P H A R M A G R A M

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

December 2006

Drug Formulary Decisions by the P&T Committee:

Additions:

Colesevelam (Welchol®) is a bile acid sequestrant indicated as an adjunct to diet and exercise for reducing elevated low-density-lipoprotein cholesterol (LDL-C) in patients with primary hypercholesterolemia. Common side effects include constipation and dyspepsia.

Levetiracetam (Keppra®) IV is the parenteral formulation approved for use in patients who unable to take the oral levetiracetam. For equivalent doses, the area under the curve (i.e. serum levels) are equivalent between the oral and intravenous formulations. Adverse effects include agitation, aggression, somnolence, headache, vomiting, anorexia and muscle weakness.

Rectal sodium phosphate (Fleets ® enema) is now a pharmacy item and has been added to the Pyxis dispensing machines on two pediatric units. Be aware this product is contraindicated in children less than two years old.

Autosubstitutions:

Zolpidem controlled-release (Ambien CR) will be substituted to regular-release zolpidem (Ambien®). Based on a similar serum drug level profile and no identifiable clinical advantage, the controlled-release zolpidem 6.25mg will be converted to zolpidem regular-release 5mg tablets.

Deletions:

Triamcinolone 4mg tablets and Urea Hydrophilic cream were discontinued by the manufacturer.

Medications Banned from the Hospital:

The following drug products are not approved for in-patient use:

Herbal or Nutritional Supplements – not regulated by the FDA, content not monitored, health claims generally not substantiated.

Alendronate (Fosamax®), risedronate (Actonel®) – associated with esophagitis and ulcers. Must be taken in an upright position with 8oz of water.

Pramlinitide (Symlin®), exenatide (Byetta®) - risk of severe hypoglycemia in the acute care setting.

PEMINIC Goes Housewide:

OSF Saint Francis Medical Center and its off-campus sites are implementing a new web-based occurrence reporting tool called Peminic. This tool will replace the paper documentation that is currently used for occurrence reports. This system will allow managers and administration to receive immediate notification of events, as well as track and trend occurrences for effective resolution and prevention. You may access Peminic from the intranet home page under the “Applications” heading.

Consolidation of Recombinant Factor VIII Products:

Due to safety, cost and current utilization, the Pharmacy will be substituting the newer Kogenate® FS recombinant Factor VIII product for all orders of Recombinate ®.

ADE (Adverse Drug Event) Hotline: 655-6805

Drug Information Service: 655-2382 (Monday-Friday 0800-1530)