P H A R M A G R A M

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

December, 2005

Ceftazidime (Fortaz®, Tazicef®) IV Push:

On June 21, the administration of cefazolin 1gm was changed for adults from a 30 minute infusion to a 3 to 5 minute push.  This change resulted in significant savings in cost, equipment, and supplies with no adverse events being reported.  Beginning in January, all doses of ceftazidime will also switch over to being given intravenously as a 3-5 minute push after diluting with 10ml normal saline.

Influenza Vaccine is Available:

Although there was a delay in delivery of influenza vaccine, all of the purchase orders have been received.  There are now plenty of adult and pediatric doses available for health care providers and other persons needing the vaccine.

Drug Formulary Decisions by the P&T Committee:

Additions: Cefdinir (Omnicef®) suspension: This cephalosporin antibiotic provides a more palatable alternative for children compared to cefuroxime (Ceftin®) suspension. Possible side effects of cefdinir are similar to other antibiotics in this class.

Fondaparinux (Arixtra®), a Factor Xa inhibitor, was approved for use by orthopedic service. Enoxaparin

(Lovenox®), which is at least as effective as this drug for non-orthopedic uses will continue to be available. Bleeding is the most significant potential side effect with fondaparinux.

Autosubstitutions: Diphenhydramine (Benadryl®) 2% cream will be substituted for 1% cream.

Deletions: Penicillamine (Cuprimine®) and Peruvian Balsam are not used.

Denials: Tigecycline (Tygacil®) and Daptomycin (Cubicin®): In order to assure appropriate prescribing of these antibiotics, non-formulary prescribing procedures must be followed if either drug is desired.

FDA Alert: Falsely Elevated Glucose Readings with Glucose Meters:

People who have received parenteral products containing maltose or galactose, or oral xylose, and are tested using glucose dehydrogenase pyrroloquinolinequinone based meters may note a false elevation of glucose and suffer life-threatening consequences resulting from the administration of ‘rescue’ insulin dose. Products that can cause this false reading include: Octagam® 5%, Gamimune N ® 5% WinRho SDF Liquid® (Immune Globulins), Vaccinia Immune Globulin (Human), D-Xylose, and icodestrin peritoneal dialysis solution (Extraneal®).

ADE (Adverse Drug Event) Hotline: 655-6805