Had a report last week where remdesivir IV study doses were compounded with twice the amount of medication. Initial doses are loading dose of 200 mg, or 2 vials. Subsequent doses are 100 mg or 1 vial. The subsequent doses were compounded with 2 vials though the dose was 100 mg.

How does your institution maintain compliance with CMS regulation 482.25 (b) (5) “Drugs and biologicals not specifically prescribed as to time or number of doses must automatically be stopped after a reasonable time that is predetermined by the medical staff?” Do all ordered medications have an automatic end date in the electronic health record? If there is an automatic end date, do providers have a prompt to renew or restart medications that have automatically completed? Does anyone not have an auto stop and if so, how do you justify?

How does your institution maintain compliance with CMS regulation 482.25 (b) (5) “Drugs and biologicals not specifically prescribed as to time or number of doses must automatically be stopped after a reasonable time that is predetermined by the medical staff?” Do all ordered medications have an automatic end date in the electronic health record? If there is an automatic end date, do providers have a prompt to renew or restart medications that have automatically completed? Does anyone not have an auto stop and if so, how do you justify?

Hi everyone-

Does anyone have med safety metrics they collect around virtual care? If so, would you be willing to share?

Thanks,

Elizabeth

Our system has re-used CSP's not used for years with a strict cleansing policy. In some instances an amount of drug may be added to get the correct dose for a new patient. Does anyone have any policies on this? It is not addressed in USP 797. Thanks, Mike

as alternative to albuterol nebulizer/inhaler, terbutaline subQ or IV is being considered. Has anyone prepared and dispensed in Covid suspected/positive cases and if so, what outcomes can you share? thanks in advance.
jbrady@svmh.com

is anyone familiar with oxygen carrier blood products for Jehovah witness patients? hemopure or sanguinate are investigational and not available to order; however if anyone has experience with bloodless surgery alternatives and approaches, thank you in advance for sharing.
jbrady@svmh.com

https://www.regulations.gov/docket?D=CDC-2020-0046

The list is in draft form and public comments are due by June 30, 2020.

Hello All,
I would appreciate if you can share how IV loading doses of phenytoin are supplied and administered at your institutions (i.e. admixture vs undiluted). Thanks!

Chris

I am curious if other inpatient pharmacies stock sterile water for injection in automated dispensing cabinets to be used for reconstitution?