P H A R M A G R A M

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

April, 2006

Formulary Additions:

The drugs have been approved to the Formulary by the Pharmacy and Therapeutics Committee:

v Tetanus toxoid, diphtheria and acellular pertussis vaccines. Boostrix® for ages 11-18 years old and Adacel® for ages 11-64 years old. These unique combination vaccines are effective in extending immunization against pertussis and will likely be recommended by the CDC for adults. Adverse effects include injection site pain and fever.

v Tiotropium (Spiriva®) – a long acting anticholinergic used in the treatment of chronic obstructive pulmonary disease (COPD) and asthma. Side effects associated with tiotropium include dry mouth, constipation, increased heart rate, blurred vision, glaucoma, urinary difficulty, and urinary retention. Advantage over ipratropium includes once daily administration and reduced cost.

v Formoterol (Foradil®) – a long acting beta-2 adrenergic agonist indicated for COPD and asthma. Although indicated for chronic respiratory management, formoterol has a faster onset and the 6-day package is less expensive than the available salmeterol inhaler. The side effects of formoterol are similar to salmeterol.

Auto-Substitutions Approved:

The following autosubstitution were approved by the Pharmacy and Therapeutics Committee:

v Formoterol (Foradil®) inhaler for salmeterol (Serevent®) inhaler.

v Calcium glucobionate liquid for calcium gluconate tablets

v Cefoxitin (Mefoxin®) for cefotetan (Cefotan®). Cefotetan is no longer available. The previous autosubstitution to cefazolin and metronidazole (Flagyl®) was used because of the availability problems associated with cefoxitin. The cefoxitin shortage has now resolved. The dose equivalency is the following: cefotetan 1gm IV every 12hrs will convert to cefoxitin 1gm IV every 6 hours; cefotetan 2gm IV every 12 hours will sub to cefoxitin 2gm IV every 6 hours.

Formulary Deletions:

The following products have been removed from the Formulary due to very low usage or product unavailability:

v Metaproterenol (Alupent®) inhaler, tablets and liquid

v Cafergot (ergotamine and caffeine) tablets and suppositories

v Calcium gluconate tablets

ADE (Adverse Drug Event) Hotline: 655-6805

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