MSOS Discussion Board

USP 797 Revisions interpretations for BUD and Exp dates

Bridget Gegorski's picture

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Hello,

Upon reading USP 797 revised, at line 1552 the new standard describes the BUDs required on the product label. It looks to me that they are requiring both a date beyond which administration must not begin AND the date after which a preparation must be discarded.

Have others interpreted this to mean that we need to differentiate and include on our pharmacy labels both the BUD and the expiration date?

RPh supervision of the IV batching process

Karen Thompson's picture

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Does anyone have a policy or SOP for your IV batching process? I'm particularly interested to know how much RPh supervision you require when batching high risk meds. We are currently having to batch heparin 1000 unit/500mL bags.

When batching 200 of these bags, which of these methods would you find acceptable?

Maximum dose of metoprolol IV in a single administration?

Forrest Shirkey's picture

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Does anyone have a hospital policy that limits the dose of metoprolol IV (push or infusion) that may be given to a patient at one time?

The best info I can find is that doses of 2.5 to 5 mg may be given at one time, but may be repeated every 5 minutes (max dose of 15 mg).

We have seen doses of 7.5mg and 10mg ordered here. We typically restrict IV push to tele/ICU floors only, the other non-ICU/non-tele areas will get metoprolol in an IVPB.

Would appreciate your thoughts and hospital specific practice on this issue.

preventing self administration of patients meds at bedside

Jennifer Tilley's picture

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Our hospital has had quite a few occurrences due to known, or suspected, self-administration of patients meds at bedside. Aside from going through everyone’s belongings, we are looking for some type of procedure/policy to help prevent this from happening. What types of procedures are hospitals following to discourage and prevent patients from taking their own medications (without the RN or provider being aware of this administration) from home while they are inpatient? Thanks!

U-500 & Correct Factor

Amanda Ries's picture

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Previous posts on this topic state that some organizations are drawing up the patients dose in pharmacy. When this is done are you drawing up both the scheduled dose and the correction factor in one syringe? Does the RN call with the glucose level for the pharmacist to evaluate what is the total dose to be given?

Does anyone have a policy/workflow they would be willing to share.

Thanks,
Amanda

Limit of dispenses from Pyxis/ADCs?

Jacqueline Kao's picture

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Hello,

Does your institution limit the number of dispenses from the Pyxis (or equivalent ADC)? If so, what is the limit for number of dispenses, and have you ran into issues in which certain exceptions must be made? How did you address it?

For example, if 10 tablets of a medication are ordered and the tablet is in the Pyxis, will it re-route to pharmacy instead of Pyxis to dispense as a safety measure? (i.e. the pharmacist would have to check 10 tablets and should question the dose since such a large amount is being dispensed).

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