Our outpatient oncology team has noticed an increased rate of cutaneous reactions to docetaxel not related to a specific manufacturer or lot number, some requiring ED transfer or other intervention/escalation of care.

The package insert includes a warning regarding cutaneous reactions, but we were wondering if anyone else is experiencing a similar trend. We have assessed our docetaxel utilization to see if it might be related to an increased utilization over the past few weeks, but our utilization has actually decreased.

Thank you!

Our site has had requests to add several new insulins to formulary for use in pediatrics. There is concern for look-alike/sound-alike storage and dispensing errors by adding new formulations.

Our site was requested to add Fiasp (insulin aspart), Lyumjev (insulin lispro), Humalog U-200 (insulin lispro 200 unit/mL), and diluted Novolog (insulin aspart 10 unit/mL).

Can any sites share if they have utilized any effective strategies to minimize this risk? A few examples are noted below but would appreciate if sites can share any helpful practices.

For those of you who also have retail pharmacies in your scope, I am interested to learn what your retail pharmacists use to visually verify the contents of a prescription. CVS, for example, has a patented visual verification pharmacy tray. This is great design; it offers a magnifying panel and deep tray to empty the contents of the prescription bottle for visual verification. Unfortunately, we are not easily identifying a company that offers this for us to purchase for use in our retail pharmacies. What equipment has worked well in your retail pharmacies?

Hi everyone,
I'm wondering if any of you have done/are aware of a detailed review on the PD of crushed nifedipine XL.

Hey all

Though the shortage has resolved, when Alteplase was on national shortage, did any of your institutions create any alterative protocols with other products, like Tenectaplase?

Thanks
Jameika Stuckey

We are in the process of upgrading our Anesthesia infusion pumps and was asked to get a survey of how many hospitals use:
1. Anesthesia smart pumps with drug libraries vs. 2. Anesthesia pumps without drug libraries
Would you please indicate 1 or 2 for your hospital?

Thanks,
Emil N Sidawy, PharmD
Adventist HealthCare

Are inhalers dispensed from pharmacy at your facility or loaded in the ADC (we use Pyxis)? If dispensed from pharmacy, how do you deal with changes in dose? We currently only load albuterol inhalers in the ED Pyxis stations, but recently, we came across the issue of when a dose is changed, we do not dispense another inhaler nor routinely send a new label. This applies to ICS as well. Nurses scan the medication barcode directly, so the actual dose given is on the MAR.

-Melody Sun, CHOC Children's

Good morning,

Thank you in advance for your feedback.

Have you been able to implement amphadase for the use of subcutaneous hydration for pediatrics?

Most of the info appears to be targeted towards Hylenex use for this indication.

We are working towards getting all of our units to a BCMA goal of 95% for pt and med scanning and one idea that we wanted to try was getting the patient involved as well. I am curious if anyone else has done any work in this regards? Our first thought was to start with messaging in the pt rooms along the line of signs that say "did your nurse scan you meds today?"

Appreciate any comments on sites that did implement something similar.

Does anyone store alteplase in ADC in ICU for PE?