Hello Med Safety Officers,

Good afternoon -

As our institution adopts the use of more biosimilar products, the question came up of the appropriate naming convention in the EHR and other places and evaluating possible safety impacts/look-alike, sound-alike risks.

Does your facility allow fentanyl to be administered IV push? If so, do you have restrictions around this? Specific indications? Allowed only on certain units? Are nurses allowed to administer? Thanks,

Cortney Swiggart PharmD
System Medication Safety Officer
Methodist Healthcare

Interested to see how other institutions handle cyclosporine oral solution dispensing. We currently dispense as the bulk bottle with the manufacturer syringe but have seen errors and confusion surrounding utilizing the bulk bottles. I have heard other institutions have made this oral solution a dual sign off product. Curious to see what other ideas are out there.
Thanks -

Maria Cumpston, PharmD, CPPS
Medication Safety Officer
WVU Medicine

Hello! The state of Nebraska has recently changed legislation that pharmacies can no longer repackage medications. Normally for our LTC/AL communities pharmacy would repack VA meds into our bublle pack system to ensure safety. Now with this new legislation pharmacy can no longer do this. Does anyone out there have experience with this? How do you ensure safety with medication administration when the medications can't be put into bubble packs?

Can anyone elaborate on their experience with regard to pharmacy led (medication focused) collaborative medication safety rounds? What do you look at/for during your rounds, if such exist at your institution?

Our compliance officer came to visit me yesterday and asked about what other institutions are doing to mitigate the risk of personnel exposure to fentanyl derivatives that may be on a person or their belongings.

I have not heard of any policies or information about appropriate gloves to use for decontamination.

Do any of you have any experience with this? Do you have a written policy/procedure or standard work for this kind of situation.

We currently have an Epi/Cal drip in our formulary (epinephrine 4mg + CaCl 1gm / 250mL D5W). Our maximum rate is 20mL/hr (~5.333mcg/min of epinephrine). Our plain epinephrine drips (various concentrations) have a max rate of 50 mcg/min.

#1: If you currently use EPI/CAL, what evidence/references do you use to support its continued use? -1990's article in Circulation showed that "calcium blunts epinephrine's beta-adrenergic actions in postoperative cardiac surgery patients." We would like to use this article as a foundation for having EPI/CAL removed from formulary.

Hi all,
Our current Cllaborative Drug Therapy Agreement (CDTA) Process does not require a second pharmacist to double check on these orders. The same pharmacist who receives the consult from the provider, doses the medication and verifies the order.
We have had numerous errors related to this process. Since the ordering pharmacist is the prescriber, another pharmacist should verify the order as a double check. I am working on implementing the double check to make the CDTA process to mirror the process for physician order entry.

We have had several medication ADS misfills due to technicians mixing up medications with several formulations:
- Bupropion XL, SR
- Metoprolol XL, ER
- Diltiazem CD, ER, LA
- Depakote
We have medication bins that label specific formulation along with how many times a day (ie. bupropion 100 mg SR 12 hour tablet vs bupropion 150 mg XL 24 hour tablet; see attached pictures below), yet the errors still continue. Unfortunately, we dont have a robust barcode scanning method because the Rx techs are not scanning each individual tablets when filling pyxis.