P H A R M A G R A M
OSF Saint Francis Medical Center, Peoria, Illinois
...an educational memo from your Pharmacy and Therapeutics Committee
December, 2001
Infiltration Treatment with Hyaluronidase (Wydase®) Expanded with Improved Drug Availability:
The current supply of hyaluronidase (Wydase®) has improved over the past several weeks. This greater availability means more drug is available to treat the following parenteral infiltrations: Chemotherapeutic agents ( etoposide, teniposide, paclitaxel, and vinca alkaloids), potassium and calcium boluses, phenytoin and parenteral nutrition solutions.
Fentanyl (Duragesic®) Patch Reminder:
Inadvertently patients have experienced drug overdoses after receiving oral or parenteral narcotic analgesics while also on a fentanyl (Duragesic®) patch. Unfortunately, the patch is not always visible and the patient or caregiver may forget or not be aware that a continuous dose of fentanyl is being administered. This situation is of special concern when patients are transferred and there is a change of caregivers. When patients are discharged or transferred, fentanyl patches should be removed or their presence on the patient must be communicated to the patient and /or receiving caregiver.
Interaction with Low Molecular Weight Heparins and Patients with Epidural Anesthesia or Spinal Puncture:
Patients who undergo epidural anesthesia or spinal puncture may be at increased risk for bleeding or hematomas if they are also receiving a low molecular weight heparin (Ex. enoxaparin (Lovenox®). This risk is present during insertion, while the catheter is in place and during catheter removal. Since many epidural analgesic drugs are prepared by the Pharmacy, pharmacists have started screening for this potential interaction.
Remember to Indicate the Whole Drug Name – Including Suffixes:
The list of drug names with suffixes, such as LA, CR, SR, seems to continue to grow. Potential life-threatening reactions can occur when drug orders do not include the suffix. One example is when an immediate-release product is dispensed in place of a sustained-released drug. Listed below is a partial list of products with suffixes as part of their names.
Adalat CC Aspirin EC Cardizem SR Cardizem CD
Catapres-TTS-1 Beconase AQ Betoptic S Bicillin LA
Creon-5 Darvocet N-100 Effexor XR Niacin SR
Norpace CR Percocet-5 Procardia XL Prostin VR
Sinemet CR Ritalin SR Tegretol XR Toprol XL
Report Adverse Drug Events on the ADE Hotline – 655-6805