P H A R M A G R A M

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

Cephalosporin Formulary Changes:

Due to antibiotic sensitivities, patient/physician preferences and past utilization, the following cephalosporin formulary changes were approved by the P&T Committee.

o Cefazolin (Ancef®), ceftriaxone (Rocephin®) and cephalexin (Keflex®) will remain on Formulary

o Delete Cefuroxime (Ceftin, Zinacef®). IV cefuroxime will be substituted to cefotaxime (Claforan®). PO cefuroxime will be substituted to cefdinir (Omnicef®)

o Delete cefaclor (Ceclor®) and ceftibutin (Cedax®). Ceftibutin will be substituted to cefdinir (Omnicef®)

o Restrict ceftazidime (Tazidime®) to adult and pediatric cystic fibrosis patients (as per pre-printed orders). All other ceftazidime orders will be substituted to cefepime (Maxipime®)

o Add Cefpodoxime (Vantin®) for gonococcal infections (approved at last meeting)

o Add Cefprozil (Cefzil®) oral suspension to avoid diarrhea when high dose cefdinir is used.

ADE Hotline Discontinued:

The ADE Hotline is no longer available for reporting adverse drug reactions. Please use the PEMINIC system which can be accessed through the SFMC Homepage. The PEMINIC system is also used for occurrence reports and ‘near misses.’

Drug Shortages:

Parenteral atropine, labetolol, neostigmine and calcium chloride are in short supply nationally. The pharmacy is monitoring this situation closely and will make adjustments and further announcements if they become necessary.

Pharmacy Website for SFMC Clinicans

A new SFMC portal has been created that provides drug information dedicated to nurses, physicians and other clinicians. By choosing ‘Guide to Medication use for SFMC Clinicians’ from the SFMC Homepage, you will have access to the Formulary, Autosubstitutions, Look-Alike/Sound-Alike drugs, Non-Formulary Request form, IV Drug Administration Guidelines (Drug Matrix) and other Medication Guidelines.

Intravenous Drug Administration Guidelines (Drug Matrix):

The IV Drug Administration Guidelines, also known as the Drug Matrix, has recently been reformatted. This reference provides a quick guide to approved use of parenteral drugs on each patient care unit. The new version has links to the Hospital Policy and clearly identifies those drugs that are ‘high risk.’ Access to this reference can be made through the Guide to Medication use for SFMC Clinicians portal.

Concentrated 3% SodiumChloride Infusions Policy:

Too rapid or prolonged infusion of 3% sodium chloride can lead to life-threatening hypernatremia. IV site necrosis and extravagation are also possible. This infusion will now be prohibited from use on general care units with the exception of Neurology (3500) and Oncology (1700), and will need to be re-ordered after 48 hours.

Formulary Deletion:

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Trinsicon®, a combination iron supplement, was deleted from the formulary due to low use.