Controlled Substances in Pediatrics

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to

3 posts / 0 new
Last post
Carol Labadie
Carol Labadie's picture
Last seen: 3 weeks 5 days ago
Joined: 08/13/2013 - 13:40
Controlled Substances in Pediatrics

How are controlled substances managed in your pediatric satellite pharmacy or Children's Hospital pharmacy?

We use Pyxis C2Safe for controlled substance management however C2Safe does not allow for dispensing fractional doses. We have resorted to using C2Safe as a glorified secure cabinet with manual documentation. To complicate matters, many products must be diluted for pediatrics, requiring multiple notebooks to document (product pulled from C2Safe, product compounded to xxx dilution, product dispensed to unit). I struggle with our ability to adequately (or easily) follow an audit trail, opening a rather large window for diversion. Our brainstorming sessions are not providing good options so thought I would reach out for a little help from my friends. Would love to hear how others are managing this! Thank you.