P H A R M A G R A M

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

Formulary Denial and Autosubstitution:

Eszopiclone (Lunesta®), a non-benzodiazepine hypnotic, was denied formulary addition. An autosubstitution to zolpidem (Ambien®), another similarly acting drug, was approved.

Central Venous Catheter Protocol Revised:

Specially in-serviced nurses may now initiate the Central Venous Catheter Protocol and administer alteplase (Cathflo®) according to the revisions approved by the P&T Committee.

Unapproved Abbreviations:

Although requiring a physician to re-write an order containing an unapproved abbreviation is not necessary IF the order can be read and interpreted correctly, the Joint Commission will still hold the medical center accountable when these abbreviations are used. Please avoid using the following abbreviations in all written orders and notes.

1. Abbreviated drug name (ex. MS, MSO4, MgSO4) – Write out the complete name (ex. Morphine, Magnesium)
2. “U” for units or “IU” for international units – Write out “units” or ‘international units”
3. "ug” for micrograms – Use “mcg” or micrograms                   
4. Q.D. – Use daily or q24hrs
5. Q.O.D. – Write out every other day or use every 48 hrs       
6. .5 (no leading zero) – Should be 0.5
7. 5.0 (trailing zero) – Should be 5                                               
8. SC or SQ –Use “subq” or subcutaneous

AU, AS, AD – Write out ‘both ears,’ ‘left ear,’ ‘right ear

Bisphosphonate Warning:

The FDA issued a warning in October, 2007 regarding bisphosphonates being associated with the development of atrial fibrillation. Bisphosphonates, such as alendronate (Fosamax®), ibandronate (Boniva®), zoledronic acid (Reclast®), Risedronate (Actonel®), etc., are increasingly prescribed drugs in the treatment of osteoporosis to increase bone mass and reduce fractures. The cause of this side effect is unknown and a further investigation is underway.

New Medication Safety Officers for the Medical Center and the Pharmacy Department

The FDA issued a warning in October, 2007 regarding bisphosphonates being associated with the development of atrial fibrillation. Bisphosphonates, such as alendronate (Fosamax®), ibandronate (Boniva®), zoledronic acid (Reclast®), Risedronate (Actonel®), etc., are increasingly prescribed drugs in the treatment of osteoporosis to increase bone mass and reduce fractures. The cause of this side effect is unknown and a further investigation is underway.

Sandra Salverson, PharmD, BCPS, is the new ‘macro’ Medication Safety Officer in the Department of Patient Safety. She will oversee the Medical Center’s global issues related to medications.

Karin Terry, PharmD, has taken the new position as the ‘micro’ Medication Safety Officer. Karin will regulate drug safety specifically associated with pharmacy operations.