Add Formweb to your mobile device
Following is a P and T Committee update (from the February 28th meeting). Starting date for specific programs is 6 March 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 |
|
Formulary, Restricted |
Use restricted to pediatric patients. If needed, a liquid suspension of lisinopril can be prepared until the commercially available solution can be obtained. |
|
|
budesonide nasal spray (Rhinocort Allergy)
|
Non-Formulary Automatic Interchange Approved
|
Interchange to fluticasone propionate 50 mcg nasal spray at the same dosing interval. |
|
Niacin / Niacinamide Products
|
Niacinamide: Formulary (100 mg, 500 mg) Niacin IR: Formulary (250 mg, 500 mg) Niacin ER: Formulary (250 mg, 500 mg, 750 mg)
Other Niacinamide/Niacin Formulations: Non-Formulary
Automatic Interchanges Approved |
Several niacinamide and niacin dosage strengths were classified as nonformulary. Pharmacists may dose round or divide daily ER doses to IR in BID or TID regimens to achieve similar total daily dosage with available formulary strengths.
|
|
edoxaban (Savaysa) Update
|
Formulary, Restricted
Automatic Interchange Approved
|
Edoxaban has been very low use – use restricted to orders specifying no substitution or patients taking edoxaban as a home medication when interchange to apixaban during admission is judged to be of higher risk.
Automatic interchange to apixaban was approved utilizing specified guidelines based on indication and drug interactions.
edoxaban is not routinely stocked. |
|
Non-Formulary |
Prescriber should be contacted to discuss alternative agents (ex. amiodarone, procainamide, or lidocaine)
|
|
|
Non-Formulary |
Oral oncology agent, patients may use home supply. |
|
|
Non-Formulary |
Oral oncology agent, patients may use home supply. |
|
|
|
Non-Formulary, Automatic Interchange Approved
|
Automatic interchange to ondansetron 16 mg PO or IV. |
|
|
Formulary, Restricted |
Restricted to use in neonatal patients. May be advantage in patients with PNALD and IFALD. |
|
Formulary, Restricted |
Restricted to oncology and nephrology strictly following approved criteria set. Reviewed by High Impact Committee. Criteria for use approved. |
|
|
Non-Formulary |
This drug will not be used at Huntsville Hospital, reviewed by High Impact Committee. |
|
|
Formulary, Restricted |
Use restricted to oncology in the outpatient setting. Some use in oncology outpatient setting expected, reviewed by High Impact Committee. |
|
|
Allopurinol Renal Dose Adjustment Update |
Dosing Adjustment Update Approved |
Based on newer guidelines. Will be updated in Sentri7 and Pharmacist Quick Reference Guide. |
|
Anti-Infective Renal Dose Adjustment Update |
Dosing Adjustment Updates Approved: AZTreonam, ceFAZolin, and oseltamivir |
Based on newer guidelines. Will be updated in Sentri7 and Pharmacist Quick Reference Guide. |
|
alvimopan (Entereg) Discontinuation with Bowel Movement |
Includes discontinuation of alvimopan at first bowel movement in all patients. |
|
|
Electrolyte Protocol Update - Adults
|
Protocol Addition Approved |
Allows the prescriber to select all four electrolyte repletion regimens (potassium, magnesium, calcium, and phosphorus) or any combination of the four. Updated procedures for each of the above electrolytes. Pending review from other institutional committees. Additional education to follow. |
|
Pediatric Dose Standardization Update
|
80 mg acetaminophen suppository and 6 mg oral prednisoLONE dose both added to program and approved by Pediatric Subcommittee
|
Both will improve accuracy of pediatric dosing. |
|
Pediatric Nebulization Protocol Update
|
Protocol Updates Approved by Pediatric Subcommittee |
Racemic epinephrine and dexamethasone added, and formatting simplified. |
|
Protocol Updates approved by Pediatric Subcommittee
|
Changes made to reflect recent changes in adult guidelines, including propofol. |
|
|
Daptomycin MUE |
Results reviewed by ID Subcommittee, 53% of cases did not meet approved criteria. |
Follow-up educational activities planned through AMT |
|
Pre-op Colon Surgery Antibiotic Guidelines
|
ID Subcommittee Recommended Specific Guidelines |
Recommendations were to use cefOXitin as antibiotic of choice instead of ertapenem, and use the combination of levoFLOXacin and metroNIDAZOLE if patient had serious allergy to penicillin. |
|
Oncology Subcommittee |
Informational: First Meeting held earlier in February |
Organizational and formulary issues addressed
|