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

May, 2002

Policy to Promote Inclusion of ‘Dose per Kilogram’ for Pediatric Drug Orders:

In order to prevent prescribing errors in the pediatric patient population, the P&T Committee for the Children’s Hospital of Illinois is encouraging prescribers to include ‘dose / KG’ with each drug order. The order sheet should also provide the current weight of the patient. An example would be a 4 KG child with an order for Ampicillin 200mg (50mg/KG) IV every 6 hrs.

Orange Medication Stickers on Patient ID Bracelet means Patient has a Drug Patch:

Medication patches containing drugs such as fentanyl, clonidine, nicotine, scopolamine, and nitroglycerin are a common means of drug administration. Unfortunately these patches can be hidden from view and this can and has led to similar drugs being co-administered with undesired, additive pharmacologic results. Starting this month, if a patient has a patch applied to their skin, an orange sticker with the drug name written on it will be attached to the wristband used for patient identification. The label is large enough to be seen, but will not cover the patient’s name on the band.

Formulary Changes: Paregoric Removed and Finasteride (Proscar®) Added:

Paregoric, which is a rarely prescribed antidiarrheal with potentially significant side effects, was removed from the Formulary. Although alpha-blockers are the usual first line choice in treating benign prostatic hypertrophy, finasteride was added to the Formulary for those patients who benefit from this alternative drug therapy.

Verbal Verification of Physician Telephone Orders:

To avoid errors with telephone orders, nurses, pharmacists and all others authorized to receive physician telephone orders are requested to repeat the orders back to the prescriber for verification.

Dosage Forms That Should Not be Crushed:

Either because it is a sustained-release dosage form, has a disagreeable taste or needs to be protected from the acidic environment of the stomach, the following are some drug products that should not be crushed or chewed.

Asacol ® (mesalamine) Humabid LA ® (guaifenisin)

Dulcolax ® (bisacodyl) Imdur ® (isosorbide mononitrate)

Calan SR ®, Isoptin LA ® (verapamil) Inderal LA ® (propranolol)

Cardizem SR and CD ® (diltiazem) Macrobid ® (nitrofurantoin)

Colace ® (docusate) Micro K ® (potassium chloride)

Creon ® (pancrelipase) MS Contin ® (morphine sulfate) Depakene ® (valproic acid) Procardia XL ®, Adalat CC ® (nifedipine)

Depakote® (divalproex) Sinement CR ® (levodopa/carbidopa)

Diamox Sequels® (acetazolamide) Slobid ®, Theodur ® (theophylline)

Ecotrin ® (aspirin) Toprol XL ® (metoprolol)

 

Report Adverse Drug Events on the ADE Hotline – 655-6805