P H A R M A G R A M
October, 2002
Autosubstitution of Imipenem/Cilastin (Primaxin®) to Meropenem (Merrem®):
The Pharmacy and Therapeutics Committee approved the autosubstitution of imipenem/cilastin to meropenem for adult patients. Meropenem’s usual adult dose for patients with normal renal function is
1 gm IV every 8 hours. Physicians who order imipenem in doses greater than 500mg every 6 hrs, will be contacted to choose an appropriate meropenem dose. Imipenem will be available for treating pancreatic abscess infections if the physician indicates ‘dispense as written’ with their order.
Beef-Lung Heparin and Danaparoid (Orgaran®) Discontinued by Manufacturers:
Two anticoagulants, beef-lung heparin and danaparoid are being discontinued by their respective manufacturers. Heparin sodium (porcine derived) will continue to be available and be used as the replacement for the beef-lung product. Danaparoid is low molecular weight heparinoid which has been rarely used in clinical practice.
Changing Manufacturers for Insulin Products :
The Pharmacy is changing from Lilly's Humulin® insulin product line (Regular, NPH, Lente, 70/30 and Humalog) to Novo Nordisk’s (formerly Squibb Pharmaceutical) Novolin® (Regular, NPH, Lente, 70/30 and Novolog) insulins. After consultation with endocrinology and recognizing both products to be equally safe and efficacious, the P&T Committee approved the product conversion. This change was prompted by a significant decrease in the price of the Novo Nordisk insulin products. There will be no change for Humulin 50/50, Ultralente or insulin glargine (Lantus®). Children are excluded from this conversion until a final decision has been made.
Formulary Maintenance by the Pharmacy and Therapeutics Committee:
The P&T Committee consists of 31 voting physicians and 8 non-voting members, who represent support services and hospital administration. Maintenance of the Drug Formulary is among several areas of responsibility of this Committee. Physicians may request a drug to be added to the Formulary by completing a Formulary Addition Request form which is available from the Pharmacy Department. The Drug Analysis Work Group Subcommittee researches and reviews each drug request. Using a balanced scorecard approach which considers efficacy, safety, patient’s acceptance and cost, this Subcommittee makes recommendations to the P&T Committee for drug product approval, denial or removal. If judged by a patient’s physician to be clinically necessary, a one-time or one patient use of a non-Formulary product may be requested by the prescribing physician completing a Non-Formulary Request form (available from the Pharmacy Department) and contacting the P&T Committee Chairman.
Fosphenytoin (Cerebyx®) Pre-Printed Physician Orders:
The dose of fosphenytoin, a parenteral agent used to treat seizures, must be dosed using Phenytoin Equivalents (PE). In order to prevent potential dosing errors, a pre-printed order sheet, which will be available soon, must be used when prescribing this drug.
Report Adverse Drug Events on the ADE Hotline – 655-6805