Approved Hospital Formulary
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Approved Hospital Formulary
05/18/18 JR -- TORADOL - multimodal pain management in order sets with elevated SCr > 1.3
From: Jerry Robinson Pharm.D.
To: Pharmacists
Sent: Friday, May 18, 2018 3:46:41 PM
Subject: TORADOL - multimodal pain management in order sets with elevated SCr > 1.3
I have submitted a request to IT to change the order sets that currently contain multimodal pain management (General surgery & colon rectal surgery) to include a SCr cut off of 1.3 with the Toradol orders. This will match the other multimodal pain management order sets that you will likely see in the next two months and the multimodal pain management that is used currently in Joint Camp patients. However, I do have to wait for the process to be approved through IT.
For now, if you are verifying orders for a patient with the Toradol ordered, please review the SCr for the patient.
If the value is above 1.3 AND there is not an order to discontinue the drug automatically, please contact the prescriber to ask for the drug to be discontinued.
We do have a Sentri7 rule that helps identify patients on Toradol with SCr > 1.7 or CrCl < 40; however, in the multimodal order sets the Toradol has a limited duration that would likely never trigger the alert.
Through active monitoring of the colon rectal surgery patient population, we have identified 3 patients in a 7 day time period that had bumps in Scr to 3. Although other factors may contribute to the rise, please continue to be observant and proactive to protect our patients.
Thanks.
Jerry Robinson, Pharm.D., BCPS
Clinical Specialist STICU/Co-Chairperson, Medication Safety Committee Department of Pharmacy Huntsville Hospital
To: Pharmacists
Sent: Friday, May 18, 2018 3:46:41 PM
Subject: TORADOL - multimodal pain management in order sets with elevated SCr > 1.3
I have submitted a request to IT to change the order sets that currently contain multimodal pain management (General surgery & colon rectal surgery) to include a SCr cut off of 1.3 with the Toradol orders. This will match the other multimodal pain management order sets that you will likely see in the next two months and the multimodal pain management that is used currently in Joint Camp patients. However, I do have to wait for the process to be approved through IT.
For now, if you are verifying orders for a patient with the Toradol ordered, please review the SCr for the patient.
If the value is above 1.3 AND there is not an order to discontinue the drug automatically, please contact the prescriber to ask for the drug to be discontinued.
We do have a Sentri7 rule that helps identify patients on Toradol with SCr > 1.7 or CrCl < 40; however, in the multimodal order sets the Toradol has a limited duration that would likely never trigger the alert.
Through active monitoring of the colon rectal surgery patient population, we have identified 3 patients in a 7 day time period that had bumps in Scr to 3. Although other factors may contribute to the rise, please continue to be observant and proactive to protect our patients.
Thanks.
Jerry Robinson, Pharm.D., BCPS
Clinical Specialist STICU/Co-Chairperson, Medication Safety Committee Department of Pharmacy Huntsville Hospital