P H A R M A G R A M

...a memo from your Pharmacy and Therapeutics Committee

September, 2005

Formulary Autosubstitutions and Additions:

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

v Dacriose® eye wash was discontinued by the manufacturer. The Pharmacy will now substitute Eye Stream® eye was for all Dacriose ® orders.

v Probiotic (VSL#3®) which contains 450 billion lactobacillus was added to the Formulary. Lactobacillus is generally well tolerated, however rash, gas, burping, hiccups, and constipation may develop.

Formulary Deletions:

Codeine oral solution and ribavirin inhalation (Rebetol®) were deleted from the Formulary. Both products have been rarely ordered and the codeine solution has been discontinued by the manufacturer.

Pharmacy and Therapeutic Committee Approved Procedure Changes:

Ondansetron (Zofran®) will no longer be available on override in Pyxis®.  This prophylactic antiemetic has been overused and the Pharmacy and Therapeutic Committee approved restricting any order that goes beyond 3 doses per day for 2 days (excluding use in chemo- or radiation therapy).   Removing the override assures that this policy is followed.

Orders for oral ziprasidone (Geodon®) no longer need to be written on a special pre-printed order form.

STOP ANTIBIOTIC OVERuse!!!  STOP ANTIBIOTIC MISuse!!!  STOP ANTIBIOTIC OVERuse!!!

Good Antibiotic Practice Target #1 Know when to say “NO” to vancomycin

· Use vancomycin for empiric treatment of a serious infection suspected to be caused by a beta-lactam-resistant gram positive microorganism (for example MRSA)

· Do NOT use vancomycin for treatment in response to a single blood culture positive for coagulase negative staph, if other cultures taken during the same period are negative.

· Do NOT continue empiric vancomycin beyond 72 hours for presumed infections when cultures are negative for beta-lactam-resistant gram-positive microorganisms. 

SFMC is compliant with national vancomycin use guidelines 72% of the time. 

SFMC’s goal is to achieve greater than 90% compliance. 

ADE (Adverse Drug Event) Hotline: 655-6805