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

March, 2003

Formulary Drug Additions:

Felodipine (Plendil®), which is a dihydropyridine calcium channel blocker indicated for the treatment of hypertension. This drug offers a less costly alternative to amlodipine (Norvasc®) and is one of the ‘preferred’ calcium channel blockers for the Illinois Medicaid Formulary.

Tacrolimus (Prograf®) injection was added to the Formulary to provide an alternative route of administration when oral tacrolimus cannot be given. This product will not normally be stocked in the Pharmacy until the drug is requested.

Loratadine (Claritin®, Alavert®) will now become a Formulary drug and the autosubstitutions for fexofenadine (Allegra®) and fexofenadine with pseudoephedrine (Allegra D®) will be reversed for these non-sedating antihistamines. Improved safety in pregnancy and reduced cost are the reasons for the change. Cetirizine (Zyrtec®) liquid is still available for pediatric patients.

New Pediarix ® Vaccine Will Allow for Fewer Injections:

A new vaccine (Pediarix®) containing diphtheria, tetanus, acellular pertussis, inactivated polio and hepatitis B vaccines is now on Formulary.

Vaccine recommendations for infants at least 2 months old and weighing at least 2 kilograms are the combination of Pediarix®, Pneumococcal conjugate (Prevnar®), and Haemophilus influenzae type B. Two booster doses for each vaccine are recommended at 2 month intervals.

A pre-printed physician’s order sheet for Childhood Immunizations is being developed to assist in vaccine selections and reduce potential prescribing and dispensing errors.

Blue Alert Code Cart Inventory Changes:

The Cardiopulmonary Resuscitation (CPR) Committee has approved the following drug changes to the Blue Alert Code Carts:

Remove: Diphenhydramine (Benadryl) injection 50 mg

Remove: Epinephrine (Adrenalin) vial 1 mg/ml 30 ml

Remove: Heparin 1000 units/ml vial 1 ml

Remove: Procainamide (Pronestyl®) 100 mg/ml vial 10 ml

Remove: Verapamil (Calan®) 5 mg/2ml vial

Add: Epinephrine 1 mg/ml ampules for subcutaneous use

Caution: Avoid Zosyn® in Patients with Penicillin Allergies:

Zosyn® is the trade name to the antibiotic combination of Piperacillin/Tazobactam. Since piperacillin is contraindicated in patients with a significant allergic history to the penicillins, Zosyn® should be avoided in these patients.

Meropenem (Merrem®) is Back to Full Supply:

After being in extreme short supply, meropenem is available once again and will be used by the Pharmacy for auto-substitution for most orders of imipenam/cilastatin (Primaxin®) as approved by the Pharmacy and Therapeutics Committee. Meropenem’s usual adult dose is 1 gm IV every 8 hours.