Pediatric Pharmacy Operational Changes Due to Drug Shortages Medication Operational Change Date Last Updated Acetaminophen 325mg Discontinued. Exhausting current supply. Switch to 8/22/18 suppositories alternative sizes. Albuterol 5mg/mL vials (for BUD of 6 hours 9/26/18 continuous neb) Aminophylline inj Minimal supply in hospital. Pfizer has extended dating of 10/3/18 current supply to 2/1/19. Conserve for status asthmaticus, but consider terbutaline as 1st line. Artificial Lacrilube Alternatives: Refresh Classic PF (Dispense #12 for q1-q2h); 9/14/18 Thera-tears Bupivicaine 0.5% inj CNR records updated to use bupivacaine 0.75% 8/16/18 Calcium gluconate inj For dilution, make 40mL. See detailed restrictions from Kim 9/19/18 Dopamine inj Use RTU for all doses. RTU removed from drug boxes. 7/5/18 Lidocaine 4% inj CNR records updated to use lidocaine 2% 7/26/18 Morphine inj Using 4mg/mL for compounding; decreased PCA volumes 6/21/18 Nelarabine inj Supply on-hand is reserved for 2 specific patients. Notify Jenn 10/3/18 if new patients are initiated on therapy. Do not lend. Penicillin G Sodium inj Use Penicillin G Potassium instead. An EPIC alert to direct 10/10/18 providers will go-live during week of 10/8. Remifentanil inj vials For infusions < 6mg: use 1mg/mL 8/29/18 For infusions > 6mg: use 2mg/2mL Sodium Bicarbonate 8.4% Extend BUD to 6 hours 9/19/18 Sodium Phosphate inj Limit sodium phosphate boluses to patients with serum K > 4. 10/10/18 Do not use sodium phosphate in IV fluids. PN templates changed for orders starting on 10/11 to use potassium phosphate only.
Pediatric Pharmacy Operational Changes Due to Drug Shortages Medication Operational Change Date Last Updated Acetaminophen 325mg suppositories Discontinued. Exhausting current supply. Switch to alternative sizes. 8/22/18 Albuterol 5mg/mL vials (for continuous neb) BUD of 6 hours 9/26/18 Aminophylline inj Minimal supply in hospital. Pfizer has extended dating of current supply to 2/1/19. Conserve for status asthmaticus, but consider terbutaline as 1st line. 10/3/18 Artificial Lacrilube Alternatives: Refresh Classic PF (Dispense #12 for q1-q2h); Thera-tears 9/14/18 Bupivicaine 0.5% inj CNR records updated to use bupivacaine 0.75% 8/16/18 Calcium gluconate inj For dilution, make 40mL. See detailed restrictions from Kim 9/19/18 Dopamine inj Use RTU for all doses. RTU removed from drug boxes. 7/5/18 Lidocaine 4% inj CNR records updated to use lidocaine 2% 7/26/18 Morphine inj Using 4mg/mL for compounding; decreased PCA volumes 6/21/18 Nelarabine inj Supply on-hand is reserved for 2 specific patients. Notify Jenn if new patients are initiated on therapy. Do not lend. 10/3/18 Penicillin G Sodium inj Use Penicillin G Potassium instead. An EPIC alert to direct providers will go-live during week of 10/8. 10/10/18 Remifentanil inj vials For infusions < 6mg: use 1mg/mL For infusions > 6mg: use 2mg/2mL 8/29/18 Sodium Bicarbonate 8.4% Extend BUD to 6 hours 9/19/18 Sodium Phosphate inj Limit sodium phosphate boluses to patients with serum K > 4. Do not use sodium phosphate in IV fluids. PN templates changed for orders starting on 10/11 to use potassium phosphate only. 10/10/18
Operational-Changes-Due-to-Drug-Shortages_.docx