P H A R M A G R A M    

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

 February, 2005

Formulary Deletions, Denials and Additions:

The following Drug Formulary deletions and denials were based on utilization and lack of need in an acute care facility. The use of a home medication supply is an option for those patients who are receiving chronic medication which should not be interrupted: 

Ø      Deletions: Tocainide (Tonocard®), Sulfasalazine (Azulfidine®) regular and enteric coated tablets, Ticlopidine (Ticlid®),and Yohimbine.

Ø      Denials: Thalidomide (Thalomid®, Natalizumab (Tysabri®), Interferon beta-1a (Avonex® and Rebif®), Interferon beta-1b (Beta-Seron®)

Ø      Addition: Glatiramer (Copaxone®): Glatiramer is administered as daily subcutaneous injections and is used to decrease the frequency of relapses in the treatment of relapsing/remitting Multiple Sclerosis. The majority of adverse reactions reported with Glatiramer are local reactions and include irritation, erythema, itching, induration and soreness at the site of injection.

Look-Alike/Sound-Alike Drugs:

With so many generic and trade names and manufacturers, it is almost inevitable to have two or more products with similar sounding names or that may look alike. Because of the frequency of mistakes related to this drug confusion and the unfortunate outcomes, the Joint Commission requires policies and procedures to prevent this type of medication error (ex. use TALLman lettering, purchase product lines that look differently, etc). Some things that prescribers can do to help in this effort are the following:

ü      Maintain awareness of Look-Alike/Sound-Alike Drugs

ü      Clearly specify dosage form, drug strength and complete directions

ü      Consider writing generic and trade names for drugs known to be problematic

ü      Include indication or purpose for the medication with the drug order

ü      Alert patients to potential mix-ups. Advise ambulatory patients to insist on pharmacy counseling when picking up their prescriptions

ü      Encourage in-patients to question any unfamiliar medication

ü      Only use telephone orders when necessary and wait for a ‘Read-Back’ to be sure your orders were interpreted correctly.

Drug Names that Look and Sound Alike:

Here are a few examples of drug names that look or sound alike.

 Adderall – Inderal        Benazepril – Benadryl             Cefoxitin – Cefotaxime            Delsym – Desyrel

Elmiron – Imuran        Fosamax – Flomax                 Glimepiride – Glipizide            Hespan – Heparin

Indocin – Imodium       K-Dur – Cardura                     Lamictal – Lamisil                   Mirapex – Miralax

Narcan – Norcuron     Os-Cal – Asacol                     Paxil – Taxol                            Quinidine – Quinine

Ritalin – Rifadin           Stadol – Sotalol                       Tiazac – Ziac                          Vytorin – Vicodin

Wycillin – Bicillin         Xanax - Zantac

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ADE (Adverse Drug Event) Hotline: 655-6805

Drug Information Service – 655-2382 (Mon-Fri; 8am – 4pm)

Visit the Pharmacy Website for past issues of the PharmaGram: http://library.osfhealthcare.org/druginfo.asp