August, 2004

Formulary Additions and Autosubstitutions:

The following were approved by the Pharmacy and Therapeutics Committee for addition to the Formulary:

            Pimecrolimus (Elidel®) – this product offers a therapeutic alternative to topical corticosteroids in the

treatment of atopic dermatitis, allergic contact dermatitis and psoriasis.

            Pentosan Polysulfonate (Elmiron®) – useful in the treatment of interstitial cystitis

            Acetylcysteine, injection (Acetadote®) – the first parenteral acetylcysteine product for treating

acetaminophen overdoses to be approved in the United States. Currently this dosage

form is still considered as a secondary alternative to the orally administered product due to

potential significant side effects. However, Policy and Procedures related to this new formulation

are being reviewed

            Fluvastatin XL (Lescol XL®) has been approved to be substituted with pravastatin (Pravachol®)

Formulary Deletions, Addition Denials and Drug Discontinuations:

The following drug products were voted on by the Pharmacy and Therapeutics Committee for either Formulary deletion, denial for addition, or Formulary removal because of discontinuation by the manufacturer.

Sodium Chloride 5% - low usage and availability of 3% parenteral solution

Amitriptyline (Elavil) injection – low usage

Zinc nasal gel (Zicam®) – denied addition due to significant side effect profile

Geftinib (Iressa®) – denied addition due to anticipated low use.

Beta carotene – discontinued by manufacturer. Retinol (Vitamin A) is still available

Dicloxacillin oral susp (Dynapen®) – discontinued by manufacturer.  An alternative is being reviewed

Mesoridazine (Serentil®) – discontinued by manufacturer

Epinephrine ophthalmic drops (Epifrin®) – discontinued by the manufacturer.

Thiethylperazine (Torecan®) – discontinued by the manufacturer.

New 2005 Hospital National Patient Safety Goals:

Just as you were getting familiar with the 2004 Patient Safety Guidelines, the new 2005 Goals have now been announced. The former Goals have either been incorporated into the current Joint Commission Standards of Practice and/or are repeated in the 2005 Goals.  The new information is provided below:

·          Measure, assess and, if appropriate, take action to improve the timeliness of reporting, and the timeliness of receipt by the responsible licensed caregiver, of critical test results and values.

·          Identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used in the organization, and take action to prevent errors involving the interchange of these drugs.

• Accurately and completely reconcile medications across the continuum of care.     
• Reduce the risk of patient harm resulting from falls.

Avoid Medication Errors; Don’t Use These Abbreviations:

Banned Abbreviations                      Potential Problem                                         Preferred Terms

U (for unit)                                          Mistaken as zero, four or cc.                        Write “unit”

IU (for international unit)                   Mistaken for IV (intravenous) or 10              Write “international unit”

Q.D., Q.O.D.                                      Mistaken for each other or Q.I.D.                 Write “daily” or “every other day”

Trailing zero (X.0mg)                        Decimal Point Missed                                  Never write trailing “0”

Lack of leading zero (.Xmg)            Decimal Point Missed                                   Use “0” before decimal point

MS, MSO4,MgSO4                          Confused for one another                              Write out morphine or

                                                            (morphine or magnesium sulfate)                       magnesium sulfate.

ADE (Adverse Drug Event) Hotline: 655-6805