From: Kristin Flanagan
To: Pharmacists
Sent: Tuesday, February 13, 2018 12:39:55 PM
Subject: IV to PO Narcotics
Attachment: IV to PO Narcotics 2018

Hello Pharmacists,

Due to the nature of our CRITICAL narcotic shortage, we want to inform everyone of a new Sentri 7 rule. The P&T Committee has granted pharmacy the ability to convert IV opioids to PO under the current IV-to-PO policy. The Morphine IV-to-PO, Dilaudid IV-to-PO, and Fentanyl IV-to-PO rule will be implemented starting February 15^th.

* What you need to know:

1. This rule will be located under the Pain tab in Sentri 7.

2. Adult patients that are prescribed an intravenous opioid without a PO opioid option who are tolerating diet and other PO medications, should be evaluated for IV-to-PO conversion per current HH policy (see Quick Reference Guide). The following patients are not eligible for PO conversion.

   • Pediatrics

   • Cancer

   • Comfort measures

   • Strict NPO

   • GI bleed

   • Active medication orders for Percocet or Norco

* Please see attachment for step-by-step conversions.
* Please inform and collaborate with nursing for these route changes.
* Further education will be provided in this month’s staff meetings.
* When both IV and PO PRN opioid options are available, please continue to encourage nursing to PICK the PO route.

Please let me know if you have any questions.

Thanks,

Kristin Flanagan, Pharm.D.
PGY1 Pharmacy Resident