P H A R M A G R A M    

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

September, 2004

Formulary Additions and Autosubstitutions: 

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

v      Ocuvite Lutein® – this product will provide 6 mg per dose of lutein, which is a dihydroxycarotenoid, used as a preventative for cataracts and age-related macular degeneration.

v      Memantine (Namenda®) – used alone or in combination with other drugs in the treatment of moderate to severe Alzheimer’s disease.

Autosubstitutions and Formulary Addition Denials: 

v      Tiotropium (Spiriva®), a long-acting anticholinergic bronchodilator, was denied formulary addition based on the lack of clinical studies in acute care and cost of the product.  Nebulized respiratory products are frequently the preferred inhalation dosage form used in acute care settings. The P&T Committee approved an autosubstitution of tiotropium to ipratropium (Atrovent®) 2 puffs four times a day.

v      Cinacalcet (Sendipar®), is a calcimimetic compound used in the treatment of hypercalcemia in patients with parathyroid carcinoma. This drug was denied Formulary addition due to predicted low use at the present time.

Handling Oral Cytotoxic Drugs:

 The Pharmacy will place a warning label stating ‘CYTOTOXIC MATERIAL’ on all ORAL dosage forms of drugs that qualify. This warning is intended to avoid nurses or others from crushing tablets or opening capsules and possibly exposing themselves and others to potential toxicities. Gloves and face masks must be used when opening capsules or crushing tablet dosage forms of these products. A biowaste container must be used to dispose of materials leftover from drug preparation. A list of these products is available from the Pharmacy.

Watch Out for Drug Names with Suffixes:

The list of drug names with suffixes such as LA, CR, SR, XT continues to grow. Potentially life-threatening reactions can occur when drug orders do not include the suffix. One example is if the immediate-release formulation of nifedipine (Procardia® or Adalat®) is ordered in place of the sustained-released (Procardia XL® or Adalat CC®) dosage form. Other examples are listed below.

Aspirin EC, Cardizem CD, Depakote ER, Catapres-TTS-1, Bicillin LA, Detrol LA, Wellbutrin XL,           

Norpace CR, Tegretol XR, Sinemet CR, Augmentin XR          

ADE (Adverse Drug Event) Hotline: 655-6805