Hello!

We have received reports of confusion from our nursing staff regarding BUD vs expiration date.

Our hospital gives a standard 24h BUD for most compounds from pharmacy as that generally falls within the USP limits. Nurses are interpreting this as an expiration date and are not comfortable infusing medications that would run past that BUD.

This also leads to confusion regarding medications where the stability dictates an expiration time that is shorter than our standard BUD. Nursing would like a one-size fits all solution but I don't know if one exists.

Hi Everyone,
What system does everyone use to categorize adverse drug events. We are currently using the CTCAE classification system and just wanted to learn best practice before building all the detail into our electronic reporting system. Thanks! angela

Are you seeing adverse effects from intrathecal dexmedetomidine?
Anesthesia started using dexmedetomidine intrathecally for OB patients and noticing side effects; specifically an increase in time of epidural duration and decrease in fetus heart rate, Is the intrathecal route being used for other indications? Have other side effects been noticed/identified?

Hello,

How do you identify high alert/high risk meds in code cart? Do you affix any high alert labels to any meds in your code cart? If so, which ones?

Thank you so much in advance,

Viktoria Fridman, Pharm.D.
Manager of Medication Safety and Education

FYI - we recently started purchasing Camber Pharmaceuticals IV protonix vials (NDC: 31722-204-31). They do not have barcodes on the vials and only contain a barcode on the box of 10. We are currently barcoding these in-house to allow for proper scanning.

I'm curious how other systems order pediatric unasyn. For a recommended dose of 50mg/kg (ampicillin component), does your system order 50mg/kg or does pharmacy adjust the dose on their end?

For those with Box Picker, how do you store high alert medications? For example, for paralytics, we would normally store in lidded bins with reminders for auxiliary labels. Thanks in advance!

We have received reports from our cath/EP lab of patients not demonstrating the intended anticoagulant effect, a therapeutic ACT, from Hospira's Heparin 10,000 units/10 ml NDC 0409-2720-31, lot HA0269, exp 2/1/2025 following administration of typical bolus doses of this product. Alternative heparin product did result in intended effect. Case reviews are underway for identifiable contributing factors to heparin resistance.

This experience has been reported to FDA and manufacturer.

Anyone else identifying similar experience?

Interested to hear if any institutions succesfully utilize any of the liquid pre-packers available on the market, such as Fluidose or the Speedy Wet Cadet. If anyone uses these, I would love to hear about your experience (wins/pitfalls/etc.) so I can either start trying to build a case, or look for alternative options. Thanks for your consideration!

Good afternoon,