P H A R M A G R A M

...a memo from your Pharmacy and Therapeutics Committee

September, 2006

Formulary Additions:

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

v Ropivacaine (Naropin®) for use in the OnQ Pump® for femoral nerve block in place of bupivacaine. Potential advantage may be less cardiac side effects and shorter duration of action.

v Pregabalin (Lyrica®) for chronic neuropathic pain, neuralgia, and seizures. Possible side effects include peripheral edema, dizziness, somnolence, ataxia and blurred vision.

v Copper sulfate 2mg tablets for replacement of trace elements in patient receiving long term total parenteral nutrition.

Formulary Deletions:

The following products were deleted from the Formulary due to discontinuation from the manufacturer or low usage: pancrease (Pancrelipase®), Pork insulins, dihyrotachysterol (DHT) tablets and liquid, and tranylcypromine (Parnate®).

Autosubstitutions Approved:

Valacyclovir (Valtrex®) and famicyclovir (Famvir®) may be substituted to an equivalent dose of acyclovir (Zovirax®). In addition, ampicillin oral capsules may be substituted to an equivalent three times a day dosage of amoxicillin oral capsules.

Interactions with the Oral Use of Levofloxacin (Levaquin®):

Although levofloxacin is nearly 100% absorbed orally, significant (up to 80%) reductions can result when this drug is taken with iron, magnesium, or aluminum containing products. Antacids, especially sucralfate (Carafate®) and multivitamins contain these elements and are frequently overlooked. If these interacting drugs cannot be stopped, it is recommended that at least 2 hours separate the administration of levofloxacin and the interacting drug.

Express Infusion Rates as Weight Not Volume per Time:

To avoid errors when ordering an intravenous drug infusion, do not use volume per time since the drug concentrations can change or not be the one being considered by the prescriber. Examples of appropriate drug infusion orders are mg/hr, mcg/kg/min, mcg/min, etc. Do not use mls/min or mls/hr.

Etomidate Added to Blue Alert Carts:

Etomidate for emergency sedation has been added to the Blue Alert Carts throughout the hospital.

ADE (Adverse Drug Event) Hotline: 655-6805

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