Approved Hospital Formulary
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Approved Hospital Formulary
4/15/22 je Acyclovir & Amphotericin B Updates - ADULTS
April 18, 2022
From: "Jonathan Edwards" <jonathan.edwards@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>
Sent: Friday, April 15, 2022 7:44:53 AM
Subject: Fwd: Acyclovir & Amphotericin B Updates - ADULTS
Pharmacists,
The P&T committee has recently approved an adjustment to the ordering process for acyclovir and amphotericin B in ADULT patients. When a provider orders either of these medications they will be presented with the following options:
- Acyclovir
- Optional hydration
- 1,000 mL NS to be infused at 125 mL/hr over a period of 8 hours
- Infusion will begin one hour prior to administration of acyclovir and continue until 6 hours after the acyclovir infusion is completed
- This order is not required, but will be presented to the provider at the time of order entry for their consideration
- Please make sure this order is timed appropriately in relation to the timing of the acyclovir dose
- Amphotericin B
- Optional hydration
- 500 mL NS bolus to be infused over 30 minutes
- This bolus will be scheduled before and after the dose of amphotericin B
- This order is not required, but will be presented to the provider at the time of order entry for their consideration
- Please make sure this order is timed appropriately in relation to the timing of the amphotericin B dose
- Optional pre-medications
- Acetaminophen 650 mg po and diphenhydrAMINE 25 mg IV/PO
- These medications will be schedule 30 minutes prior to the dose of amphotericin B
- This order is not required, but will be presented to the provider at the time of order entry for their consideration
- Please make sure this order is timed appropriately in relation to the timing of the amphotericin B dose
- Required laboratory tests
- BMP, magnesium, and hepatic function panel
- These tests will be ordered automatically when amphotericin B is ordered
- Please make sure these laboratory tests are ordered at some point during the verification process
These adjustments are in an effort to reduce the risk of nephrotoxicity of these agents as well as to prevent infusion related reactions with amphotericin B. Please let me know if you have any questions or if you see these orders are not behaving appropriately.
Thank you,
Jonathan