P H A R M A G R A M                   an educational memo from your Pharmacy and Therapeutics Committee

April, 2008

NEW Therapeutic aPTT Range – Coming April 2nd:
^{A new laboratory analyzer is changing the PTT readings starting at noontime on April 2nd. For patients receiving heparin therapy, the NEW therapeutic PTT range will be 64 – 101 sec, with a critical value of 130 seconds. New pre-printed order sheets containing a heparin dosing scale are being revised.}

D / C – Discontinue OR Discharge?
The abbreviation ‘D/C’ has been confused to mean either ‘discontinue’ something or ‘discharge’ a patient. Prescribers are encouraged to avoid this abbreviation and to write out the word.

Avoid Transdermal Fentanyl (Duragesic®) Patches in Opiate-Naive Patients:
The FDA has recently reported life-threatening side effects and deaths associated with opiate overdoses when transdermal fentanyl was initiated in opiate-naive patients. This product should not be used to treat acute pain, but may be employed as an alternative to maintain pain control in patients currently being treated with other orally or parenterally administered opiate analgesics.

Content Change for ‘Paralytic’ Boxes in Critical Care Areas:
The neuromuscular blocking agents typically used for intubations in the ICUs and other critical care areas are being adjusted to accommodate current use and physician preferences. Pancuronium has been removed and dosing information has also been attached to the new boxes. The following drugs are now contained in the Paralytic Boxes:

Cisatracurium	(Nimbex®)	2 mg/ml
Rocuronium	(Zemuron®)	10 mg/ml
Succinylcholine	(Anectine®)	20 mg/ml
Vecuronium	(Norcuron®)	10 mg