Approved Hospital Formulary
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Approved Hospital Formulary
3/28/22 js Keppra IVP- Go Live Information
March 30, 2022
From: "Jackson Spradlin" <jackson.spradlin@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>
Cc: "Nellie McKee" <nellie.mckee@hhsys.org>
Sent: Monday, March 28, 2022 1:11:12 PM
Subject: Keppra IVP - Go Live Information
Good afternoon, all.
As you probably remember, several months ago we trialed administering Keppra via IVP in 8NE. We had good success with the project and are now planning on rolling it out house-wide on Thursday, March 31. I wanted to provide some details about the change:
- All IV doses of Keppra 1 g and less (250 mg, 500 mg, 750 mg, and 1 g) will now be administered IVP administered over 1-2 minutes for adult patients. New order sentences will be created in Cerner to help guide providers to pick the IVP option. The IVPB option will still be available if for some reason they really want it, but we will treat it almost like a "No sub" scenario with IVP being the preferred option for these doses. If a provider still orders the IVPB option for these doses, we ask at verification to convert it to IVP unless explicitly marked as a "No sub" or "Do not convert" - we don't foresee this being an issue.
- The Keppra vials (500 mg/5 mL) will be loaded into Pyxis. RNs will draw up the correct volume for the dose and administer undiluted over 1-2 minutes, flushing as they do following other IVP meds. Education council has distributed an educational flyer that we created for the nurses. See attached if interested.
- Keppra 1,000 mg and 2,000 mg IV Push Once order sentences are still available for a loading dose before a maintenance regimen is started. This is the only time a dose other than the ones mentioned above could be administered via IVP.
- A good way to catch IVPB orders that might still be lingering as we go live is reviewing the Keppra IV to PO Sentri7 rule. If you notice a patient still on IVPB come 3/31 or after, evaluate switching to PO as normal. If the patient is still requiring IV therapy, consider changing the order from IVPB to IVP.
As this goes live, please let us know if there are any issues you encounter. Thanks to everyone who made this change possible!