July2007pharmagram

Phenylephrine (Neosynephrine®) Infusion Concentration Change:

Phenylephrine infusions are now available in a concentration of 0.3mg/ml (30mg in 100ml NS or 150mg in 500ml NS). The size of the IV bags will help differentiate this drug from norepinephrine (Levophed®) which is 4mg in 250ml.

Formulary Denials:

Insulin detemir (Levemir®)) was denied Formulary addition. Another long-acting insulin, insulin glargine (Lantus®) is currently on Formulary and is part of the new Basal/Bolus protocol.

‘Inhaled’ insulin (Exubera®) use will not be allowed within the hospital. Potential errors in administration and the inappropriateness of this dosage form for acutely ill patients were some of the reasons for this decision.

Formulary Approvals:

Hydroxocobalamin (Cyanokit®) for cyanide overdose was approved for adults as a safer and easier to administer alternative as compared to the Cyanide Antidote Kit® which contains sodium nitrite and sodium thiosulfate.

Crotalidae Polyvalent Immune Fab (CroFab®), which is used for venomous snake bits, will now be available on Formulary.

Formulary Deletions:

Methazolamide (Neptazane®, amprenavir (Agenerase®), granisetron (Kytril®) and ergoloid (Hydergine®) were deleted from the Formulary due to very low or discontinued by the manufacturer.

Approval Autosubstitution:

Ondansetron (Zofran®) will be substituted for granisetron (Kytril®) orders in adult patients.

Acetaminophen Maximum Daily Doses

Be aware of how much acetaminophen your patients are receiving. Daily doses above 4000mg are to be avoided.

Formulary products with high acetaminophen content are:

Darvocet N-100 (650mg/tab), Vicodin 5/500 (500mg/tab) and

Lortab liquid ( 500mg/15ml)

Possible Confusion with ‘J’ Drugs

Some people may not be aware of some new drugs with trade names starting with ‘J’ and may be confusing them with one another. The drugs are Jantoven® (warfarin),

Januvia (sitagliptin), and Janumet® (sitagliptin and metformin).