Pharmacy Updates

Critical Drug Shortage Update

by kimbra on June 13, 2012

Below are AAMC’s critical drug shortages as of June 11:

1. Furosemide IV: This shortage affects all sizes. It is recommended to use IV bumetanide if needed or oral/liquid furosemide. Currently, only a few days’ supply remain on hand with no supply available at the wholesaler and manufacturer level.

2. Morphine and hydromorphone PCA: Supply is still limited; please conserve.

3. Medications out of stock include atracurium, chloroprocaine 2%, etomidate, lidocaine PF 1.5%, methyldopa IV, pancuronium, phentolamine, prochlorperazine IV, secretin, and Bactrim IV.

4. Resolved: Bumetanide (Bumex) IV and chloroprocaine 3%.

Questions, please contact Jared S. Calish, PharmD; pharmacy clinical coordinator, at jcalish@aahs.org.

Click here for a list of all shortages

April Medication Shortage Update

by medstaff on April 30, 2012

For more information, please click here.

Physical Therapy Treatment During Hemodialysis (HD)

by medstaff on April 10, 2012

The physical therapy department at AAMC recognizes that many dialysis patients are unable to participate in physical therapy due to a medical or scheduling conflict. Studies have shown that resistance training and aerobic exercise during HD is safe and can improve the efficacy of HD, improve physical function, improve lower extremity strength, and decrease boredom.

The physical therapy department at AAMC has developed a standardized exercise program for patients receiving hemodialysis, which combines aerobic and strength training and will be provided while patients are receiving dialysis. The program will be performed in the HD unit or during bedside dialysis while the patient is monitored for hemodynamic stability. The extremity with the dialysis graft is kept immobile during exercise. Exercise will only be provided within the first two hours of the start of HD.

We are very excited to be providing this service to our dialysis patients! Our goal is to improve functional mobility in a safe, controlled environment. If you have any questions or concerns, please contact Lauren Davis, DPT, Kamila Frederick, MPT or Jennifer Gurka, MPT at 443-481-4100.

NEW: Chlorhexidine gluconate (CHG) cloths available only on CCU, SCU, MSU3 and L&D

by medstaff on March 23, 2012

Chlorhexidine gluconate (CHG) 2% antimicrobial prep cloths

are used at AAMC for daily decolonization of the body in CCU, SCU and MSU3, and for an additional prepping of the Csection patients in L&D prior to going to the OR; some of our other surgical patients use them prior to being admitted for surgery.   While extremely effective in reducing the microbial density of bacteria, these cloths are only to be used in these areas for these purposes.

Only staff in the above areas have been trained on the use of these cloths, which includes learning certain safety precautions in application. Also, the cloths are placed in a warmer designed only for these type of cloths, have a specific expiration timing, and may not be microwaved.  I have recently heard a handful of reports of physicians ordering the use of the CHG cloths in areas not listed above and untrained persons obtaining cloths/ using microwaves in lieu of the warmers not available to them, both of which may carry potential safety issues  to the patient.   Policies regarding the use of CHG cloths include IC5.1.08  CHG decolonization bath, SNP15.2.05 Circulating for Cesarean delivery, and SNP 15.2.051 CHG cloths used for skin prep prior to Cesarean section surgery.

 

I have asked the central storage room/ Materiel Management to continue to restrict release of the CHG cloths to areas that are not part of this plan. Nursing staff have been told that they may not accommodate orders for the use of CHG cloths in areas other than CCU, SCU, MSU3, and L&D.   We will continue to monitor for the need to expand this program, but for now the use of them is restricted to certain areas/purposes.

 

Thanks for the help. For questions, please contact:  Anne R. Van Waes, RN, MS, CIC; Director,  Infection Control; Anne Arundel Medical Center; 443-481-1591. (posted 3/21/12)

NEW – Medication Shortage Update – March 2012

by medstaff on March 23, 2012

Attached are updates on many medication shortages that AAMC is currently facing. Click Here. Please note a few of the highlights listed below.  Please forward this to colleagues within your group/service as well.  If there are any questions please do not hesitate to contact me.  Thank you.

Key urgent issues:

  1. MVI Injection – limited to initial order only, pharmacist with help by contacting prescriber to alert them of change.  All existing orders will need to be adjusted as well.    These will go into effect 3/20/12.
  2. Pantoprazole – all patients will be switched back from esomeprazole to pantoprazole IV effective 3/20/12 afternoon.  We have enough IV pantoprazole for this.  Vigilance still needs on appropriateness for GI prophylaxis use.  Alternative alert will be modified effective 3/20/12 in the afternoon to reflect this.  Pantoprazole drips will be restricted to 72 hours.
  3. Etomidate – restricted to pediatrics use currently; already pulled from all adult code carts.
  4. Metoclopramide – alternative alert goes into effect 3/20/12 in the afternoon alerting prescribers to select alternative antiemetic.

Again please read through attached bulletin – this will be sent to all medical and nursing staff as well.

Jared S. Calish, PharmD; Pharmacy Clinical Coordinator; Anne Arundel Medical Center;

jcalish@aahs.org; (O) 443-481-4833; (F) 443-481-4842

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