P H A R M A G R A M

May, 2007 ..an educational memo from your Pharmacy and Therapeutics Committee

Formulary Additions:

Gelclair® oral gel is a commercially available product indicated for oral mucositis. This product is an alternative to the pharmacy compounded ‘BMX’ suspension.

Nifedipine immediate-release was approved as an alternative agent in the treatment of pre-term labor. This drug will be restricted to obstetric use and antepartum patient care unit.

Cinacalcet (Sensipar®) is used to treat hypercalcemia associated with hyperparathyroidism. Nausea, vomiting and diarrhea are common side effects with the use of this drug.

Nisoldipine (Sular®) is a calcium channel blocker indicated for the treatment of hypertension and stable angina. Although not commonly prescribed, several patients per month are admitted on this drug.

Xenaderm®, ointment, which is a combination of Balsam Peru, castor oil and trypsin, is indicated for decubitus ulcers that do not respond adequately to current Formulary agents.

Formulary Denial:

Nicardipine tablets (Cardene®, Cardene SR®)  was denied Formulary addition due to anticipated low use and the oral agent is not generally used after IV nicardipine therapy.

Approved Autosubstitutions:

Lovastatin ER (Altoprev®) may be substituted to an equivalent dose of pravastatin (Pravachol®) by the pharmacist.

Formulary Deletions:

Tegaserod (Zelnorm®) was recalled by the manufacturer due to cardiovascular events.

Pergolide (Permax®) was withdrawn by the manufacturer due to an association with vascular heart disease.

Granulex ® spray has had no use in the past year.

ICU Insulin Infusion Therapy

The P&T Committee approved the ICU Insulin Infusion Protocol pre-printed orders which has a target blood glucose of 80-120mg/dl (Form#642-0009). This protocol is restricted to the adult ICUs.

Renal Adjustments for Drug Dosing

The Cockcroft-Gault estimation of creatinine clearance is currently the preferred method to adjust dosing of renally eliminated drugs.  The modification of diet in renal disease calculation (MDRD) estimates glomerular filtration rate, and does not allows yield the same result.

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