P
H A R M A G R A M 
...an educational memo from your Pharmacy and Therapeutics
Committee
March, 2007
Formulary Additions:
Daptomycin (Cubicin®) is a cyclic lipopeptide antibiotic with a spectrum of
activity limited to gram-positive organisms, including
glycopeptide-intermediately susceptible Staphylococcus aureus,
methicillin-resistant staphylococci, penicillin-resistant Streptococcus
pneumoniae, and vancomycin-resistant Enterococcus.
Because of poor tissue
distribution, daptomycin is not indicated for
pulmonary infections. Common side effects include anemia, diarrhea, vomiting
and constipation. Muscle weakness and creatine kinase elevations are dose-related. Dose reduction is required with renal
impairment.
Simvastatin (Zocor®) is a HMG-CoA reductase inhibitor used in the
treatment of hyperlipidemia. Factors considered in approval of this drug are
frequency of use, safety considerations, and recent availability of less costly
generic equivalent products.
NeoCare®, a nutritional supplement for neonatal infants, was
approved.
Tobramycin nebulized
solution (TOBI®) was approved for use
in treating pulmonary infections in patients with cystic fibrosis. Side effects
associated with this product include voice alterations, tinnitus and serum creatinine
elevations.
Cellulose Ophthalmic drops
(Genteal®) is an ophthalmic solution
with special indications in the neonatal patient.
Drug Procedure or Policy Changes:
Dexmedetomidine (Precedex®) administration is now allowed in the
Post Anesthesia Recovery unit.
Dornase alpha (Pulmozyme®), a mucolytic indicated for treating
patients with cystic fibrosis, will have an automatic 48 hour discontinuation
if ordered for non-cystic fibrosis indications.
Formulary
Deletions and Denials:
Ethanolamine
(Ethamolin®) and sodium morrhuate (Scleromate®), two
sclerosing agents, were removed from the Formulary. Sodium tetradecyl sulfate
(Sotradecol®) is currently the agent of choice.
Alfuzosin
(Uroxatral®) is a selective alpha blocker indicated for functional symptoms of
benign prostatic hypertrophy. No advantage was identified with this agent
compared to the current formulary drug, tamsulosin (Flomax®). An
autosubstitution of alfuzosin to tamsulosin was approved by the Pharmacy and
Therapeutics Committee.
Pharmacy Website:
A new Pharmacy Website (Portal) was launched in February. This
site is accessible through the OSF Intranet, under ‘Committees, Departments and
Nursing Units,’ and then click on ‘Pharmacy.’
Among numerous pharmacy-related items on this website, the Medical
Center Formulary and a complete list of Autosubstitutions. Thank you to Sandy
Salverson, PharmD and Mimi Garrett for facilitating this project.
Drug Information Service – 655-2382
(Mon-Fri;