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Epinephrine Infusion Compounding

Sara Gibson's picture


What are other facilities doing in regards to epinephrine IV infusion compounding since the IMS brand of epinephrine 1 mg/ml, 30 ml for IV dilution has been discontinued by the manufacturer?

Currently, the only large vial of epinephrine available is the Adrenalin 1 mg/ml, 30 ml vial by PAR and it is very specifically listed for Intramuscular or Subcutaneous Use only. The FDA has not approved for IV infusions and the company cannot provide any off-label use for IV infusion as well.

Methotrexate for Ectopic Pregnancy

Sarah Katherine Gallup's picture


Our pharmacy compounding suite is undergoing a renovation starting mid-July, including our sterile hazardous compounding room. For any chemotherapy needed our Cancer Center across the street will compound it for us (we do a low inpatient volume). The one scenario that we don't know what to do with is methotrexate for ectopic pregnancy since this could happen overnight when our Cancer Center is closed. Any one have any contingency plans for something like this?

Resource updating

MSOS currently has a list of list of Resource Links for Medication Safety Officers under the Resources tab of our website ( This list was developed to help new medication safety officers identify resources that they can utilize in their new position.  Knowing how rapidly things change, we would appreciate your feedback! Let us know if any new links should be added or deleted. Please email your suggestions to Darryl Rich at by no later than July 15, 2017. Thank you.

Your help is needed

MSOS is looking for volunteer members to assist ISMP in updating two of its medication safety guidelines. Based on the prevalent use of computerized prescriber order entry (CPOE) and new automated dispensing cabinet (ADC) technology, the MSOS guidelines committee has recommended that ISMP update the ISMP Guidelines on Standard Order Sets (2010) and the ISMP Guidelines on Interdisciplinary Safe Use of Automated Dispensing Cabinets (2008). MSOS members who volunteer for a task force will be responsible for reviewing the current guidelines and participating in a couple of conference calls to discuss suggested edits (including additions and deletions). ISMP will review the recommended edits and issue an updated set of guidelines. If you are interested in being on one of these task forces, please send an email to Darryl Rich at by no later than July 15, 2017 indicating which task force you would like to participate in.  Thank you. 

Crushing Hazardous Medications

Madiha Syed's picture


Do you allow nursing to crush one time doses of hazardous medications on the floor to administer via g-tube or do you require pharmacy to crush in a controlled environment per USP 800?

If you allow nursing to crush on the floor, what device do you use for crushing and what additional PPE requirements do you have for them?

We are struggling to determine if pharmacy needs to take over crushing activities for hazardous medications (non-antineoplastics and reproductive risk).

Thank you,