...an educational memo from your Pharmacy and Therapeutics Committee

December, 2002

Augmentin ® is a combination of amoxicillin and clavulanate and is available in the following strengths: 250mg/125mg, 500mg/125mg and 875mg/125mg. The patent has expired on this product and the manufacturer has now introduced a similar product called Augmentin XR ®. Augmentin XR ® contains 1000mg of amoxicillin and 62.6mg clavulante. It is important that healthcare providers be aware of this difference and to include product strengths and suffixes associated with a drug name when prescribing drug products such as these. Augmentin ® is on the Formulary, whereas Augmentin XR® is not.

A revised Telephone Medication Order Policy will require the ordering clinician to clearly identify themselves, with their dictation numbers, and provide the patient’s full name, name and spelling of the medication, along with the dose, route and frequency. The receiving clinician will write the order, including the date and time, and then the patient’s name and medication order will be read back and verified by the prescriber. The written order will include the notation ‘read back’ to assure compliance with this policy.

Occasionally an assumption is made that administration of intravenous medications is sufficient reason to hospitalize a patient. Many oral versions of parenteral medications are nearly 100% absorbed and can be safely and effectively used in place of the intravenous product. Homecare services frequently provide parenterally administered medications to patients on an outpatient basis. Maintaining a patient on parenteral medication increases hospital costs and is not sufficient criteria to not discharge a patient.

A parenteral gold preparation used for rheumatoid arthritis, aurothioglucose (Solganol®) has been discontinued by the manufacturer. In it’’s place the P&T Committee has added gold sodium thiomalate (Myochrysine®).

Galantamine (Reminyl®) has join donepezil (Aricept®) on the Formulary for the treatment of Alzheimer’s Disease. Tacrine (Cognex®) and rivastigmine (Exelon®) were denied Formulary addition due to the side effect profiles or lack of comparative benefit to the drugs on Formulary.

Casanthranol, which is contained in PeriColace®, is being removed from the market. Senokot S®, which contains 8.6mg senna and 50mg docusate has been selected as the substitute for PeriColace®.. An equivalent dose to 1 capsule of Peri Colace® would be 2 tablets of Senokot S®. Since there is not a Senokot S® liquid formulation, Senokot ® liquid 5mls (8.8mg senna) given with docusate 15ml (50mg doucsate) will be used as a subsitute for 15ml of PeriColace ® . Pharmacists have been approved to use these substitutions for all PeriColace® orders .