An audit of PRN orders written at both hospitals confirmed the need to do more education with physicians and hospital staff at both institutions. JCAHO and skilled care regulations require PRN orders to have a stated indication for when the medication is to be administered. The indication is required for all orders, even if the reason seems obvious (e.g. morphine 2 mg every 3 hours PRN pain). Watch for posters and flyers to appear at both hospitals reminding all of us to write complete orders.
To prescribe Tikosyn® a physician must register at the Tikosyn® website, www.tikosyn.com. The P&T Committee continues to urge all cardiologists to register to be able to prescribe and monitor patients receiving this medication. Even if you never will prescribe Tikosyn® you need to register for when you are covering for the prescribing physician. All of the cardiologists from United Heart and Cardiologists, PC have completed, or are in the process of completing, the enrollment process allowing them to prescribe Tikosyn®.
Pamlab, the manufacturer of Diatx®, has reformulated their product to include cyanocobalamin (B12) 2 mg, copper 1.5 mg, and zinc 25 mg. The new product is called Diatx®Zn. All future orders for Diatx® will be filled with Diatx®Zn.
Retavase® was removed from the formulary earlier this year. In the last month both hospitals have had physician requests for this medication. Retavase® has been added back to the formulary for use in providing early thrombolysis when there is a delay taking the patient to the cardiac cath lab. Its status will be re-evaluated in one year.
The Pharmacy & Therapeutics Committee approved the therapeutic interchange of albuterol for levalbuterol at an equivalent dose and frequency after the patient has received 24 hours of therapy with levalbuterol and when the frequency is every 3 hours or more.
The “Medication Matters’ cards were the first step in assuring a continuity of drug therapy from when the patient is admitted through potentially 2 or 3 transfers while hospitalized until patient receives the list of medications to take after discharge. Both hospitals are working to make the process as smooth as possible and thank those physicians who have adapted to checking off which medications from home are to be continued upon admission. Remember that blanket orders such as “resume home meds’ are not acceptable. “List patient´s home meds and call to verify’ is a preferred order. Another option would be to request the patient´s primary care physician to review the list and decide which medications to continue.