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Vancomycin Dosing Service The Committee approved a new vancomycin pharmacy dosing-service. This service will be piloted at University with plans for expansion at the suburban hospitals. The dosing service may be ordered by writing "vancomycin dosing per pharmacy". Darbepoetin Epoetin + Ferrous Sulfate The Committee approved a policy that pharmacists may automatically start multivitamin, ferrous sulfate, and docusate upon order of epoetin or darbepoetin. If the patient is on dialysis, the pharmacist may start a renal vitamin. For patients who cannot take oral, the pharmacist will consult with the ordering physician. The pharmacist will also monitor ferritin levels. SALAD List The Committee approved the addition of 6 more groupings to be added to the Soundalike Look-alike list. These drugs have been associated with medication errors at MHMH. Please write clearly when prescribing: Percocet oxycodone acetaminophen ; Lortab hydrocodone acetaminophen ; Apresoline hydralazine ; Atarax hydroxyzine ; Catapres clonidine ; Klonopin clonazepam ; Xaax alprazolam ; Ativan lorazepam ; Intropin dopamine ; Dobutrex dobutamine ; Antibiograms 2006 antibiograms are ready. They can be accessed at MethodistMD : Clinical Care: Pharmacy &Therapeutics. Orthopedic Warfarin Protocol The orthopedic warfarin protocol will be transitioned to a pharmacy warfarin dosing service. This transition will allow for individualized dosing based on applicable disease states, drugdrug interactions, patient age, drug-food interactions, INR response, and other significant past medical history.

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Class: non-nucleoside analog also called non-nucleoside reverse transcriptase inhibitor, NNRTI or non-nuke ; Standard dose: Two 200 mg tablets or four 100 mg tablets three times a day. Only the 100 mg tablets can be dissolved in liquid, however avoid grapefruit juice; no food restrictions may be taken with or without food ; . Take missed dose as soon as possible, but do not double up on your next dose. AWP: $316.35 month for 200 mg Manufacturer contact: Agouron Pharmaceuticals, a Pfizer company, pfizer , 1 888 ; 7776637 AIDS Treatment Information Service: 1 800 ; HIV0440 4480440 ; Potential side effects and toxicity: Most common side effects include headache, nausea, vomiting, diarrhea, fatigue, elevated liver enzymes, itchy skin or rash. A serious side effect of the NNRTI class is rash, which can be life-threatening. Most rashes occur within the first 1-3 weeks after starting Rescriptor. If you experience blistering, mouth lesions, conjunctivitis redness or inflammation of eye, which if untreated may result in permanent vision loss ; , swelling, muscle or joint aches, fever or general malaise general ill feeling ; , stop taking Rescriptor and seek immediate medical attention. Body fat accumulation or redistribution may occur. Potential drug interactions: You cannot take the following medications with Rescriptor: Versed midazolam ; , Halcion triazolam ; and Xqnax alprazolam ; , pimozide a psychiatric medication ; , ergot alkaloids Wigraine, Methergine, and Cafergot ; in any form--serious interactions are seen with dilation during gynecological exams vasospasm, a spasm of a blood vessel; or ischemia, a poor blood supply due to obstructed circulation ; . Do not use Zocor simvastatin ; or Mevacor lovastatin ; cholesterol lipid ; lowering meds; suggested alternatives are Lipitor atorvastatin ; , Lescol fluvastatin ; , Crestor rosuvastatin ; , and Pravachol pravastatin, the one with less incidence of problems and interactions according to study data ; . Liver enzymes should be checked regularly if you are on these cholesterol meds, as they can increase risk for liver toxicity with Rescriptor. Certain amphetamines and antiarrhythmic drugs should not be used with Rescriptor, therefore inform your healthcare provider if you have a history of heart or blood pressure problems. Potential toxicity when given with Biaxin clarithromycin ; , dapsone, Mycobutin rifabutin ; , Procardia or Adalat nifedipine ; , Norvasc amlodipine ; , Plendil felodipine ; , Coumadin warfarin ; , Propulsid cisapride ; , and quinidine. Tegretol carbamazepine, an anti-seizure medication used to treat peripheral neuropathy ; , phenobarbital, Dilantin phenytoin ; , Mycobutin rifabutin ; and rifampin used to treat tuberculosis ; are drugs that decrease Rescriptor levels. Rescriptor increases levels of Agenerase, Crixivan, Fortovase, Lexiva, Invirase, Kaletra, Norvir, Reyataz, Viracept, immunosuppressants, birth control pills ethinyl estradiol ; and methadone. Cialis, Levitra, and Viagra levels are increased by Rescriptor; doses should not exceed 10 mg Cialis per 72 hours, 2.5 mg Levitra per 72 hours, or 25 mg Viagra per 48 hours. Do not take with St. John's wort, due to decreased virologic response. Tips: Research demonstrates smaller doses of Rescriptor increases blood levels of some protease inhibitors, making it unique among the NNRTIs. Videx not Videx EC ; , antacids like Tagamet, Zantac, Prilosec and Tums ; and gastric achlorhydria low stomach acid ; decreases absorption of Rescriptor, so take at least one hour apart from these drugs and take with acidic beverages such as orange or cranberry juice.
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