P H A R M A G R A M
...an educational memo from your Therapeutics Committee
February, 1999
Nationwide gentamicin shortage
Please be aware of this situation when ordering parenteral gentamicin for
your inpatients.
If clinical conditions permit, choose another antibiotic such as tobramycin.
Tobramycin dosing guidelines are very similar to gentamicin dosing guidelines
for the dose administered and the dosing interval. In most cases, you may make
a direct substitution.
Please try to decrease the use of gentamicin until further notice.
temazepam (Restoril) to be substituted for triazolam (Halcion)
- triazolam (Halcion) has been removed from the inpatient formulary
- orders for triazolam (Halcion) 0.125mg po at HS or 0.25mg po at HS will be
automatically substituted by Pharmaceutical Care Services to temazepam (Restoril)
15mg.
- All other orders for triazolam (Halcion) will prompt a phonecall to the
physician by the pharmacist
ranitidine (Zantac) to be substituted for famotidine (Pepcid)
- orders for famotidine (Pepcid) will be automatically substituted by
Pharmaceutical Care Services to ranitidine (Zantac), according to an approved
substitution program
- cimetidine (Tagamet) will still be available for special clinical
indications in the Emergency Department and Nephrology Services
P H A R M A G R A M
...an educational memo from your Therapeutics Committee
February, 1999
pravastatin (Pravacol) to be substituted for simvastatin (Zocor)
orders for simvastatin (Zocor
Ò
) will be automatically substituted by Pharmaceutical Care Services to
pravastatin (PravacolÒ
), according to an approved substitution program
Nationwide injectable phenobarbital shortage
- Please be aware of this situation when ordering injectable phenobarbital for
your inpatients.
- If clinical conditions permit, choose another anticonvulsant such as
carbamazepine (Tegretol
Ò
), clonazepam (KlonopinÒ
), ethosuximide (ZarontinÒ
), fosphenytoin (CerebyxÒ
), gabapentin (NeurontinÒ
), lamotrigine (LamictalÒ
), phenytoin (DilantinÒ
), primidone (MysolineÒ
), topiramate (TopomaxÒ
) or valproic acid (DepakeneÒ
, DepaconÒ
, and DepakoteÒ
).
Try to decrease the use of injectable phenobarbital until further notice.
piperacillin/tazobactam (Zosyn
Ò
) may be temporarily substituted for ticarcillin/clavulanic acid (TimentinÒ
), due to a shortage of TimentinÒ
- Please be aware of this situation when ordering Timentin
Ò
for your inpatients.
TimentinÒ
and ZosynÒ
differ in their dosage intervals, and an adjustment will be made to allow for
this pharmacokinetic difference.
If a patient is started on TimentinÒ
, every effort will be made by Pharmaceutical Care Services to keep the
patient on TimentinÒ
throughout the course of therapy. Likewise with ZosynÒ
.
ZosynÒ
has not been added to the OSF Saint Francis Medical Center inpatient
formulary. It is only temporarily being made available for substitution if
the shortage of TimentinÒ
necessitates its use.