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
June, 2003
Drug
Deletions from the Formulary:
Clonidine for epidural administration was removed from the Formulary because
of low or no usage. Multivitamins with
fluoride is rarely prescribed for in-patients and could potentially be confused
with plain multivitamin products and therefore was removed from the Formulary.
Parenteral Pantoprazole (Protonix®) Autosubstitution will Continue:
During the shortage of parenteral pantoprazole, an autosubstitution to famotidine (Pepcid ®) was made by the pharmacist if the prescribing physician did not indicate with the drug order that acute GI bleeding or significant gastroesophageal reflux disease (GERD) was present. Based on a drug utilization review, the Pharmacy and Therapeutics Committee has agreed to continue this autosubstitution for parenteral pantoprazole. To avoid the substitution to IV famotidine, physicians must indicate if the IV pantoprazole is being used for acute GI Bleed or significant GERD.
Darbepoetin (Aranesp®) added to the Formulary:
A new, longer acting erythropoiesis
stimulating protein, darbepoetin alpha, was added to the Formulary. Increasing outpatient
usage, every 2-week dose administration schedule and reduced costs were the reasons
sited for Formulary approval.
.
Ceftriaxone (Rocephin®) Dosing Frequency:
The most commonly used dose for
ceftriaxone in adults for treatment of complicated and uncomplicated infections
is 1gm IV every 24 hours. Because the half-life is 6-9 hours, the once-a-day
dosing is adequate to treat most infections. The one exception is in treating a
CNS infection, where the dosing frequency is shortened to every 12 hours.
Hospital
Protocols/Process Changes:
Several protocol or process changes
have been approved by the P&T Committee:
v
Patients receiving calcium IV infusions no longer need to be on
telemetry.
v
Dexmedetomidine (Precedex®) approved for use on the Pediatric ICU
v
Strict guidelines for Factor VIIa (NovoSeven®) use in treating
life-threatening, warfarin-induced bleeding was approved.
v
Autosubstitution of parenteral promethazine (Phenergan®) for
prochlorperazine (Compazine®) will be phased out as changes to pre-printed
physician orders are made.
v
Autosubstitution of pravastatin (Pravachol®) 80mg for simvastatin
(Zocor®) 80mg orders was approved.