Daily Patches (6)
Daytrana (QAM 2h before school)
Nicoderm
Exelon
Neupro
Emsam
Androderm (nightly)
"Em Andr, Neu, Nice, Excellent Day"
Daily Patches
(Special Instructions)
Lidoderm (1-3 on for 12 h - 12 h off)
Nitroglycerin (on for 12-14 h - 10-12 h off)
"lido deck - 12 h on, 12 off"
"Nitro - 12-14h - 10-12h off" (still adds to 24h my G)
Twice Daily Patches
Flector
"Two arms, two patches, Flector"
Twice Weekly Patches
Alora, Vivelle-Dot
Oxytrol (Oxybutynin) - overactive bladder
picture the calendar and 2 dots, Aloe and Oxytrol
Weekly Patches
1) Butrans (Buprenorphine)
2) Catapres-TTS (Clonidine)
3) Climara, Menostar (Estradiol)
,4) ClimaraPro (Estradiol Levonogesterol)
5) Xulane (qwk for 3 wks - 1 wk off)
Xula once a week
Climax with men stars once a week
Butrans once a week,
Catapress Chillax once a week,
Other Patch Durations
1) Duragesic (q72h or q48h) --- Fentanyl
2) Transderm Scop (q72h) --- Scopalamine for N/V
every 3 days
National Patient Safety Goals
1) 2 patient identifiers (name, DOB, MRN)
2) Report critical test results
3) Label all medications
4) Anticoagulant therapy safety measures
5) Med information (med rec + D/C counseling)
6) Prevent HC-associated infections
7) CDC hand hygiene
Basically clinical pharmacist roles
Penicillin Allergy AND Syphilis in Pregnancy or HIV
Must test, and if positive, desensitize
PCN is the only acceptable treatment
Penicillin Allergy and AOM
w/o allergy: Amoxicillin or Amox/Clav (least amount of clav -
Augmenting ES 600)
May use 2nd or 3rd gen cephalosporin
Cefuroxime (Zinacef)
Cefdinir (do not refrigerate btw) (Omnicef)
,Cefpodoxime
Ceftriaxone (Rocephin)
Ammo/Clav for them ear
then alien's 2 Furry Dinner, or Tri Pod (3 legs)
Testing HLA-B*5701
Abacavir
If (+) --> risk of fatal hypersensitivity
(Test ALL patients prior)
Testing HLA-B*5801
Allopurinol (Aloprim, Zyloprim) - Gout
If (+) --> risk of SJS
(Consider testing in Korean + renal impairment, Han, or Thai)
All pure +58 koreans have SJS
Testing HLA-B*1502
Carbamazepine, Oxcarbazepine, Phenytoin
If (+) --> risk of SJS/TEN
(Test all Asian pts prior to Carbamazepine)
+15 Car and Ox car, and tow has SJS/TENS
Testing CYP2C19
Clopidogrel
If 2 or 3 --> Poor metabolizers
(consider alt tx)
Testing CYP2D6
Codeine
, Ultra-rapid --> risk of OD
2D=OD on Codeine if ultra rapid
Testing CYP2C9 + VKORC1
Warfarin
If CYP*2 or *3 or VKOR G>A --> increased bleeding risk
(start with lower dose)
Testing HER2
Trastuzumab (Herceptin)
HER2 (-) --> drug not effective
Testing KRAS
Cetuximab (Erbitux)
If KRAS (+) --> Do not use
Testing TPMT
Azathioprine (Azasan or Imuran - a DMARD)
TPMT activity low/absent --> risk of myelosuppression
(Use lower dose or consider alt tx)
Testing DPD
1)Capecitabine (Xeloda)
2) Fluorouracil (Tolak, Fluoroplex, Carac)
If DPD deficient --> risk of toxicity
(Do not use)
Common Symptomatic Treatment in Toxic OD
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