianxiety med because it was in the red/ white MDS book  even when the purpose of med  was for SZ disorder. Is this correct or not.

/---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/

Caroline Larson, RN, MS, RAC-C

MDS/PRI Coordinator

Fairport Baptist Homes, Fairport, NY 14450

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/---------------------------------------------------------- The Case Mix Discussion Group is a free service of the American Association of Nurse Assessment Coordinators "Committed to the Assessment Professional" Be sure to visit the AANAC website. Accurate answers to your questions posted to NAC News and FAQs. For more info visit us at http://www.aanac.org -----------------------------------------------------------/