Approved Hospital Formulary
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Approved Hospital Formulary
9/1/21 dh Sodium Phosphate Injection
September 2, 2021
From: "Donna Huggins" <donna.huggins@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>, "PharmTechs PSP" <psp.pharmtechs@hhsys.org>
Sent: Wednesday, September 1, 2021 9:13:20 AM
Subject: Re: Sodium Phosphate injection
Good morning,
Thank you,
Donna Huggins, RPh.
Manager - Pharmacy Sterile Products
Huntsville Hospital
Office - 256-265-6293
Cell - 662-871-2513
donna.huggins@hhsys.org
Manager - Pharmacy Sterile Products
Huntsville Hospital
Office - 256-265-6293
Cell - 662-871-2513
donna.huggins@hhsys.org
From: "Donna Huggins" <donna.huggins@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>, "PharmTechs PSP" <psp.pharmtechs@hhsys.org>
Sent: Thursday, August 26, 2021 12:17:27 PM
Subject: Sodium Phosphate injection
2 packets Neutra-Phos q 6 hr x 4 doses = 32 mmol absorbed phosphorus
2 packets Neutra-Phos q 6 hr or q 8 hr x 3 doses = 24 mmol absorbed phosphorus
2 packets Neutra-Phos q 6 hr or q 8 hr x 2 doses = 16 mmol absorbed phosphorus
To: "Pharmacists" <grp_allpharm@hhsys.org>, "PharmTechs PSP" <psp.pharmtechs@hhsys.org>
Sent: Thursday, August 26, 2021 12:17:27 PM
Subject: Sodium Phosphate injection
Sodium Phosphate injection is now on backorder and our supply is currently very limited (less than 2 weeks). We are currently utilizing 6 vials per day for TPN preparation and 25 vials per day for sodium phosphate boluses.
We need to expedite the following conservation measures.
- Remove sodium phosphate from all adult TPNs in order to preserve our supply for neonatal patients. Utilize potassium phosphate instead, where appropriate (evaluate serum K, renal function).
- In patients with a normal serum potassium, requiring phosphate repletion, utilize IV POTASSIUM phosphate instead. If the patient has a CRITICALLY low phosphate level and cannot tolerate the potassium salt, whether due to existing hyperkalemia or a combination of potassium level and renal dysfunction, you may consider using sodium phosphate.
- If patient is able to tolerate NG or PO route, NeutraPhos packets should be selected:
2 packets Neutra-Phos q 6 hr x 4 doses = 32 mmol absorbed phosphorus
2 packets Neutra-Phos q 6 hr or q 8 hr x 3 doses = 24 mmol absorbed phosphorus
2 packets Neutra-Phos q 6 hr or q 8 hr x 2 doses = 16 mmol absorbed phosphorus
- If using POTASSIUM Phosphate, watch for additional Potassium CHLORIDE boluses . Patient likely will not need both POTASSIUM phosphate and potassium CHLORIDE.
* 45 mmol Potassium Phosphate = 66 mEq Potassium
* 30 mmol Potassium Phosphate = 44 mEq Potassium
* 15 mmol Potassium Phosphate = 22 mEq Potassium
* 30 mmol Potassium Phosphate = 44 mEq Potassium
* 15 mmol Potassium Phosphate = 22 mEq Potassium
Thank you,