Medication Special Consideration

Isuprel

• EP lab may call requesting “Large” or “Small” Isuprel bags.  Notify IV tech and verify completed bags are tubed to CSSU side 1 ASAP.

Thalidomide

• Kept in investigational drug cabinet
• Complete sign out sheet
• Follow procedure in book

Tikosyn

• Complete sign out sheet
• Kept in investigational drug cabinet
• Follow directions  in “Tikosyn” notebook for discharge supplies
• Similar to charity med process

Methacholine Challenge

• Use order set
• Technician must be directly supervised by pharmacist while preparing
• See mixing guidelines located on g-drive

Respiratory Outpatients

• Respiratory may call asking for “Colistin” or “Tobramycin” for inhalation for specific outpatients. Verify order in pyxis connect and enter/dispense to CSSU side 1.

Respiratory Meds

• Most inhaled meds are administered by respiratory services and not dispensed from pharmacy directly to the patient floor.  The major exceptions to this rule are Spiriva (caps in pyxis, inhaler requested by nursing) and Mucomyst (nebs requested by respiratory)

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Loaning Medications

• Be sure requested med is not on shortage list before allowing the loan
• Perform “Manual Pick” from Talyst to remove medication needed
• Be sure to pick the intended quanity
• Fill out “Borrow/Loan” form located under the pharmacy window
• Requesting facility should contact courier for pick-up

Specialty Processes

Investigational Meds

• Pharmacy is responsible for the storage and distribution of all investigational drugs used in the hospital. Investigational drugs used for outpatients may be stored in the Physician’s office if approved by the Pharmacy Director. Transport of the drug and all appropriate documentation will be maintained by the Physician or his designee.
• These drugs are stored in locked cabinets near the chemo hood in the main pharmacy.
• If a patient is admitted on an investigational drug from a trial initiating outside of Memorial Healthcare Systems, the pharmacist will obtain study drug and obtain pertinent information.
• Pharmacy will maintain a perpetual inventory of all investigational drugs showing receipts, issues, dates, lot numbers, theoretical balance, sponsor's name, address, phone number and pharmacist name, or as required by study protocol.
• When dispensed from the Pharmacy, the investigational drug shall be labeled with the following information:
• Product Name
• Dosage form and strength
• Patient's name
• Patient's hospital identification number
• The words "For Investigational Use"
• Investigational drugs will be issued from Pharmacy only upon a written order of the approved investigator.

Chemo

• Chemotherapy (both inpatient and outpatient) requires a double check by 2 pharmacists and 2 nurses before administration.
• Pharmacy procedure
• Accept Chemo order on “Chemotherapy” order form only (order set)
• Review order verifying dose (according patient weight/height, renal function and other appropriate lab values), frequency, infusion rate, and concentration.
• Print Chemo Safety Form
• Pharmacist Main Menu ->#100 (Custom Reports) -> # 207
• Fill in appropriate information and affix labels to sheet
• Another pharmacist will be needed for 2^nd check and sign/initial
• Technician/Pharmacist to mix chemo (Tech to be under direct supervision of pharmacist) using aseptic technique and in chemotherapy hood
• Package completed chemo in “Chemotherapy Bag” with safety sheet and call chemo certified nurse (4 east) to notify chemo is ready.