Dear All

Recently some of the NICU Physicians raise an issue on efficacy/Potency of Vancomycin 5 mg/ml in Dextrose 5% W/V syringes that are supplied from our IV admixture unit.
They suspect the concentration of the active ingredient is less in the syringes, as they did therapeutic drug monitoring. Recently I spoke to one of the NICU specialists regarding the wrong frequency of Vancomycin (As per NICU Antibiotic guideline), he told that this baby’s TDM result shows very low trough, so he increased the frequency from Q8 Hourly to Q6 Hourly.

Could any of you share your Standards, Policies, and/or Guidelines regarding patients who come in for a procedure and has a medication patch on. Specifically, I am looking for the following:

1. Direction on situations requiring removal (ie. procedural sedation, MRI due to metallic content, when procedural site is occluded by the patch, etc.)

2. Documentation of removal or of continued therapy during procedure

3. If patch removal is indicated, destruction or storage process and its documentation

We are reviewing our potassium Chloride IV administration policy. Would anyone be willing to share the maximum concentration for peripheral bolus doses; i.e., 10 mEq/100 mL or 20 mEq/100 mL, etc?

Thanks, Vic

We are reviewing our potassium Chloride IV administration policy. Would anyone be willing to share the maximum concentration for peripheral bolus doses; i.e., 10 mEq/100 mL or 20 mEq/100 mL, etc?

Thanks, Vic

Hello Everyone,

I am writing today to ask about your institution's practice with regards to amphotericin B.

1) Does your institution carry the conventional form and any of the lipid-based formulations? If so, what is the reasoning for carrying both?

2) Did your institution carry both formulations (conventional and lipid-based) in the past and then removed one formulation? If so, what was the reasoning for the removal?

3) If your institution removed amphotericin B (either formulations) from the formulary, was there any push-back/resistance?

When a pharmacist at your institution is involved in a medication error, what methods do you use in order to discuss the incident and close the communication loop on changes that were made? Are there any other actions taken?

For example, we send out a template letter to the pharmacist. The letter briefly describes the incident as we know it, then asks several questions regarding details recalled from the event, contributing factors leading to the event, and any suggestions for improvement (performance, system, or otherwise). Supervisors may also follow up with the employee.

Do any of you use the vial 2 bag system for dispensing fentanyl and versed gtts from your ADCs? If so, in addition to blind count, scan on load/removal and witnessing, what processes do you have in place to identify diversion/discrepancies?

Hi-
I was wondering if anyone had information regarding specific amounts of excipients or preservatives that is considered harmful in the neonatal population? Thanks so much!
~Kara

Kara M. Bozik, PharmD, BCPS
UNC Rex Healthcare
Raleigh, NC

Hi-
I was wondering if anyone had information regarding specific amounts of excipients or preservatives that is considered harmful in the neonatal population? Thanks so much!
~Kara

Kara M. Bozik, PharmD, BCPS
UNC Rex Healthcare
Raleigh, NC

I wanted to find out how others are dispensing liquid medications for g-tube administration? Are you dispensing in an "oral syringe"? Are you color coding the syringe tip? IF you're a peds institution, is it ordered and/or dispensed differently when the provider wants it added to feeds? Do you have special labeling?

Thanks in advance.
DiAnthia