Do you use a ramp up ramp down for neonate PN? If so, do you have any sources that I could refer to?
I have found 1 reference that is 12 yo which recommends 50% rate for the first hour and to wean off at50% for the last hour.
Thank you for your help.
Doug Shafer

I would like to alert everyone that Xellia Pharmaceuticals' premixed vanomycmycin bags (VANCO READY) have a warning to not use in 1st and 2nd trimesters of pregnancy. This is due to the excepients PEG400 and NADA used in these bags. There is a warning statement on the bag, but it may get missed. Can you share your experience with this product?

How are other institutions handling baricitinib dose preparation with regards to NG, or G tube administration?

A. Pharmacy staff prepares all oral liquid doses and assigns 4 hr BUD

B. Nurses disperse doses in liquid with PPE in place

c. Nurses crush tablets with no precautions in place.

D. Other options?

Hello,
We are in the process of converting to NR fit tubing for epidural infusions and would welcome any feedback from any institutions who have made this conversion. Any input on lessons learned, what went well, what didn't go well would be appreciated.
Thank you!

Hello - wondering if any institutions are giving lacosamide IV push at your institution? We have had some interest in this route to minimize delays in high risk/seizing patients. There is some literature that has made its way into tertiary resources, but unclear to me if folks are actually doing this (and any experiences to report). Thanks!

We are considering using LET Topical solution prepared by Quva. Main concern is that it is in an oral syringe that could easily be confused with any other oral syringe and accidentally given orally (esp. in the setting of a pediatric emergency room). See image attached.

We have added a dispensing alert when the nurse removes from the ADC.

Curious to know if other institutions are dispensing LET in an oral syringe and what mitigation strategies have you put in place?

We recently had an event at my hospital in which nutritional insulin for tube feeds was incorrectly given when tube feeds were interrupted resulting in a hypoglycemic event. Currently our workflow relies on a manual process involving the changing of a colored placard on the patient IV pole when tube feeds are held. We would like to make this workflow more resilient possibly utilizing our EMR system, we have EPIC. I would greatly appreciate hearing how other institutions handle this. Thank you!

For unknown/unidentified patients that we don't have a confirmed age, our system is inputting an age >100 years old. We use EPIC and the CrCl is automatically calculated using the documented patient age and is visible for pharmacists on the main screen.

1. How do you handle dosing adjustments for patients with a documented, but unconfirmed/inaccurate age?
2. Is there anything in your system that would notify you that the age documented is not the patient's actual age?

Hello all,

I help manage 23 smaller, critical-access hospitals within our health organization. One of the struggles we have been having are nurses/providers not knowing they have certain meds available (ie Kcentra, nicardipine, praxbind, etc).

Often the smaller sites will transfer these pts to a higher acuity of care to our larger medical centers and assume they don't have access to some of these critical meds. We have pharmacist on-site (not 24/7) and a remote service who manages after hours.

What are healthcare facilities doing in regards to Ammonia Inhalants? I was under the impression that they would eventually all be phased out due to the CARES act, but there seems to be a resurgence in their availability. Are your facilities still stocking or have you made them non-formulary?