Specific storage condition

Protect from light

• Amphotericin B
• Cisplatin, doxorubicin, vinblastin, vincristine, Flourouracil
• Doxycycline
• Nitroprusside solution
• Phytonadione

Refrigeration

Eye drops, ear drops

• Chloramphenicol
• Cyclopentolate
• Latanoprost (Xalatan)
• Azasite

Antibiotic

• Erythromycin, Augmentin

Tablet

• Leukeran, alkeran, ritonavir, VePesid

Injection

• Interferons: pegasys, Forteo, Rebif
• Byetta, Victoza
• Caverject, Botox, Humira, Epogen, DDAVP, Aranesp, Enbrel, Neupogen, Procrit, Sandostatin

Inhalation

• Brovana (aformoterol), calcitonin (Miacalcin) nasal spray, Pulmozyme nebulizer sol’n.

Other meds

• MUSE urethral application
• Rapamune, Regranex, Phenergan suppositories

References

• AHFS Drug Information:  general drug information in monograph format
• Facts and Comparisons:  general drug information in monograph format.
• Physician desk reference (PDR): collection of product package inserts, contains general drug information.
• United States Pharmacopeia Drug Information (USP DI) Volume III: approved drug products (generic availability) and legal requirements; Volume II: general drug information for patients in layman’s term.
• National library of medicine (NLM): daily med, database of product package inserts, contains general drug information.
• Pharmacotherapy: A Pathophysiologic Approach: a general pharmacotherapy resource.
• Red book: determine product formulations, cost and availability.
• Orange book: generic equivalency.
• Purple book: biologic product and interchangeable
• Drug Interaction Facts: detailed information on specific interactions between medications.
• Martindale: information on foreign drugs.
• Remington: The Science and Practice of Pharmacy: reference to obtain information regarding compounding.
• Harriet Lane Handbook: pediatric drug information resource.

RX drug disposal

• The best way is to put in a "take back" program or mix with unpalatable substance and placing in a non-descript container before discarding in trash, unless the prescribing info specifically states "flush down to toilet"
• Flush list: Mostly are control substance to help prevent danger to people and pets
• E.g: Actiq, Demerol, Diastat, Embeda (morphine + naltrexone)
• Review our chapter on federal law for a complete list of flush list.

Med Watch

• A voluntary program that allows any health care professional to report a serious AE, product problem, med errors with the use of a FDA regulated product.
• Manufacture must file a report to FDA if an AR reported
• Provides info on safety labeling changes to package insert.

Orphan drugs

Drugs developed in the diagnosis or treatment of rare diseases, e.g: Gaucher’ s disease is a rare disease.  Disease states that affect millions of people, such as hypertension, diabetes, would not be granted orphan drug product status.

Protected health information (PHI)

Any type of identifiable health information that pertains to a patient’ s past, present, and future medical or mental health conditions and treatments, including payment of health services.  PHI does not apply to de-identified information.

Institute for safe medication practice (ISMP)

• Contains a list of high alert meds.
• Safeguarding practices
• Use a single size infusion bag or concentration product
• Use commercially prepared products
• Centralize IV sol’n by preparing pediatric IV in pharmacy and outsources TPN and cardioplegic solutions
• Use Tall man letter
• Use stickers, labels, markers to make products look different
• Bar code scan, separate problem products

 

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