P H A R M A G R A M   

...a memo from your Pharmacy and Therapeutics Committee

 

November, 2006

‘If Okay With……’ Medication Orders are Not Acceptable:

 

The Pharmacy and Therapeutics Committee recognized that errors of omission and extra work for unspecified individuals results when drug orders are written as pending approval from another individual. The Committee voted that these orders are not acceptable and will not be processed. It is the responsibility of the person writing the order to get the approval necessary.

 

Parenteral Prochlorperazine (Compazine®) is Available:

 

For about 2 years the parenteral form of prochlorperazine had been unavailable due to material shortages and production problems. During this interim period the Pharmacy and Therapeutics Committee had authorized an auto-substitution to promethazine (Phenergan®). Recent information from the Institute of Safe Medication Practice (ISMP) raises concerns about the safety of intravenous promethazine and at least one head-to-head trial showed significant antiemetic benefit of prochlorperazine over promethazine. In addition to the parenteral formulation now being available once again, prochlorperazine is available as tablets, liquid and suppositories.

 

Fleet’s ® Sodium Phosphate Rectal Solution Under Pharmacy Control:

 

Historically, Fleet’s Phosphate Enema® had been a Central Supply item and was not charted as a medication in IDX. Because of safety concerns, starting November 7th, orders for  Fleet’s Phosphate Enema (Adult and Pediatric sizes) will be processed and dispensed by the Pharmacy and available in Pyxis®. All doses will be charted as given in IDX. To avoid potential toxicity, orders will be limited to single doses and subsequent doses will require a new order.

 

Drug Formulary Additions and Deletions:

 

The following items have been approved to the Drug Formulary:

Ø      Citrasate Dialysate – for use in hemodialysis in patient who cannot receive heparin.

Ø      Dutasteride (Avodart®) – indicated in the treatment of benign prostatic hyperplasia. Similar to finasteride (Proscar®), except dutasteride inhibits a second isoform of 5-alpha-reductase. Potential side effects include decreased libido, gynecomastia and decreased prostate specific antigen (PSA) concentrations.

Ø      Sodium tetradecyl sulfate (Sotradecol®) – a sclerosing agent used in treating varicose veins and esophageal varices. Only a physician knowledgeable in the use of this product is allowed to administer to patients.

 

The following drugs have been removed from the Drug Formulary:

Ø      Saquinavir (Fortovase®) – discontinued by the manufacturer.

Ø      Mivacurium (Mivacron®) – discontinued by the manufacturer.

Ø      Reserpine – very rarely used and potential confusion with risperidone (Risperdal®).

 

 

ADE (Adverse Drug Event) Hotline: 655-6805

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