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Following is a P and T Committee update (from the August 22nd meeting). Starting date for specific programs is 29 August 2017, unless otherwise noted. Please let me know if you have any questions or comments. Don’t forget to check the “New Drug Monitoring Spotlight” section of the website, which provides important monitoring information about newly approved drugs. Also, attached is the updated version of the “Not Stocked, Not Ordered” drug list with the new additions highlighted in red.
Below is the memo with links to the drug monographs, protocols, and formulary documents. Click to access the full P&T packet for this month, or here to access the P&T packet archive.
|
Drug or Drug Class |
Formulary Decision |
Comments |
| pecanatide (Trulance) |
Formulary, Restricted
|
Pecanatide will be restricted to no substitution orders and not routinely stocked. Pecanatide may be used for enteral administration (may be crushed). Orders for pecanatide will be automatically interchanged to linaCLOtide (Linzess). |
| valbenazine (Ingrezza) | Non-Formulary | Inpatients may use own supply. Initiation should be deferred until after discharge. |
| urea (Ure-Na) |
Formulary
|
Medical food used for the treatment of hyponatremia. Due to safety concerns related to the potential rapid correction of serum sodium in patients with profound hyponatremia, pharmacists will monitor serum sodium levels after initiation and dosage increases (follow tolvapatan monitoring protocols). |
| oxyCODONE (RoxyBond) |
Non-Formulary
|
RoxyBond is an anti-abuse formulation. Automatic interchange to oxyCODONE IR. |
| montelukast (Singulair) granules |
Non-Formulary
|
Interchange to montelukast chewable tablet at the same dosing interval. |
| polysaccharide-iron complex (NovaFerrum) Iron Supplements and Multivitamins |
Iron Supplement – Formulary,
|
NovaFerrum liquid iron will be formulary, restricted to pediatric patients due to superior taste compared to other iron supplements. All other NovaFerrum products are non-formulary. |
| calcifediol (Rayaldee) |
Non-Formulary
|
Calcifediol (Rayaldee) 30 mcg will be automatically interchanged to calcitriol 0.25 mcg at the same dosing interval. |
| Influenza Vaccine Update 2017-2018 Flu Season | No Change from 2016-2017 |
Formulary Workhorse – Fluzone
|
| Infusion Reaction Order Set (Inpatient) Update | Updates Approved |
Treatment, monitoring, and notification processes for infusion related an anaphylaxis reactions updated. Pending final review from other institutional committees. |
| Procalcitonin (PCT) Monitoring / MOSES Trial | Informational | PCT levels may predict survival of patients diagnosed with sepsis and septic shock; however the study did not provide insight for additional interventions in this patient population to improve survival. |
| Nephrotoxic Injury Negated by Just-in-time Action (NINJA) Project Update – Pediatrics | Patient Care Guideline Approved | Pharmacists covering pediatric floor and pediatric ICU will review electronic screening tool to identify patients receiving multiple nephrotoxic medications. Serum creatinine monitoring at least every 48 hours will be recommended. |
| Phosphate Bolus – Adult Electrolyte Protocol MUE | Informational | A review phosphate repletion after protocol change showed a decrease in patients achieving normal phosphate levels after bolus (51.1%) compared to previous protocol (71.6%). |
| Adult Electrolyte Protocol – Phosphorus Update | Updates Approved | For adult patients < 40 kg, pharmacist may select alternative dosing. To address decreased effectiveness of phosphate repletion protocols, the infusion times were extended for all standard doses: 15 mMol (4 hrs), 30 mMol (6 hrs), and 45 mMol (8 hrs). |
| Adult Standard Concentrations Update | Updates Approved |
Added: Aminocaproic acid, clevidipine, glucagon, isoproterenol, ketamine, & propofol. Updated: cisatracurium, furosemide, |